What can cause spots on the tongue

Healthcare providers treat erythroplakia with radiation, surgery or by eliminating relevant risk factors.

Spots on Tongue

Spots on your tongue are often harmless. But in some cases, they can indicate serious health conditions. Some spots are easily identifiable, while others require further evaluation by a healthcare provider.

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You have many types of spots on your tongue. Normal spots include taste buds and papillae. Abnormal spots may include cold sores, canker sores or lie bumps.

Why do I have spots on my tongue?

There are many reasons why you might have spots on your tongue. First, healthy tongues have lots of little spots — like taste buds and papilla (tiny projections) — to help with sensation and taste. But sometimes, you may develop spots on your tongue that aren’t usually there.

In most cases, these spots are harmless. In other instances, they can indicate an underlying health condition. It’s important to know the difference between these types of spots so you can seek care when you need it.

What do spots on my tongue mean?

Most of the time, spots on your tongue aren’t dangerous and they usually resolve without treatment. But certain spots on your tongue can indicate an underlying health issue, such as food allergies, autoimmune diseases or, less commonly, tongue cancer.

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Here are some of the most common spots you can get on your tongue and what they look like:

What kinds of spots are present on a healthy tongue?

Your tongue is covered with papillae — tiny bumps and projections that help with sensory things like speaking, chewing food and detecting temperature. Some papillae contain taste buds and some don’t. There are four kinds of papillae on your tongue:

1. Filiform: These are at the front and in the center of your tongue. Filiform papillae appear threadlike, and they don’t contain taste buds. You have more of this type of papillae than any other.
2. Fungiform: Most people have between 200 and 400 fungiform papillae. They’re all over your tongue, but they’re most prominent at the edges and tip of your tongue. Each fungiform papilla contains about three to five taste buds.
3. Foliate: These papillae are on each side of the back of your tongue. Unlike other papillae on your tongue, foliate papillae look like rough folds of tissue. You have approximately 20 foliate papillae, and each one contains several hundred taste buds.
4. Circumvallate: These are the largest type of papillae on your tongue. Found on the very back of your tongue, circumvallate papillae contain about 250 taste buds.

What are some of the most common conditions that may involve spots on my tongue?

In addition to papillae and taste buds, you may occasionally develop other spots on your tongue. Most of the time, this isn’t a cause for concern. But sometimes, spots on your tongue could point to an underlying, more serious health issue.

Below are some of the most common types of spots people get on their tongues and whether they might point to other health conditions.

Canker sores

Also called aphthous ulcers, canker sores are small ulcers that develop in the lining of your mouth. They look white or yellowish in color and they usually have a red border. Canker sores can appear on your tongue, lips, inner cheeks or even the roof of your mouth.

Cold sores

Also called fever blisters, cold sores look like fluid-filled blisters (or clusters of blisters). They often appear on your lips, but you can also get them on your tongue. The herpes simplex virus (HSV-1) causes cold sores. HSV-1 easily spreads through saliva or close contact.

There are over-the-counter options for treating cold sores. Your healthcare provider can help you find a product that works for you.

Geographic tongue

Geographic tongue gets its name because of its “map-like” appearance. People with the condition develop smooth patches of redness or discoloration on their tongues. These areas are often surrounded by a white or light-colored border.

Geographic tongue is totally harmless and it’s not contagious. Treatment usually isn’t necessary.

Transient lingual papillitis (lie bumps)

Commonly called lie bumps, transient lingual papillitis refers to enlarged or inflamed papillae (the tiny projections on your tongue). They usually appear as small red or white bumps.

Lie bumps are very common. They usually go away on their own within a few days. They’re not dangerous and typically don’t require treatment.

Lie bumps get their name from a myth that a person could develop them after telling a lie.

Thrush

Oral thrush is a fungal infection inside your mouth. It can affect anyone, but it’s most common in toddlers and young children. It’s not highly contagious, but it can spread to people with weakened immune systems.

People with thrush develop raised, white spots on their tongues and inner cheeks. These irritated areas resemble cottage cheese. You can scrape these lesions off, but doing so will cause bleeding. Your healthcare provider can prescribe an antifungal medication to clear up the infection.

