An Overview of Geographic Tongue

A Benign Inflammatory Condition

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Benign migratory glossitis, also called 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 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 unusual, and you may be alarmed by how your tongue appears. However, the condition is benign, meaning harmless. In fact, some people may not even realize they have an issue with their tongue until it's noticed by a doctor such as during a routine dental exam.

Common characteristics of geographic tongue include:

  • Bald patches or lesions on the tongue's surface
  • Discoloration of the tongue, usually white patches
  • Raised areas on the tongue with a defined border
  • Occasionally, lesions that appear in other mucosal areas of the body such as the labia (outer lips that protect the vagina)

This photo contains content that some people may find graphic or disturbing.

Geographic tongue disease
Geographic tongue disease. angelsimon / Getty Images

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 or shape, change location, or change color (usually they appear as white, yellow, pink, or red). It's possible that only one area of the tongue may be affected, or several areas might have patches and lesions.

Lesions may change slowly over the course of several days, but sometimes geographic tongue lesions can change over the course of a single day or even within a few hours.

People often worry that the lesions associated with geographic tongue make them more likely to have other health problems, but there's no evidence that the condition increases your risk for more serious diseases such as oral cancer.

For most people, the condition is painless. However, some people who experience geographic tongue report sensitivity to hot or spicy foods, acidic food like citrus fruit, alcohol, and tobacco.

Recap

Other than making the tongue appear discolored and patchy, geographic tongue often causes no symptoms. It’s usually painless and doesn’t damage the tongue in the long run. However, you may be sensitive to certain types of spices or acidic foods.

Causes

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

Many people with the condition say that it appears during times of stress. It also seems to run in families, implying there's a possible genetic or environmental cause. One study exploring the possible connection with psoriasis did identify a possible genetic link. Specifically, people with geographic tongue may have a variant on a protein coding gene known as interleukin-1 beta (IL-1B).

In some cases, certain habits such as teeth grinding have been linked to the development of geographic tongue. Additionally, people who have grooves along the surface of the tongue, a condition known as fissured tongue, may be more likely to develop geographic tongue.

Other potential causes of geographic tongue include:

  • Diet-related causes (food sensitivities and nutrient deficiencies)
  • Allergies (metals and environmental material)
  • Hormone-related causes (use of oral contraceptives)
  • Dermatologic conditions (psoriasis and eczema)
  • Autoimmune disorders and other inflammatory conditions
  • Chronic diseases (diabetes)
  • Hereditary disorders (chronic granulomatous disease, a genetic disorder that causes abnormal white blood cells)

Geographic tongue affects both men and women of all ages and racial backgrounds. It appears to occur more frequently in children. While the condition is believed to affect a very small percentage of the population, many people may not realize they have it.

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.

Before diagnosing geographic tongue, a doctor will visually examine your mouth and ask questions such as "When did the lesions appear?" or "Are the lesions causing you pain?"

Doctors usually do not need to order any specific tests to diagnose geographic tongue. If there is uncertainty about the diagnosis, or if doctors want to rule out another condition, they may take a tissue sample from the tongue for biopsy.

Other conditions that can look similar to geographic tongue include:

Recap

There are a number of theories about the causes of geographic tongue. A genetic component is possible, but food sensitivities or allergies, birth control pills, or underlying illnesses are all believed to be causes. 

There’s no test for geographic tongue. Your doctor will base a diagnosis on symptoms 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, a doctor may prescribe topical treatments such as corticosteroids to treat geographic tongue. If the pain is severe, topical anesthetics or agents that numb the tongue may be offered. Mouth rinses can also be used to soothe any discomfort associated with the condition.

In some instances, allergy medication (antihistamine) might help. However, if you experience geographic tongue as a result of a chronic health condition (such as psoriasis), you'll need to treat the underlying condition in order to heal the lesions.

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.

A Word From Verywell

Since most people who have benign migratory glossitis don't realize they have it, finding painful lesions in the mouth can be alarming. The condition usually doesn't require medication, but if you're in pain, talk to your doctor. They can recommend treatments such as topical steroids, antihistamines, or soothing mouth rinses. More importantly, geographic tongue may be a sign that you have a more serious condition. Getting a thorough examination and an accurate diagnosis is important to solve the problem.

Frequently Asked Questions

  • Is geographic tongue contagious?

    No. You can't get geographic tongue by, say, kissing someone who has it.

  • What causes lesions in geographic tongue?

    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. Most of the papillae on the tongue have sensory organs that are responsible for the ability to taste (taste buds) and to distinguish between sweet, sour, savory, salty, and bitter flavors.

  • How common is geographic tongue?

    It's estimated only 1% to 3% of the worldwide population have the condition. Some research suggests young adults are most often affected and females are more likely to have geographic tongue than males.

  • Can geographic tongue spread to other parts of the mouth?

    It doesn't spread in the same way as an infection might. However, patches can appear in other parts of the mouth, including the gums, top of the mouth, and insides of the cheeks. In these cases, the condition is called geographic stomatitis or erythema migrans.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Radfar L. Geographic tongue. American Academy of Oral Medicine.

  2. National Organization of Rare Disorders. Geographic tongue.

  3. Picciani BL, Domingos TA, Teixeira-souza T, et al. Geographic tongue and psoriasis: clinical, histopathological, immunohistochemical and genetic correlation - a literature review. An Bras Dermatol. 2016;91(4):410-21. doi:10.1590/abd1806-4841.20164288

  4. Medline Plus. Geographic tongue.

  5. Netto J, Dias M, Garcia T, Amaral S, Miranda Á, Pires F. Geographic stomatitis: An enigmatic condition with multiple clinical presentations. J Clin Exp Dent. 2019. doi:10.4317%2Fjced.55758

By Abby Norman
Abby Norman is a freelance science writer and medical editor. She is also the author of "Ask Me About My Uterus: A Quest to Make Doctors Believe in Women's Pain."