What is Geographic Tongue?

Geographic tongue is a condition of the tongue that presents with transitory discolored patches that resemble a map in appearance. Resulting from the shedding of papillae, the patches that form on the tongue's surface adopt a characteristic appearance allowing for easy identification and diagnosis. Also known as benign migratory glossitis, geographic tongue may necessitate the use of over-the-counter (OTC) or prescription medications to alleviate discomfort.

Migratory in nature, the patches that form on the tongue often present on one area of the tongue’s surface, heal, and then present in another area. The regenerative nature of the papillae usually follows a one- to two-week cycle where the papillae are shed and replaced. Why the papillae are shed from the tongue’s surface to begin with remains unknown. The loss of these finger-like protuberances does not impair tongue functionality; more specifically the affected individual does not lose his or her ability to taste.

Oftentimes, the affected areas of the tongue may appear distinctive and change in appearance. The outer edges of the reddish, bare patches may be defined by white or pink bumps that adopt a border-like appearance outlining the affected area. The fluidity of presentation associated with geographic tongue is common, often changing by the minute, hour or day. The mercurial nature of the patches may also contribute to the varying intensity of discomfort that can develop.

It has been asserted that individuals with allergies and certain chronic conditions, such as asthma and psoriasis, often demonstrate an accentuated susceptibility to developing geographic tongue. There have also been studies conducted that strongly suggest benign migratory glossitis may be a hereditary condition. Additional factors that may contribute to the development of this harmless condition include hormonal fluctuations and extreme stress. Smokers and those who regularly drink alcohol may also be at a greater risk for developing geographic tongue.

Easily identifiable with a visual examination, geographic tongue usually requires no treatment. Some individuals may develop episodic sensitivity and pain that coincides with the development of new patches necessitating the use of medication. Generally, symptomatic individuals are instructed to rinse with an anesthetic-based mouth rinse and take an over-the-counter analgesic medication to alleviate discomfort. Rarely, extreme discomfort may necessitate the administration of a prescription strength analgesic, or pain medication. In most cases, geographic tongue subsides without the continued administration of extensive treatment.

Individuals diagnosed with geographic tongue are often encouraged to journal their condition, recording specifics, such as the dates and duration of outbreaks, as well as potential triggers. Once individuals learn to recognize their triggers, they may take proactive measures to reduce flare-ups and better manage the discomfort they may experience. Avoiding known triggers, such as acidic beverages and spicy foods, and adapting one’s behaviors, including limiting exposure to stressors, can help promote effective symptom management.