10 Geographic Tongue Symptoms
Article Sources
- 1. 'Geographic Tongue - Symptoms and Causes.' Mayo Clinic, 6 Mar. 2018, www.mayoclinic.org/diseases-conditions/geographic-tongue/symptoms-causes/syc-20354396
- 2. Shareef S, Ettefagh L. 'Geographic Tongue.' 2020 Aug 10. In: StatPearls /[Internet/]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. https://pubmed.ncbi.nlm.nih.gov/32119353
- 3. 'Oral Mucosal Changes Induced by Anticancer Targeted Therapies and Immune Checkpoint Inhibitors.' Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, U.S. National Library of Medicine, 2017, pubmed.ncbi.nlm.nih.gov/28224235
- 4. Liang, Jianying et al. 'Mutations in IL36RN are associated with geographic tongue.' Human genetics vol. 136,2 (2017): 241-252. https://link.springer.com/content/pdf/10.1007/s00439-016-1750-y.pdf
- 5. 'Down Syndrome - Symptoms and Causes.' Mayo Clinic, 8 Mar. 2018, www.mayoclinic.org/diseases-conditions/down-syndrome/symptoms-causes/syc-20355977
- 6. Bilgili, S Gunes et al. 'Mucocutaneous disorders in children with down syndrome: case-controlled study.' Genetic counseling (Geneva, Switzerland) vol. 22,4 (2011): 385-92
- 7. 'Fissured Tongue.' Cleveland Clinic Journal of Medicine, 1 Nov. 2019, www.ccjm.org/content/86/11/714/tab-figures-data
- 8. Katz J, Shenkman A, Stavropoulos F, Melzer E. 'Oral signs and symptoms in relation to disease activity and site of involvement in patients with inflammatory bowel disease.' Oral Dis. 2003 Jan;9(1):34-40. https://onlinelibrary.wiley.com/doi/abs/10.1034/j.1601-0825.2003.00879.x
- 9. Gonzaga, H F S et al. 'Environmental factors in benign migratory glossitis and psoriasis: retrospective study of the association of emotional stress and alcohol and tobacco consumption with benign migratory glossitis and cutaneous psoriasis.' Journal of the European Academy of Dermatology and Venereology : JEADV vol. 29,3 (2015): 533-6. https://onlinelibrary.wiley.com/doi/abs/10.1111/jdv.12616
Contrary to popular belief, geographic tongue is not a hamlet in England. It's a little-known but relatively common benign condition that causes map-like marks on the tongue. It's normal for the tongue to have papillae and ridges that make up the taste buds, but with geographic tongue, these areas can have smooth patches instead of the normal rough surface.
Although the tongue is designed to convey different tastes such as sweet, sour or salty to the brain, these nerve bundles are part of the taste buds. Geographic tongue doesn't change the ability to distinguish one taste from another.
Red Patches on the Tongue Surface
The tongue normally has small white papillary patches on the surface. These white patches are designed to convey the sense of taste to the brain. With a geographic tongue, the white patches become red and smooth. The red areas can heal in one spot and begin in another.1‘Geographic Tongue - Symptoms and Causes.’ Mayo Clinic, 6 Mar. 2018, www.mayoclinic.org/diseases-conditions/geographic-tongue/symptoms-causes/syc-20354396
Certain flavors can cause sensitivity in geographic tongues. Spicy, salty and sweet flavors can bring discomfort on the tongue surface. The discomfort isn't permanent, and as the red areas heal, this sensation also subsides. Although the appearance of these red areas can be alarming, the condition is perfectly benign.1‘Geographic Tongue - Symptoms and Causes.’ Mayo Clinic, 6 Mar. 2018, www.mayoclinic.org/diseases-conditions/geographic-tongue/symptoms-causes/syc-20354396
Inflammation of the Tongue
Geographic tongue usually becomes pronounced during periods of inflammation. Doctors suspect that geographic tongue could be an autoimmune condition or allergic reaction similar to asthma, eczema, psoriasis or seasonal allergies.2Shareef S, Ettefagh L. ‘Geographic Tongue.’ 2020 Aug 10. In: StatPearls /[Internet/]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. https://pubmed.ncbi.nlm.nih.gov/32119353
Although the geographic tongue is benign, as the tongue becomes inflamed, sensitivity to foods and liquids increases. A bland diet and cool liquids can help during times of inflammation. Avoiding alcohol, spicy foods, hot beverages and acidic foods during flare-ups can comfort a geographic tongue.2Shareef S, Ettefagh L. ‘Geographic Tongue.’ 2020 Aug 10. In: StatPearls /[Internet/]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. https://pubmed.ncbi.nlm.nih.gov/32119353
Lesions Inside and Around the Mouth
Geographic tongue lesions are usually limited to the tongue itself, although they're occasionally found on other parts of the mouth, including the hard palate, uvula and mucosal areas. Unique to geographic tongue is the characteristic of the lesions moving around to different areas of the tongue.2Shareef S, Ettefagh L. ‘Geographic Tongue.’ 2020 Aug 10. In: StatPearls /[Internet/]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. https://pubmed.ncbi.nlm.nih.gov/32119353
Geographic tongue is not contagious. However, it can be misidentified as herpes simplex, fever blisters or other viral diseases. Topical corticosteroids can help manage outbreaks.2Shareef S, Ettefagh L. ‘Geographic Tongue.’ 2020 Aug 10. In: StatPearls /[Internet/]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. https://pubmed.ncbi.nlm.nih.gov/32119353
Burning Sensation
During active periods of geographic tongue, a burning sensation can be felt on the tongue surface. This can be very uncomfortable or even painful. The pain can be managed with over-the-counter medications like acetaminophen.2Shareef S, Ettefagh L. ‘Geographic Tongue.’ 2020 Aug 10. In: StatPearls /[Internet/]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. https://pubmed.ncbi.nlm.nih.gov/32119353
Cold compresses can help soothe the geographic tongue during an outbreak. The outbreak periods can last from a few days to several weeks. A dermatologist can confirm a diagnosis of geographic tongue and offer treatment options.2Shareef S, Ettefagh L. ‘Geographic Tongue.’ 2020 Aug 10. In: StatPearls /[Internet/]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. https://pubmed.ncbi.nlm.nih.gov/32119353
Reaction to Targeted Therapy
Targeted therapies are used in cancer treatments and are biologically designed to target a specific receptor in an attempt to cure the primary disease. Geographic tongue is one of the side effects of some targeted therapies that commonly occurs during treatment periods.3‘Oral Mucosal Changes Induced by Anticancer Targeted Therapies and Immune Checkpoint Inhibitors.’ Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, U.S. National Library of Medicine, 2017, pubmed.ncbi.nlm.nih.gov/28224235
The important goal to remember when undergoing treatment of the primary condition is the end result of being disease-free, not the inconvenience of geographic tongue. Geographic tongue and other side effects of targeted therapies subside when treatment ends.
