Geographic tongue is a condition where the tongue surface gets inflamed from time to time.1 It is a noncancerous (benign) condition thus it is harmless in nature. The surface of the tongue is normally covered with tiny, pinkish-white bumps (papillae), which are fine, short, and hair-like projections. But in the case of geographic tongue, there are smooth, red “islands” like patches that are present usually with slightly raised borders. These patches in the geographic tongue miss the papillae.
The geographic tongue appears the same as its name, these patches make the tongue appear maplike.1 These lesions have the potential to migrate from one surface to another, it heals in one area of the tongue and then appears on a different part of the tongue. And hence it is also known as benign migratory glossitis.2
Geographic tongue sometimes causes discomfort on consuming certain substances such as salts, spices, and even sweets. It may look alarming, but it does not cause any serious health problems and it is not associated with any kind of infection or cancer.
Causes of geographic tongue
There is no known cause of geographic tongue thus no specific way to prevent it.1 It is believed that the geographic tongue shares a link with several medical conditions.1 However, more research is needed to understand better about a possible connection of geographic tongue with the following conditions.
- Lichen planus3
- Atopic conditions like asthma, atopic eczema, allergic rhinitis
- Hormone disturbances (e.g. Type 1 diabetes, use of oral contraceptive pills)
- Nutritional deficiencies (e.g. Vitamin D, B6, B12, folate, iron, zinc)
Signs and symptoms of geographic tongue
The signs and symptoms of geographic tongue may comprise of:1
- The presence of smooth, red, irregular shaped patches on the top surface or sides of your tongue
- Frequent changes in the size, location, and shape of the lesions seen on the surface of the tongue
- Pain, discomfort, or a burning sensation, mostly when consuming spicy or acidic foods
However, many people do not experience pain (painless glossitis).4 Geographic tongue may continue for days, months, or years. It may often resolve on its own but may reappear after some time.1
Management and treatment for geographic tongue
No treatment is needed for the geographic tongue, as it resolves on its own. But healthcare providers may recommend the following medical advice and medications including:
- Mouthwash with an antihistamine (which has the potential to relieve allergic reactions)
- Topical analgesics (which are used as pain relievers) that one can apply directly on the affected surface of the tongue
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Corticosteroids ointments or rinses
- Vitamin supplementations are needed in some of the cases
- Avoiding alcohol
- Avoiding hot, spicy, acidic, or sour food
- Maintaining good oral hygiene
Diagnosis of geographic tongue
The diagnosis of geographic tongue by your healthcare provider will include the following steps.
- The healthcare provider may ask about your symptoms, such as whether your tongue feels any discomfort or pain, or whether the patches go away and come back on your tongue
- The healthcare provider may also ask about your family history, as geographic tongue tends to occur in members of the same family
- The healthcare provider will also examine your tongue
- Usually, no special tests will be needed for the diagnosis
Can I prevent geographic tongue
Unfortunately, the geographic tongue cannot be prevented. As the exact cause behind the geographic tongue is not known, one cannot prevent its occurrence.
Can geographic tongue be cured
The geographic tongue cannot be cured. It often goes away on its own without any treatment, but there are chances of its recurrence.
Who are at risks of geographic tongue
Medical literature suggests people assigned females at birth (AFAB) have a slightly higher possibility of developing a geographic tongue than people assigned males at birth (AMAB).1 Healthcare providers believe that people with a family history of geographic tongue, people having diabetes, or skin diseases are more prone to develop geographic tongue.
How common is geographic tongue
The geographic tongue occurs in approximately 1-3% of the general population.1,4
When should I see a doctor
Usually the geographic tongue subsides on its own thus it doesn't require special care. If a geographic tongue is accompanied by any kind of discomfort, pain or severe swelling which interferes with swallowing or speaking, then you should seek medical advice from your healthcare provider.
Geographic tongue is a benign condition that appears red, and smooth, map-like areas with raised edges on the surface of the tongue. AFAB are slightly more likely to develop a geographic tongue as compared to AMAB. Approximately 1-3% of the general population have geographic tongue. There is no known cause of geographic tongue.Geographic tongue usually doesn’t require any treatment as it subsides on its own, but there are chances of recurrence. People with a family history of geographic tongue, people with diabetes or certain skin diseases are at a higher risk to develop geographic tongue. Treatment is mainly supportive to ensure symptom relief, although some people may need vitamin supplements.
- Shareef S, Ettefagh L. Geographic tongue. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Jun 20]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK554466/
- Assimakopoulos D, Patrikakos G, Fotika C, Elisaf M. Benign migratory glossitis or geographic tongue: an enigmatic oral lesion. The American Journal of Medicine [Internet]. 2002 Dec 15 [cited 2023 Jun 20];113(9):751–5. Available from: https://www.sciencedirect.com/science/article/pii/S0002934302013797
- Wadia R. Geographic tongue - risk factors. British Dental Journal [Internet]. 2022 Sep 1 [cited 2023 Jun 20];233(6):494–494. Available from: https://www.nature.com/articles/s41415-022-5040-x
- Chaubal T, Bapat R. Geographic tongue. The American Journal of Medicine [Internet]. 2017 Dec [cited 2023 Jun 20];130(12):e533–4. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0002934317306927