What Causes a Swollen Tongue?

Table of Contents
View All
Table of Contents

A swollen tongue can be a type of angioedema, a buildup of fluid in the lower layer of the skin or mucous membranes that can occur in different areas of the body. In medical terms, tongue swelling or enlargement is known as macroglossia and usually is accompanied by redness and other symptoms, depending on the cause.

Allergies, infections, congenital disorders, underlying medical conditions, and certain medications can trigger tongue swelling. While the condition usually isn't an emergency, it can be severe enough to obstruct breathing, and rapidly worsening macroglossia can be a sign of anaphylaxis, which is a medical emergency

If you or someone you're with experiences severe tongue swelling, go to the nearest emergency room or call 911.

swollen tongue
Verywell / Jessica Olah

Swollen Tongue Symptoms

Depending on the cause of the swelling, one or both sides of your tongue may become enlarged. In minor cases, swelling can interfere with eating or talking, or if your taste buds are affected, it can cause an unusual taste in your mouth.

Serious effects:

  • Progressively worsening swelling can block your airway, so it’s important to seek medical attention if you ever feel that your tongue is fatter or larger than usual. In some situations, you may need a breathing tube placed immediately.
  • Rapid, severe swelling can be a sign of anaphylaxis, which may be accompanied by swelling of your face or lips, hives, difficulty breathing, cyanosis (bluish discoloration of the lips), nausea, and vomiting.

You should call 911 or go to the emergency room right away if your swollen tongue is accompanied by difficulty breathing, drooling, or swallowing difficulties.


Many different conditions and situations can cause your tongue to swell.

Allergic Reactions

The leading causes of a swollen tongue are food or chemical allergies. You might only have a mild allergic reaction. However, if the swelling is a result of anaphylactic shock, it can be fatal.

Symptoms of an allergic reaction usually start within minutes or hours of coming into contact with an allergen, such as peanuts, tree nuts, milk, eggs, sesame seeds, fish, and shellfish.

Increasingly, dentists are seeing patients who experience reactions to flavorings, dyes, and chemical additives in toothpaste, mouthwash, denture cleansers, and other oral care products.


After food allergies, medication reactions are the most common cause of angioedema of the face, lips, or tongue seen in emergency rooms. Such cases aren’t always due to allergies.

The reaction can be a result of the body releasing too many bradykinins, which are immune-system chemicals normally needed to open blood vessels. They cause swelling if they are overproduced. A variety of prescription and over-the-counter drugs can cause this type of non-allergic tongue swelling.

A swollen tongue is an uncommon drug side effect, but it is a risk with certain medications. Angiotensin-converting enzyme (ACE) inhibitors, frequently prescribed to lower blood pressure, are the most likely to cause angioedema of the tongue.

20 to 40% of emergency room visits related to drug-related angioedema are a result of reactions to ACE inhibitors.

In rare instances, other drugs can cause tongue swelling, including antidepressant medication, pain relievers such as NSAID, or drugs that are used to treat high cholesterol.

Skin Conditions

Diseases that affect the skin can cause tongue irritation as well, which may cause slight swelling. For instance, mouth lesions and oral erosion occur with these disorders, causing the tissue around the tongue to puff up:

  • Pemphigus: A group of potentially fatal autoimmune diseases that cause mouth sores and skin blisters
  • Oral lichen planus: A little-understood disease that causes rashes on the skin or in the mouth
  • Oral psoriasis: Leads to geographic tongue and fissured tongue, creating a feeling of swelling or discomfort


Consuming hot foods or drinks, biting down on the tongue, or piercing the tongue may cause temporary swelling, which should disappear within about five days. If it doesn't, see your healthcare provider.

Serious injuries or oral piercings can lead to a bacterial infection known as Ludwig's angina, with swelling of the area under the tongue. With this condition, your airway may be completely blocked if you don't receive treatment.


The mouth is susceptible to a host of infections, including sexually transmitted infections that can be passed during oral sex. Syphilis, gonorrhea, and the human papillomavirus (HPV) can cause inflammation, sores, warts, or swelling of the tongue and nearby tissue. 

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) can cause chronic irritation at the back of the throat. In some cases, this leads to an enlargement of the tongue at its base.

Sjogren’s Syndrome

An autoimmune disease associated with dryness of the eyes and mouth, Sjogren’s syndrome can cause a host of oral problems including enlargement of salivary glands and parotid glands (large saliva-producing glands that sit on each side of the cheeks). In the midst of these symptoms, the tongue may swell or it can feel like it’s swollen.

Melkersson Rosenthal Syndrome

Melkersson Rosenthal syndrome is a rare neurological disorder that primarily affects the facial muscles. Edema, including tongue swelling, may occur, although facial paralysis is a more common symptom. 


To determine the cause of tongue swelling, your healthcare provider will examine your tongue and the tissue around it, with special attention to make sure your airway is clear.

They will also consider the following:

  • Is there an immediate risk to your breathing?
  • Do you have an underlying condition such as an autoimmune disease?
  • Do you have other symptoms such as hives?
  • What is your medical history, current medications, diet, and lifestyle?

If your healthcare provider suspects an allergy, drug reaction, or underlying medical problem, additional testing may be necessary.