Family History of Geographic Tongue
Geographic tongue is a trait that may be passed down through generations of family members. There may be no other recollections other than, "Grandma had a weird-looking tongue!" A known genetic link exists between geographic tongue and other oral mucosal conditions such as generalized pustular psoriasis (GPP).1‘Geographic Tongue - Symptoms and Causes.’ Mayo Clinic, 6 Mar. 2018, www.mayoclinic.org/diseases-conditions/geographic-tongue/symptoms-causes/syc-20354396
Some cases of geographic tongues have been associated with mutations in the IL36RN gene, suggesting a genetic component of this condition. Geographic tongue is also linked with fissured tongue, a condition with strong genetic predisposition.4Liang, Jianying et al. ‘Mutations in IL36RN are associated with geographic tongue.’ Human genetics vol. 136,2 (2017): 241-252. https://link.springer.com/content/pdf/10.1007/s00439-016-1750-y.pdf
Down Syndrome
Down syndrome is the most common of genetic disorders and occurs when chromosome 21 has three separate copies of the chromosomes instead of just two. This extra copy of the chromosome is responsible for Down syndrome features.5‘Down Syndrome - Symptoms and Causes.’ Mayo Clinic, 8 Mar. 2018, www.mayoclinic.org/diseases-conditions/down-syndrome/symptoms-causes/syc-20355977
One of the earliest signs of Down syndrome in infants is a thickened tongue, which can cause problems when feeding. Another of the mucocutaneous disorders is geographic tongue. This condition doesn't affect the child in the slightest, but it may cause parents undue concern.6Bilgili, S Gunes et al. ‘Mucocutaneous disorders in children with down syndrome: case-controlled study.’ Genetic counseling (Geneva, Switzerland) vol. 22,4 (2011): 385-92
Poor Oral Hygiene
Deep grooves or fissures in the tongue can also be a symptom of geographic tongue. A fissured tongue is often associated with poor oral hygiene, and the condition can worsen over time, causing inflammation, infection and bad breath.7‘Fissured Tongue.’ Cleveland Clinic Journal of Medicine, 1 Nov. 2019, www.ccjm.org/content/86/11/714/tab-figures-data
It's common for a geographic tongue to develop along with a fissured tongue. Research shows the genetic connection between the two conditions, but fissured tongue associated with poor oral hygiene should be investigated by a physician or dentist.7‘Fissured Tongue.’ Cleveland Clinic Journal of Medicine, 1 Nov. 2019, www.ccjm.org/content/86/11/714/tab-figures-data
Gastrointestinal Conditions
Oral diseases can develop in people with gastrointestinal diseases. Gastroesophageal reflux disease, regurgitation and dry mouth can cause problems for the tissues of the mouth and tongue, increasing the risk for geographic tongue.8Katz J, Shenkman A, Stavropoulos F, Melzer E. ‘Oral signs and symptoms in relation to disease activity and site of involvement in patients with inflammatory bowel disease.’ Oral Dis. 2003 Jan;9(1):34-40. https://onlinelibrary.wiley.com/doi/abs/10.1034/j.1601-0825.2003.00879.x
Chewing food and the addition of enzymes from saliva start the digestive process. If the process is disrupted, acids can flood back up the esophagus and into the mouth, covering the mucosal surfaces and tongue. Geographic tongue can be a clue to a gastrointestinal condition.8Katz J, Shenkman A, Stavropoulos F, Melzer E. ‘Oral signs and symptoms in relation to disease activity and site of involvement in patients with inflammatory bowel disease.’ Oral Dis. 2003 Jan;9(1):34-40. https://onlinelibrary.wiley.com/doi/abs/10.1034/j.1601-0825.2003.00879.x
Stress
Geographic tongue may be linked to autoimmune conditions, such as eczema and psoriasis. With autoimmune conditions, stress plays a large part in flare-ups of these conditions. Although geographic tongue is completely benign, the appearance is unsettling and may cause embarrassment or shame.9Gonzaga, H F S et al. ‘Environmental factors in benign migratory glossitis and psoriasis: retrospective study of the association of emotional stress and alcohol and tobacco consumption with benign migratory glossitis and cutaneous psoriasis.’ Journal of the European Academy of Dermatology and Venereology : JEADV vol. 29,3 (2015): 533-6. https://onlinelibrary.wiley.com/doi/abs/10.1111/jdv.12616
Emotional stress, combined with alcohol and tobacco consumption, can cause geographic tongue and other health conditions to become unmanageable. Taking measures to lower stress levels, reduce alcohol consumption and eliminate tobacco use may help alleviate geographic tongue.
