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Geographic tongueBy Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/geographic-tongue/DS00819
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Geographic tongue is a harmless condition affecting the surface of your tongue. The tongue is normally covered with tiny, pinkish-white bumps (papillae). With geographic tongue, patches on the surface of the tongue are missing papillae and appear as smooth, red "islands," often with slightly raised borders.
These patches (lesions) give the tongue a map-like, or geographic, appearance. The lesions often heal in one area and then move (migrate) to a different part of your tongue. Geographic tongue is also known as benign migratory glossitis.
Although geographic tongue may look alarming, it doesn't cause health problems and isn't associated with infection or cancer. Geographic tongue can sometimes cause tongue discomfort and increased sensitivity to certain substances.
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Signs and symptoms of geographic tongue may include:
- Smooth, red, irregularly shaped patches (lesions) on the top or side of your tongue
- Frequent changes in the location, size and shape of lesions — hourly to daily
- Discomfort, pain or burning sensation in some cases, most often related to eating hot, spicy, salty or acidic foods
Geographic tongue can persist for months or years. The problem eventually resolves on its own but may appear again at a later time.
When to see a doctor
Geographic tongue is a minor — although sometimes uncomfortable — condition. However, lesions on the tongue may indicate other more serious conditions of the tongue or diseases affecting the body in general. If you have lesions on the tongue that don't resolve within seven to 10 days, see your doctor or dentist.
The cause of geographic tongue is unknown, and there's no way to prevent the condition.
The lesions on the tongue result from the activity of certain types of white blood cells that normally induce inflammation at the site of disease or injury. The reason for this immune system error isn't well understood.
Some people with geographic tongue have a family history of the disorder. Therefore, genetics may be a contributing factor in some cases.
Studies of factors that may be associated with an increased risk of geographic tongue have produced mixed results.
Factors that are likely associated with an increased risk — relatively well supported by research — include the following:
- Family history. Inherited genetic factors may increase the risk of the disorder.
- Fissured tongue. People with geographic tongue often have another disorder called fissured tongue, the appearance of deep fissures, or grooves, on the surface of the tongue.
Other possible factors
Some studies have suggested a number of other factors that may increase the risk of geographic tongue, but other studies haven't supported the same conclusions. These other possible factors include:
- Oral contraceptive use
- Allergies and other immune system hypersensitivities
- Stress or psychological disorders
- Other skin disorders
Geographic tongue is a benign condition. It doesn't pose any threat to your health, cause long-term complications or increase your risk of major health problems.
However, anxiety about the condition is fairly common because:
- The appearance of the tongue may be embarrassing, depending on how visible the lesions are
- It may be difficult to be reassured that there is, in fact, nothing seriously wrong
Preparing for your appointment
If you're concerned about the appearance of your tongue, make an appointment with your doctor or dentist.
Be prepared to answer the following questions:
- When did the lesions first appear?
- Have the lesions changed in appearance or location on your tongue?
- Have you had any other lesions in your mouth?
- Have you experienced any discomfort or pain?
- Does anything, such as spicy or acidic food, seem to trigger pain?
- Have you had any other symptoms that may seem unrelated to the condition of your tongue?
- Have you had a fever?
Tests and diagnosis
Your doctor or dentist can usually make a diagnosis of geographic tongue based on an examination of your tongue and your answers to questions about signs and symptoms. However, your doctor will want to rule out other disorders.
During the exam, your doctor may do the following:
- Use a lighted instrument to examine your tongue and mouth
- Ask you to move your tongue around in various positions
- Gently touch (palpate) your tongue to check for tenderness or unusual changes in the tongue's texture or consistency
- Check for signs of infection, such as fever or swollen lymph nodes in the neck
Treatments and drugs
Geographic tongue typically doesn't require any medical treatment. Although geographic tongue can sometimes cause tongue discomfort, it's otherwise a harmless condition.
Your doctor may prescribe medications to manage discomfort or sensitivity:
- Over-the-counter pain relievers
- Mouth rinses with an anesthetic
- Antihistamine mouth rinses
- Corticosteroid ointments or rinses
Because these treatments haven't been studied rigorously, their benefit is uncertain. Since the condition resolves on its own and has an unpredictable course, you may not be able to tell if the symptomatic treatments are actually working.
Lifestyle and home remedies
You may reduce discomfort associated with geographic tongue by avoiding or limiting substances that commonly aggravate sensitive oral tissues, including:
- Hot, spicy, acidic or salty foods
- Tobacco products
- Toothpaste that contains tartar-control additives, heavy flavoring or whitening agents
- Assimakopoulos D, et al. Benign migratory glossitis or geographic tongue: An enigmatic oral lesion. American Journal of Medicine. 2002;113:751.
- Byrd JA, et al. Glossitis and other tongue disorders. Dermatologic Clinics. 2003;21:123.
- Reamy BV, et al. Common tongue conditions in primary care. American Family Physician. 2010;81:627.
- Shulman JD, et al. Prevalence and risk factors associated with geographic tongue among US adults. Oral Diseases. 2006;12:381.
- Carr AB (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 23, 2010.