What Is Geographic Tongue?

What is a Geographic Tongue?

Geographic tongue, also known as benign migratory glossitis, is an inflammatory condition that occurs on the surface of the tongue. It’s a benign disorder that affects up to 3% of the population.¹ 

Most people who have it are asymptomatic, though some may be sensitive to spicy or acidic foods. Affected tongues also have red, smooth patches in different areas, similar to a map. The patches vary in size and are lined with a thin, white border.

Lesions may appear on other parts of the mouth, including the gums, cheeks, soft palate, and under the tongue. Such lesions are known as geographic stomatitis or erythema migrans.

Geographic Tongue Symptoms

Signs and symptoms of geographic tongue may include:

• Oral lesions – the red patches on the tongue are lesions. They may change shape and size or move around the mouth over time. They are most common on the side and top of the tongue.
• Loss of papillae – papillae are bumps that cover the tongue. These pinkish-white, hairlike projections help your tongue grip and taste food.² In geographic tongue, the lesions are the areas of lost papillae.
• Burning sensations or discomfort – some people with geographic tongue may experience a burning sensation when they eat. This is most common when eating certain foods.

Most of the time, people with geographic tongue will not notice any symptoms. The signs of the lesions may be visible on the tongue without any discernible impact. Geographic tongue should not interfere with daily life.

Is Geographic Tongue Serious? 

Geographic tongue is a benign condition with no serious implications. It most often affects the appearance but not the health of the tongue. Occasionally, geographic tongue can result in a burning sensation.  

There are no known reports of geographic tongue causing cancer. Geographic tongue is also not contagious, so you can’t spread it to other people.

When to See a Doctor

Some people may find geographic tongue uncomfortable. Consult your doctor if you experience pain or discomfort.

Also, contact your doctor if you experience any of the following symptoms:

• Breathing issues
• Swollen tongue
• Difficulty speaking, chewing, or swallowing
• Tongue sores that won’t heal

These indicate a more severe problem that needs evaluation.

Diagnosing Geographic Tongue

Your healthcare provider can make a diagnosis by looking at your tongue. Diagnosis rarely requires additional tests. In some cases, your provider might perform a biopsy to determine a definitive diagnosis.

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What Is Geographic Tongue

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What Causes Geographic Tongue?

The cause of geographic tongue is unknown. There are many theories about what factors might influence the condition’s development. No conclusive evidence exists for any of them, although there are some factors that might play a role in its development:³

Nutritional Deficiencies

A deficiency of certain nutrients, such as vitamin B, may play a role in geographic tongue. However, researchers have found that vitamin and mineral supplements do not ease the symptoms or appearance of the condition.⁴

Allergies and Other Conditions

Geographic tongue coincides with other conditions in some people. These conditions include food and environmental allergies, hay fever, asthma, diabetes, psoriasis, and eczema.⁵ 

Some consider geographic tongue an oral form of psoriasis. The relationship between geographic tongue and these issues remains unclear.

Oral Habits

Your habits could influence whether you develop geographic tongue. Irritation from eating hot or spicy foods could be a contributory factor. Alcohol may also play a role. However, geographic tongue is less common in smokers.⁶

Medications

Oral contraceptives, lithium, and antihypertensives may coincide with developing geographic tongue. Currently, though, there is no conclusive evidence describing their relationship.⁷ 

Psychological Factors

Emotional stress has been proposed as a possible cause of geographic tongue. However, the evidence is inconclusive. 

Other Risk Factors

While the cause of geographic tongue is unknown, several factors may increase your risk of developing it:

• Age – geographic tongue can occur at any age but is more prominent in adults than in children. Studies conflict on the likelihood in children. Some found a higher prevalence in children ages 2 to 3.⁸  Others saw a higher incidence in ages 4 to 5.⁹ Further evidence is necessary to establish a correlation.
• Genetics – you may be more likely to develop it if one or both of your parents has it.
• Ethnicity – one study found a higher prevalence of geographic tongue in Caucasian and Black people than in Mexican-Americans.¹⁰
• Fissured tongue – geographic tongue often occurs alongside a fissured tongue. Fissured tongues have one or more grooves on their surface.

Predicting who will experience geographic tongue is difficult. These risk factors may make you more likely to develop it, but they do not guarantee it.

How to Get Rid of Geographic Tongue

There is no cure for geographic tongue. Certain treatments can decrease any discomfort or inflammation that results from the condition. These treatments include:

• Antihistamine gels
• Topical analgesics
• A numbing agent, such as viscous lidocaine or Benadryl
• Steroid mouth rinses (in cases of severe discomfort)
• Vitamin A
• Zinc supplements

You may also wish to avoid spicy or acidic foods and alcohol if these exacerbate your discomfort. Good oral hygiene can also help. 

How Long Does a Geographic Tongue Last?

The symptoms and appearance of geographic tongue can last a few days to several months or years. Often, geographic tongue resolves spontaneously on its own in one area only to have another lesion appear in a different location. The lesions may disappear for some time before reoccurring later.

There’s no way to predict how long an episode of geographic tongue will last or what causes it. It is a lifelong condition with periodic flare-ups for most people.

Outlook

Geographic tongue may last a long time or come and go in cycles. It may flare up during emotional stress or infection, but it has no long-term health complications. You can manage any symptoms with treatments from your doctor. 

Summary

Geographic tongue is a benign condition that affects the tongue’s surface. It manifests as red patches of absent papillae with a white border. It is named for its map-like appearance and the migration of the lesions around the tongue and mouth. 

Some people with geographic tongue may experience mild discomfort. The condition’s cause is still unknown, but it has no serious health implications.