Geographic tongue is where irregular spots or patches appear on the top and sides of the tongue, creating patterns that resemble a map. The condition is usually harmless, but may be a first indication of celiac disease.
Geographic tongue causes island-shaped lesions that give your tongue a map-like appearance. The lesions can appear on the upper surface and sides of the tongue. They look ragged and uneven, and they sometimes have white borders or edges.
These lesions are harmless. They’re not a sign of an infection or cancer.
Instead, the misshapen spots are a sign of inflammation affecting your tongue’s surface.
On a typical tongue, tiny, finger-like extensions called papillae stick up and help you eat, swallow, and taste. If you have geographic tongue, those papillae disappear, leaving behind patches of your tongue that are bald, smooth, and red.
Geographic tongue is also known as both erythema migrans tongue and benign migratory glossitis. This is a very different condition than erythema migrans (or erythema chronicum migrans), which is a rash that may appear on people who have Lyme disease.
If the map-like spots begin appearing in other parts of your mouth, such as under your tongue or on the soft palate, you may have another condition called stomatitis erythema migrans. It has the same symptoms and signs of classic geographic tongue, but the lesions have spread beyond the tongue.
Geographic tongue does not always cause symptoms. Some people will not notice the change in appearance and only receive a diagnosis after a doctor’s exam.
People who do notice symptoms may initially see signs on the tongue. These signs and symptoms are distinct, which often makes diagnosis easy for your doctor.
The symptoms of geographic tongue include:
- irregular, island-shaped red lesions that are smooth and possibly sensitive
- white or light-colored borders that may be slightly raised around the edges of the lesions
- patches or lesions of varying sizes and shapes
- patches or lesions that appear to “migrate” or move from one area of the tongue to another in a matter of days or weeks
- patches that come and go very quickly
- sensitivity to certain substances, including cigarette smoke, toothpaste, mouthwashes, sweets, sugar, and hot, spicy, or highly acidic foods
- mild discomfort or burning sensations on the tongue or in the mouth
Symptoms can last as long as a year, and they may return at another point.
Some people who experience a geographic tongue will also develop a fissured tongue. These two conditions occur together frequently.
A fissured tongue causes cracks and grooves in the surface of the tongue. These indentations can be irritating and sometimes painful.
Risk factors
Geographic tongue is estimated to occur in about 1 to 3 percent of the population.
Researchers do not know exactly why geographic tongue develops, but certain people may be more likely to develop it than others. These people typically have a disease or condition that increases their risk.
Celiac disease
Celiac disease is an abnormal allergy to gluten that causes serious digestive problems. A
Psoriasis
This common skin condition causes a build-up of skin cells on the surface of the skin. The overabundance of skin cells can turn into thick, scaly patches that are frequently itchy and uncomfortable.
People with psoriasis are more likely to develop geographic tongue, and some experts think geographic tongue is an oral form of psoriasis.
Lichen planus
This inflammatory condition causes bumps and lesions on the surface of the skin or inside the mouth. A geographic tongue may be the oral form of this condition.
Vitamin and mineral deficiencies
Having too little vitamin B can cause inflammation, swelling, and other symptoms on the tongue. Specifically, B6, B12, and folate (B9) deficiencies have been associated with geographic tongue.
People who are vitamin B deficient are more likely to have bald areas on the tongue. These areas are where the papillae have disappeared. People who do not have enough vitamin B may also develop geographic tongue.
Deficiencies in vitamin D, zinc, and iron have also been linked to geographic tongue.
Pregnancy
Pregnant people go through a lot of hormonal changes, and the growing fetus takes a lot of nutrients from your body. This can make you deficient in certain vitamins, and you may experience symptoms similar to those of a geographic tongue.
Geographic tongue does not have a treatment or cure. Most lesions and symptoms will disappear in a few days or weeks. Still, some treatments may help reduce symptoms:
- OTC medication. Any pain or discomfort caused by the lesions may be treated with an over-the-counter pain medicine, like ibuprofen or naproxen sodium.
- Prescription medication. Your doctor may prescribe a corticosteroid rinse to help reduce the inflammation. A mouth rinse with a mild anesthetic may also help reduce pain and irritation.
- Avoid problem foods. If you experience greater irritation with certain foods, avoid them. Foods that commonly cause irritation or a burning sensation include hot or spicy foods, acidic foods, salty foods, and sweet foods.
- Avoid flavored toothpaste. Toothpastes that are highly flavored or have added astringent cleaning ingredients may irritate your tongue.
Can geographic tongue turn into cancer?
Geographic tongue cannot turn into cancer.
A geographic tongue itself is not a serious condition, but has been associated with other conditions that can be serious, such as celiac disease.
Some people with geographic tongue may experience anxiety and worry because of their tongue’s unusual appearance, but the condition is not serious.
Is geographic tongue contagious?
Geographic tongue is not contagious. You can’t pass it to someone by kissing or sharing food utensils.
Geographic tongue is very distinct, so a healthcare professional may only need to see your tongue to make a diagnosis. Still, the doctor may decide to rule out other possible conditions to make sure the lesions are not the result of another disease or problem.
To do this, your doctor may use blood tests to look for markers of inflammation, infection, or nutritional deficiencies. They may also use a lighted instrument to inspect your mouth, throat, and tongue for signs of other conditions.
Rarely, a biopsy of skin may be necessary if the condition does not resolve in a few weeks.
How long does geographic tongue last?
Symptoms may appear for a few days and then disappear for several months. Likewise, the map-like appearance may be present for several months and then disappear for years.
Doctors do not yet understand why some people have longer episodes, and they don’t have any way of knowing who will experience the condition later.
If you notice unusual lesions on your tongue and you begin experiencing breathing problems, difficulty speaking, or an inability to swallow or chew, seek emergency medical attention. You may be experiencing a more serious condition that is not geographic tongue.
A geographic tongue may be harmless in most cases, but it’s important to see a doctor to rule out the possibility of celiac disease or another serious condition.
If you notice the telltale signs of the condition or begin developing irritation or pain, make an appointment to see your doctor.
Most cases of geographic tongue will go away without treatment in a few days.