Lichen planus

Lichen planus is a condition that results in skin irritation. It occurs when your immune system attacks cells in your body for unknown reasons. It’s possible to get lichen planus inside of your mouth, as well.

Oral lichen planus can look like white, lacy patches, or it can result in open sores or swollen tissues.

Your healthcare provider can prescribe medications to help manage symptoms.

Leukoplakia

Leukoplakia lesions look like white patches or spots inside your mouth. These spots can develop on your inner cheeks, or on or under your tongue — and you can’t scrape or rub them off.

People who develop leukoplakia have an increased risk for oral cancer. But most people who get leukoplakia don’t go on to develop oral cancer.

In most cases, providers recommend removing leukoplakia lesions with surgery or another type of therapy.

Erythroplakia

Erythroplakia causes abnormal red spots to develop inside your mouth. You can get these lesions on your tongue or the floor of your mouth. Like leukoplakia lesions, areas of erythroplakia don’t come off when scraped.

People who have erythroplakia have a higher risk of developing oral cancer.

Healthcare providers treat erythroplakia with radiation, surgery or by eliminating relevant risk factors.

Tongue cancer

Tongue cancer is a rare type of cancer that starts in the cells that line your tongue. Cancerous lesions may look like:

• Red or white patches.
• Ulcers or open sores that won’t go away.

When should I call my doctor?

You should call a healthcare provider any time you notice a new sore spot or ulcer on your tongue or in your mouth — especially if it doesn’t go away in a few days.

A note from Cleveland Clinic

Most of the time, spots on your tongue are harmless and go away rather quickly. But some spots, ulcers or lesions can indicate a more serious underlying condition. If you have spots on your tongue that won’t go away, schedule an appointment with your healthcare provider. They can help determine what they are and whether they’re associated with any other health conditions.

Last reviewed by a Cleveland Clinic medical professional on 01/19/2023.

References

• Kornerup IM, Senye M, Peters E. Transient lingual papillitis. (https://pubmed.ncbi.nlm.nih.gov/27669723/) Quintessence Int. 2016;47(10):871-875. Accessed 1/19/2023.
• Merck Manual. Color Changes and Spots in the Mouth. (https://www.merckmanuals.com/home/mouth-and-dental-disorders/symptoms-of-oral-and-dental-disorders/color-changes-and-spots-in-the-mouth?query=spots%20on%20tongue) Accessed 1/19/2023.
• National Library of Medicine. Canker Sores. (https://medlineplus.gov/cankersores.html) Accessed 1/19/2023.
• Reamy BV, Derby R, Bunt CW. Common tongue conditions in primary care. (https://pubmed.ncbi.nlm.nih.gov/20187599/) Am Fam Physician. 2010 Mar 1;81(5):627-34. Accessed 1/19/2023.
• The American Academy of Oral Medicine. Geographic Tongue. (https://www.aaom.com/index.php?option=com_content&view=article&id=131:geographic-tongue&catid=22:patient-condition-information&Itemid=120) Accessed 1/19/2023.
• The Oral Cancer Foundation. Oral Cancer Facts. (https://oralcancerfoundation.org/facts/) Accessed 1/19/2023.

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What can cause spots on the tongue?

The tongue has lots of small spots on it for taste and sensation. If spots are an unusual color or cause irritation, they may indicate an infection, past injury, or other condition.

In this article, we look at what healthy spots on the tongue do, and the causes of unusual spots. We also cover diagnosis, treatment, and prevention tips.

Tongue spots that are unusual in color, size, or appearance or are accompanied by other symptoms could signal a health problem.

Causes of unusual tongue spots include:

Lie bumps

Transient lingual papillitis is a condition more commonly referred to as lie bumps. A key symptom is small red or white bumps on the tongue. These bumps are enlarged or inflamed papillae.

Lie bumps can affect one or several papillae. Other symptoms can include:

• pain
• a burning or itching sensation
• greater sensitivity to heat

Lie bumps commonly result from injury to the tongue, for example, when a person accidentally bites their tongue.

Viruses, psychological stress, and poor nutrition can also cause the condition.

Lie bumps usually heal without treatment within a week. If treatment is necessary, a person can try a medicated mouthwash or antihistamines to help them reduce the swelling.

