Geographic Tongue: Symptoms, Causes, and Treatment

Geographic tongue is a harmless condition affecting the tongue's mucous membrane. It causes discolored bald spots on the tongue's surface that often appear in island-like patches, making the tongue's surface look like a map. This condition is also called benign migratory glossitis.

This article explains what geographic tongue is and how to tell if you have it. It explains how geographic tongue is diagnosed and what you can do to manage symptoms.

Symptoms

Geographic tongue is fairly common, though you may be alarmed by how your tongue appears. For most people, this harmless condition is painless. However, some people with geographic tongue may report sensitivity to hot or spicy foods, acidic food like citrus fruit, alcohol, and tobacco.

Common characteristics of geographic tongue include:

• Bald patches or lesions on the tongue's surface
• Discoloration of the tongue (usually white, pink, or red patches)
• Raised areas on the tongue with a defined border

Although less common, lesions may also occur in other mucosal areas of the body such as the labia (outer lips that protect the vagina).

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Symptoms Come and Go

People who experience geographic tongue may have periods when the symptoms disappear, but the lesions may return. In addition to coming and going at random, lesions may change:

• Size
• Shape
• Location
• Color (usually they appear as white, yellow, pink, or red)

These changes may occur slowly over the course of several days or even within a few hours.

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Causes

The characteristic patches of smooth skin develop when there's a loss of papillae—the minute, finger-like projections that cover the surface of the tongue. These papillae have sensory organs that are responsible for the ability to taste (taste buds) and to distinguish between sweet, sour, savory, salty, and bitter flavors.

The exact cause of geographic tongue isn't known. However, there are many theories associated with the disorder. Potential causes of geographic tongue include:

• Stress
• Nutritional deficiencies
• Autoimmune disorders and other inflammatory conditions (such as psoriasis and eczema)
• Type 1 diabetes
• Hormonal disturbances
• Allergies
• Genetics
  

Diagnosis

Geographic tongue is often diagnosed accidentally when a doctor or dentist notices the condition during a routine exam. However, some people specifically seek treatment for their tongue because they're worried that the symptoms they see are a sign of a serious health problem such as an infection or cancer.

There’s no test for geographic tongue. Your doctor will make a diagnosis based on medical history and a physical exam while ruling out other possible causes.

Treatment

Geographic tongue does not require any treatment because it's benign, resolves on its own, and usually doesn't cause pain. If someone with the condition notices sensitivity to certain foods, drinks, or substances (such as tobacco or toothpaste), they may want to take note of what irritates the lesions and avoid them when the condition is present or flaring up.

If you have consistent pain or sensitivity related to geographic tongue, your healthcare provider may recommend:

• Corticosteroids
• Antihistamines
• Topical anesthetics or agents that numb the tongue
• Soothing mouth rinses

Summary

Geographic tongue usually causes mild symptoms or possibly no symptoms. Your tongue may have changes in appearance that come and go, but these don’t cause permanent damage to the tongue. There are no long-term health consequences associated with geographic tongue. 

While there are theories about why people develop geographic tongue, none have been proven. Your doctor can diagnose the condition based on symptoms. However, they may need to do further testing to be sure that tongue lesions and other symptoms aren't related to an underlying condition that needs to be treated.