Geographic tongue is a condition characterized by smooth, red, and irregular patches that appear on the surface of the tongue. These markings often shift in shape and size, creating an appearance similar to a map.
Although the look of the condition may be concerning, it is generally a benign and non-infectious issue. Some individuals might experience a mild burning sensation or sensitivity when eating certain types of food.
In most instances, the condition clears up on its own without the need for medical treatment. If the patches cause significant discomfort, a doctor or dentist can provide options to help manage the symptoms.
Symptoms of geographic tongue
The primary symptoms of geographic tongue include:
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Red, smooth, and irregular patches on the top or sides of the tongue
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White or light-colored borders surrounding the affected areas
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A loss of papillae (the tiny bumps on the tongue surface) in the red zones
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Pain, discomfort, or a burning sensation when eating spicy or acidic foods
While less common, these patches can occasionally appear in other areas of the mouth, such as the inside of the lips, the roof of the mouth, or the floor of the mouth. This variation is known as ectopic geographic tongue.
Symptoms can last for several days, weeks, or even years. They often disappear spontaneously, only to reappear later in different sizes or locations on the tongue.
How to confirm a diagnosis
A general practitioner or dentist can diagnose geographic tongue by examining the appearance of the patches. According to the American Academy of Oral Medicine, a diagnosis is typically reached through a clinical examination of the tongue's appearance and the patient's history of symptoms, often making a biopsy unnecessary. They will typically look at the size, texture, location, and color of the markings while also checking for any swollen lymph nodes in the neck.
In certain situations, a doctor might request a culture test to rule out a tongue infection. They may also order additional tests to see if the geographic tongue is linked to another underlying health condition. Rarely, a biopsy might be performed to examine the cells in a lab and rule out other concerns, such as tongue cancer.
Possible causes
The exact cause of geographic tongue is not yet fully understood. However, several factors and conditions appear to increase the likelihood of developing it, including:
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A family history of the condition
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Fissured tongue (deep grooves or cracks on the tongue)
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Asthma or eczema
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Allergic rhinitis (hay fever)
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Psoriasis or atopic dermatitis
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Diabetes
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Smoking
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Nutritional deficiencies, specifically in iron, zinc, folic acid, or vitamins D, B6, and B12
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The use of oral contraceptives
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The use of angiogenesis inhibitors, such as bevacizumab, everolimus, or pazopanib
The condition occurs when the tiny papillae on certain areas of the tongue disappear, resulting in the smooth, red patches that resemble a map.
Is geographic tongue transmissible?
Geographic tongue is not contagious. Because it is caused by non-infectious health factors and genetic predispositions, it cannot be passed from one person to another.
Treatment options
Geographic tongue usually resolves on its own without medical intervention. If a person experiences significant pain or discomfort, a healthcare provider may suggest the following treatments:
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Pain relievers or anti-inflammatories: Over-the-counter options like acetaminophen or ibuprofen can help manage pain during flare-ups caused by spicy or seasoned foods.
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Topical anesthetics: Mouthwashes or ointments containing lidocaine can provide rapid relief for burning sensations on the tongue.
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Corticosteroids: Medications such as prednisolone may be used to reduce inflammation and pain if standard pain relievers are not effective.
Doctors may also treat any underlying conditions contributing to the geographic tongue or recommend vitamin supplements if a nutritional deficiency is identified.
To manage symptoms at home, it is best to avoid triggers such as very hot, spicy, salty, or highly acidic foods. It is also helpful to quit smoking and avoid toothpastes that contain whitening agents or heavy flavoring, as these can irritate the tongue.