A person with lie bumps can quicken the healing of the tongue by:

• avoiding spicy foods
• avoiding hot liquids or food
• not sucking sweets
• brushing teeth with care

Tongue burn

If a person burns their tongue on hot food or liquid, it can cause blisters. These can appear as small, fluid-filled spots on the tongue.

Blisters will heal more quickly if they remain unbroken. A person can promote healing and prevent blisters from breaking by taking care when brushing the teeth and eating and drinking.

A burn on the tongue does not usually require treatment. Keeping the mouth clean by using mouthwash can help to prevent an infection.

Canker sores

Canker sores are very common. These small ulcers look white or yellow and can appear on the tongue, inside of the mouth, and on the lips. The cause of canker sores is not clear.

Canker sores usually go away without treatment. Directly applying an over-the-counter (OTC) medication, such as benzocaine, to the ulcer can relieve discomfort and promote healing.

In some cases, canker sores can be a sign of an underlying health condition. If a person has other symptoms, they may wish to seek medical advice. These symptoms include fever, stomach pain, and a rash elsewhere on the body.

Geographic tongue

Share on Pinterest Geographic tongue may appear as a blotch or spot of redness with a white border.
Image credit: Dimitrios Malamos, 2015

The medical term for geographic tongue is benign migratory glossitis.

Geographic tongue causes inflammation on the sides or top of the tongue and usually appears as a blotch or spot of redness surrounded by a white border.

Doctors are not sure what causes geographic tongue, but it may be related to stress, allergies, or diabetes. The condition does not usually cause any other symptoms and should heal without treatment.

Oral yeast infection

A yeast infection known as oral thrush can affect the mouth and tongue. Symptoms include:

• white spots, bumps, or patches on the inside surfaces of the mouth
• a bad taste
• pain or soreness inside the mouth

If a person scrapes off a white patch on the tongue, they will usually see a red, inflamed patch underneath.

Oral thrush results from an overgrowth of yeast that occurs naturally in the mouth. Certain groups of people are more at risk of developing the infection, including:

• newborn babies
• people who wear retainers or dentures
• people with diabetes
• people receiving chemotherapy
• people with a dry mouth due to medication or a medical condition
• people living with HIV
• people using corticosteroid inhalers for asthma or COPD

A person can usually treat oral thrush using OTC antifungal medications. A doctor may also recommend:

• changing a person’s dentures
• changing how a person cleans their mouth or teeth
• trying a different medication that does not dry out the mouth

Scarlet fever

Share on Pinterest Symptoms of scarlet fever can include “strawberry tongue.”
Image credit: SyntGrisha, 2015

Scarlet fever is a bacterial infection in the nose and throat. One of the key symptoms is a red, bumpy tongue that people often refer to as “strawberry tongue.” Other symptoms include:

• a red, sore throat
• fever
• a red, blotchy rash that usually starts on the chest and stomach
• headache
• stomach pains

Doctors treat scarlet fever with antibiotics. Following antibiotic treatment, scarlet fever usually goes away in around one week, but the rash can last for longer.

Scarlet fever most commonly affects children and is contagious. The infection can be passed on through:

• coughing and sneezing
• sharing or using contaminated objects, such as cups, foods, towels, baths, and clothes

Oral allergy syndrome

An allergy to certain raw fruits and vegetables can cause itching and swelling in the mouth or on the tongue. Swollen patches on the tongue may appear red and irritated.

The reaction is often mild, and a person can avoid it by cutting out the foods that cause the allergy. Cooking or peeling the fruit or vegetable can often prevent a reaction.

Tongue cancer

Tongue cancer is a form of head and neck cancer. Drinking alcohol, smoking, and infection with the human papillomavirus (HPV) can increase a person’s risk of developing tongue cancer.

A bump or spot on the side of the tongue, or a red patch on the tongue, is usually harmless. But if it does not go away, it could be a symptom of tongue cancer. Other symptoms include:

• a sore throat that lasts for a long time
• pain when swallowing
• numbness in the mouth

Anyone who has a painless sore, lump, or red or white patch on the tongue that does not go away should see a dentist or doctor.