I've had a black tongue for over a year. Scraping hasn't helped and it's so unsightly. What's wrong with me? DR SCURR reveals the little-known condition that affects so many... and what it means for your health

Published: 06:59 EDT, 17 August 2026 | Updated: 06:59 EDT, 17 August 2026 I have had a black tongue for nearly a year. I have tried scraping it with various things, and when it is really bad it comes off like iron filings. The only thing I take that might be the cause is echinacea. I am very conscious of it as it is so unsightly. Please help.Janice Lambell, Bournemouth.Dr Martin Scurr replies: I sympathise with you – but although your tongue’s appearance may be shocking, let me reassure you it is not sinister and there are steps you can take to address it.This condition has a name, black hairy tongue, and is thought to be caused by an imbalance in the micro-organisms that live in the mouth. This leads to a build-up of dead skin cells on the tiny bumps on the tongue, known as the papillae.In turn, food, drinks and tobacco become trapped and stain the surface of the papillae in a range of colours: black, brown, green, yellow or white.One potential cause is medication such as certain antibiotics (penicillin, tetracycline and doxycycline) and the acid reflux drug lansoprazole which change the balance of our bacteria not just in the gut but also in the mouth.Supplements can also have this effect – echinacea is not a known cause but as there are a number of compounds contained in the capsule it would be advisable to stop taking it for three months or so and see if it makes a difference.I would also recommend avoiding black tea and coffee, alcohol and tobacco – and a policy of only consuming a fresh, whole food diet, steering away from industrialised foods containing preservatives, colouring agents and other additives as these, too, may interfere with the balance of microbes in the mouth. Black hairy tongue is thought to be caused by an imbalance in the microorganisms that live in the mouthSimilarly, avoid astringent mouthwashes – even ‘natural’ remedies like apple cider vinegar – as the tongue is delicate.My one suggestion would be to take a liquid probiotic, usually once daily, and swish it around the mouth before swallowing. This may be useful for your overall gastrointestinal health and there is a chance that it might restore a healthy microbiome within your mouth.And keep up that physical tongue-scraping.I’m 76 and experiencing night terrors. I’ve always talked in my sleep but in the past 12 months my husband tells me I’m restless in bed, particularly moving my legs, and screaming. Recently I attacked him while asleep, which I’m upset about as he is frail. My GP prescribed sleeping tablets which worked well but she said I shouldn’t take them for long.Name and address supplied.Dr Martin Scurr replies: I believe that you have REM (rapid eye movement) sleep behaviour disorder (RBD). We go through different stages when we sleep and REM is a highly active stage, characterised by vivid dreaming.Normally the body is temporarily ‘paralysed’ during this stage, but with RBD this doesn’t happen properly, so you physically act out whatever you are dreaming, which explains the restless legs, screaming and hitting out.You should be referred to a sleep disorder clinic for a full evaluation by specialists. This involves spending a night in a unit while your sleep is assessed: your movements would be filmed while sensors measure your brain activity, breathing and heart rate. If this diagnosis is confirmed then treatment includes the drug clonazepam. Some doctors also recommend the sleep hormone melatonin.This is a recognised medical condition – you have nothing to be embarrassed about and help is available.Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email drmartin@dailymail.co.uk. Replies should be taken in a general context. Consult your own GP with any health concerns. In my view... pharmacists should fill dosette boxes Some of my patients complain pharmacies no longer supply their prescribed medication in a dosette box. This contains a week’s supply in compartments according to the time of day and day of the week – and while it could be filled by a family member or a carer, the better option is to have them professionally assembled by a pharmacy.But pharmacies are increasingly reluctant to do this – partly because it is labour-intensive, requiring careful checking by trained staff. But also not all medicines are suitable to be taken out of their sealed foil and repackaged (for instance, if they’re sensitive to light, moisture or air). And when there are frequent changes, prescription medicine ends up being wasted.Plus, while a dosette box might help with remembering doses, poor vision, arthritis or cognitive impairment may still mean the medication is taken wrongly.However, some carers are reluctant – or even decline – to issue patients with their medication if there’s no dosette box, in case they make a mistake.To my mind supporting these stalwart care providers is more important than the pharmacists’ concerns.