If your tongue is only slightly swollen, you can see your regular healthcare provider for treatment. If the swelling is rapidly worsening or accompanied by signs of anaphylaxis, you should go right to the emergency room. Treatment will initially focus on reducing the swelling to ease breathing problems or discomfort, and your healthcare provider will also work with you to prevent future incidents.


Up to 15% of people who have angioedema quickly experience airway blockage. This is usually a sign of anaphylaxis and requires a life-saving injection of epinephrine. In less severe allergic reactions, an oral antihistamine may be given instead.

When tongue swelling is not related to an allergy, your healthcare provider may use one of the following treatments:

  • For a reaction associated with too much bradykinin, you may be given a drug that stops its production, which may be administered orally or via injection.
  • For oral sores and inflammation, you may be given topical corticosteroids or retinoic acid to relieve lesions.

For a swollen tongue related to an infection or pre-existing disease, your healthcare provider will also prescribe treatments for managing your underlying condition.  

A variety of products have also recently come on the market to help relieve dry mouth. You can ask your healthcare provider about oral drugs available by prescription that increase saliva production. There are also over-the-counter rinses and sprays that act as artificial saliva to add moisture to your mouth.

At-Home Remedies

For a mildly swollen tongue that isn’t getting worse, you may try some simple things at home to reduce swelling:

  • Eat and drink something cool or suck on ice chips to soothe your mouth and possibly reduce swelling. 
  • Practice good oral hygiene such as brushing and flossing, but avoid irritating mouthwashes, such as those containing alcohol.
  • Rinse with a warm saltwater solution.
  • Avoid very acidic or extremely salty foods.

If dry mouth is causing tongue discomfort, chew sugar-free gum or suck on sugar-free hard candy. Drink plenty of fluids.

A Word From Verywell

Your tongue plays a major role in eating, speaking, and breathing, so any enlargement can have a significant impact on your immediate health and quality of life. Even if it seems minor, swelling could be a sign of an infection, tongue cancer, or another health condition that might cause long-term problems.

If you or someone you're with suddenly feels their tongue is puffing up, get medical help right away. And if the swelling is slight or gradual, talk to your healthcare provider to find out what you can do to manage your condition.

Was this page helpful?
Article 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. Long B, Koyfman A, Gottlieb M. Evaluation and management of angioedema in the emergency department. West J Emerg Med. 2019;20(4):587-600. doi:10.5811%2Fwestjem.2019.5.42650

  2. Cianferoni A, Muraro A. Food-induced anaphylaxis. Immunol Allergy Clin North Am. 2012;32(1):165-95. doi:10.1016%2Fj.iac.2011.10.002

  3. Budanur D, Yas M, Sepet E. Potential hazards due to food additives in oral hygiene products. J Istanb Univ Fac Dent. 2016;50(2):61-69. doi:10.17096%2Fjiufd.72103

  4. Kalambay J, Ghazanfar H, Martes pena K, Munshi R, Zhang G, Patel J. Pathogenesis of drug induced non-allergic angioedema: a review of unusual etiologies. Cureus. 2017;9(8):e1598. doi:10.7759%2Fcureus.1598

  5. Harvard Health Publishing Harvard Medical School. Common blood pressure drugs can trigger rare allergic reaction. Updated April 2014.

  6. Pietrzak D, Pietrzak A, Krasowska D, Franciszkiewicz-Pietrzak K,Polkowska-Pruszyńska B, Baranowska M, Reich K. Digestive system in psoriasis: an update. Arch Dermatol Res. 2017;309(9):695-696. doi:10.1007/s00403-017-1775-7

  7. Inchingolo F, Tatullo M, Abenavoli F, Marrelli M, Inchingolo A, Palladino A, Dipalma G. Oral piercing and oral diseases: a short time retrospective study. Int J Med Sci. 2011;8(8):649-52. doi:10.7150%2Fijms.8.649

  8. American Dental Association Mouth Healthy. Sexually transmitted diseases and your mouth. Updated 2020.

  9. Valle E, Yalamanchali S, Friedman M. The association of reflux and lingual tonsil hypertrophy: A systematic review. Otolaryngology–Head and Neck Surgery. 2014;151(1)145-146. doi:10.1177/0194599814541629a28

  10. Błochowiak K, Olewicz-Gawlik A, Polańska A, Nowak-Gabryel M, Kocięcki J, Witmanowski H, Sokalski J. Oral mucosal manifestations in primary and secondary Sjögren syndrome and dry mouth syndromePostepy Dermatol Alergol. 2016;33(1):23‐27. doi:10.5114/pdia.2016.57764

  11. Desai S, Dumraliya P, Mehta D. Melkersson-Rosenthal syndrome. J Neurosci Rural Pract. 2014;5(Suppl 1):S112-4. doi:10.4103%2F0976-3147.145258

  12. Loverde D, Iweala O, Eginli A, Krishnaswamy G. Anaphylaxis. Chest. 2018;153(2):528-543. doi:10.1016%2Fj.chest.2017.07.033

  13. Najafi S, Gholizadeh N, Akhavan Rezayat E, Kharrazifard M. Treatment of Symptomatic Geographic Tongue with Triamcinolone Acetonide Alone and in Combination with Retinoic Acid: A Randomized Clinical TrialJ Dent (Tehran). 2016;13(1):23‐28.

Additional Reading