Spots on Tongue

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.

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.