Geographic tongue

Geographic tongue is an inflammatory but harmless condition affecting the surface of the tongue. The tongue usually is covered with tiny, pinkish-white bumps called papillae. These papillae are actually fine, hairlike structures. With geographic tongue, patches on the surface of the tongue are missing papillae. These patches are smooth and red, often with slightly raised borders.

This condition is called geographic tongue because the patches make your tongue look like a map. The patches often appear in one area and then move to a different part of the tongue.

Although geographic tongue may look alarming, it does not cause health issues. It's not related to infection or cancer. Geographic tongue sometimes can cause tongue pain and make you more sensitive to certain foods, such as spices, salt and even sweets.

Symptoms of geographic tongue may include:

• Smooth, red, irregularly shaped patches on the top or side of your tongue. These patches may look like sores.
• Frequent changes in the location, size and shape of the patches.
• Pain or burning feeling in some cases, most often related to eating spicy or acidic foods.

Many people with geographic tongue have no symptoms.

Geographic tongue can continue for days, months or years. The problem often goes away on its own, but it may appear again later.

When to see a doctor

Because most people with geographic tongue don't show symptoms, they won't need treatment. If you have symptoms, they may be related to a fungal infection, so see your doctor or dentist. In some cases, medicine may be prescribed to help ease symptoms.

The cause of geographic tongue is not known, and there's no way to prevent it. There may be a link between geographic tongue and other conditions, such as psoriasis. This is a skin disease that causes a rash with itchy, scaly patches. But more research is needed to learn about possible connections to other health conditions.

Factors that may increase your risk of geographic tongue include:

• Family history. Some people with geographic tongue have a family history of it. So genetic factors may raise the risk.
• Fissured tongue. People with geographic tongue often have a condition called fissured tongue. This is when deep grooves, called fissures, appear on the surface of the tongue.

Geographic tongue is harmless, but it can sometimes be uncomfortable. It does not pose a threat to your health, cause long-term complications or raise your risk of major health problems.

This condition can cause anxiety. That's because the appearance of the tongue may be embarrassing, depending on how well the patches can be seen. It also may be hard to believe that nothing is seriously wrong.

Your physician or dentist usually can diagnose geographic tongue by looking at your tongue and going over your symptoms.

During the exam, your physician or dentist may:

• Use a lighted instrument to check your tongue and mouth.
• Ask you to move your tongue around in various positions.
• Gently touch your tongue to check for tenderness or unusual changes in the tongue's texture.
• Check for signs of infection, such as fever or swollen lymph nodes in the neck.

Some symptoms of geographic tongue may look like other conditions, such as oral lichen planus. This condition appears as lacy white patches in the mouth — sometimes with painful sores. So some conditions might need to be ruled out before making a diagnosis.

Geographic tongue usually does not need any medical treatment. While geographic tongue sometimes can cause tongue pain, it's a harmless condition.

To manage pain or sensitivity, your doctor may recommend medicines such as:

• Pain relievers available without a prescription.
• Mouth rinses that numb the area.
• Antihistamine mouth rinses. Antihistamines are used to reduce swelling.
• Corticosteroid ointments or rinses. Corticosteroids are used to manage conditions that cause swelling or affect the immune system, such as lichen planus.
• Vitamin B or zinc.
• Medications for fungal infections.

Because these treatments haven't been studied in great detail, their benefit is not known. Since geographic tongue comes and goes on its own, you may not be able to tell if treatments are making symptoms go away.

Most people with geographic tongue don't experience symptoms. But if you have symptoms, you may reduce pain by staying away from or limiting substances that commonly make sensitive oral tissues feel worse. These substances include spicy or acidic foods or beverages, as well as alcohol and tobacco.

If you're worried about how your tongue looks, make an appointment with your doctor or dentist.

What you can do

Prepare questions ahead of time to make the most of your appointment. Basic questions to ask include:

• Why does my tongue look like this?
• Could there be any other possible causes?
• How long will this condition last?
• What treatments are available?
• Is there anything I can do at home to ease my pain?
• What should I do if my tongue flares up again?

What to expect from your doctor

Be prepared to answer these questions:

• When did the red patches first appear?
• Has the look of the red patches changed?
• Have the patches moved to different places on your tongue?
• Have you had any other red patches or sores in your mouth?
• Have you had any aches or pain?
• Does spicy food, acidic food or anything else seem to cause pain?
• Have you had any other symptoms that may seem unrelated to the condition of your tongue?
• Have you had a fever?

Preparing and expecting questions will help you make the most of your time.