Geographic Tongue: A Real Pain in the Mouth

Even in my earliest memories about food, I can remember the terrible consequences that would follow when I ate any meal which combined tomatoes and citrus together. Most often it happened if I drank orange juice and ate something with ketchup on it–within minutes, my tongue felt as if it had raised, painful ridges on it, red ridges which itched and burned like crazy and would not be soothed with drinking anything. Ice relief lasted only as long as the ice lasted in my mouth, and then the aggravating itch and burn would be back. Sometimes I resorted to scraping my tongue with my teeth or fingernails, which didn’t really help but made me feel a little less powerless against this until it finally went away (it usually took about an hour).

My mother always called this condition “geographic tongue,” and I learned that members of both sides of my family had experienced this reaction to certain foods or combinations of foods. For my immediate family, we quickly learned to avoid the tomato/citrus combination for my sake, and I became more aware of what I was about to eat. But sometimes it snuck up on me, or I forgot about it until it was too late–like the time I ate a slice of cheese pizza slathered in tomato sauce along with a citrusy drink for school lunch. (Let’s just say getting through third block was VERY interesting…)

However, while doing a bit of casual Googling and Wikipedia-ing about this topic, I noticed that there is more to “geographic tongue” than a simple, silly-sounding temporary food reaction. In fact, this is a medical condition, one that explains far more about my own gustatory habits.

What Exactly IS Geographic Tongue? (Warning, Picture Ahead)

Geographic tongue, aka “benign migratory glossitis” or “erythema migrans,” is a harmless mouth condition that affects about 3 percent of adults around the world. (Yay, I feel special now, LOL.) It seems to be more common in middle-aged and older adults than children, and more common in women than men. Upon eating foods with high acid content or strong flavors (it varies among sufferers), the tongue burns, stings, and/or itches. And, if you look at a geographic tongue, you’ll see patches of red and white all over it in map-like formations which give the condition its name.

As an example: my own tongue.

tongue As you can see, my tongue looks pretty strange–it has always looked patchy like this, even in my childhood. (Bonus: not only do I have strange patterns all over it, but I also have deep fissures in my tongue, which often appear in people with geographic tongue–you can see a big one running right down the center of my tongue in this pic, and there are other smaller ones as well. These fissures tend to exacerbate geographic tongue, producing swelling when already irritating foods get down into the fissures.)

The reason all these weird patches show up is because my tongue is missing papillae (the things that contain taste buds) on the redder parts of my tongue, while the lighter parts have papillae in abundance. The areas of darker and lighter red can change places at random, so you can never tell exactly what my tongue is going to look like (LOL). This “missing papillae” phenomenon doesn’t sound like much, but apparently it’s really important when it comes to processing strong flavors or acidic foods. People still don’t really know why it happens.

Is It Contagious/Dangerous?

If you’re one of the 3% of human beings who has this, do not fret: this is NOT a precancerous/cancerous condition, but rather a “minor annoyance” condition, at least as doctors classify it. (Ha, it doesn’t FEEL minor when it’s happening and you can’t do squat about it!) Also, it seems to have nothing to do with oral hygiene, though a lack of said hygiene can make geographic tongue worse in some cases. If you develop very painful sores or swelling on your tongue that keeps you from breathing correctly, however, get to a doctor ASAP.

Geographic tongue is not contagious; it appears to be purely hereditary, and the same people who have geographic tongue often have allergies, asthma, eczema, and/or are more susceptible to hay fever. There are also suspected links to anemia and psoriasis as well. (Yep, all this is in my family, too. [sarcasm] YAY. [/sarcasm]) Lastly, there may be a connection between geographic tongue and celiac disease, though more research needs to be done.

What Can Cause Geographic Tongue to Flare Up?

Foods/Drinks

Oral Products

Other Triggers

  • Spicy foods (esp. chilies, chili powder/chili sauce)
  • Citrus fruits, especially pineapple
  • Sour foods
  • Oregano
  • Walnuts & pecans
  • Raw spinach
  • Chard
  • Tomatoes
  • Eggplants
  • Really strong cheeses (like bleu cheese)
  • Strongly-flavored candy (esp. peppermint, chocolate, and cinnamon)
  • Alcohol
  • Mouthwashes (esp. with strong flavors)
  • Whitening toothpastes
  • Tobacco (esp. chewing tobacco)
  • Environmental sensitivity (see previous section on heredity)
  • Stress (possibly)
  • Diets high in sugar or processed foods (possibly; needs more research)
  • Vitamin B deficiency
  • Psoriasis flare-up
  • Hormonal changes
  • What Can Help Soothe/Keep Down Geographic Tongue?

    • Vitamin B supplements
    • Zinc supplements
    • Toothpaste for sensitive teeth with no additives
    • Ice (temporarily)
    • Anesthetic mouth rinses
    • Mint gum/lozenges (supposedly)

    (If constantly painful, a doctor can treat geographic tongue with certain topical ointments, antifungal products, or even corticosteroid treatments.)

    Living With Geographic Tongue

    For me, the list of “trigger foods” surprises me; most if not all of those are on my “do-not-eat” list. I never have been able to enjoy cinnamon-flavored gum or candy, for instance, and I’ve always been very particular about the kind of orange juice I get–it’s got to be “Low Acid.” And though I love sweets, too much chocolate with nothing to drink with it leaves me with a burning, “coated”-feeling tongue and throat.

    In light of this condition, my picky eating makes a little more sense, since I’ve been avoiding many foods possibly based on how they make my mouth feel rather than the taste. And it also sheds light on why my tongue often feels so irritated after I brush my teeth, too, since I use a lot of whitening agents and special mouth rinses.

    I don’t know whether adding Vitamin B or zinc would help me, nor am I sure if my geographic tongue might be connected to stress, allergies, psoriasis, etc. But these sure help give clues as to what I can try!

    For Further Reading/Reference

    NIH.gov Article on Geographic Tongue
    Foods that Cause Geographic Tongue
    WebMD.com’s Guide to Geographic Tongue
    Geographic Tongue: Top 10 Causes and Cures
    Geographic Tongue: Wikipedia Article
    Fissured Tongue: Wikipedia Article

    25 thoughts on “Geographic Tongue: A Real Pain in the Mouth”

    1. I am italian, and i am 24. i have this problem from about 6 months. I am very sad. I think that is linking with psioriasis but i dont have the last one.
      The point of my tongue give me a stronght sensation of sensibility. If you want, add me on facebook, Alessandro Ludwig Agati.

    2. people… I have lived with this for over a decade and lost a ton of weight cause I couldn’t eat anything without my mouth feeling on fire. I saw 10 different doctors and no one knew what it was and a couple of them told me it was geographic tongue, and that it shouldn’t be painful…. but it’s not true!! I found relief with research on leaky gut syndrome and by doing my first whole 30. please do yourself a favor and read it starts with food and check out whole30.com.

      Do it! Don’t live like this! You can heal your mouth and your body with the right foods. Do this for yourself!

      best of luck!

    3. Hey, Robin, thanks so much for this informative blog. Apparently there are different degrees of this problem and even different triggers. I’ve been having these symptoms for almost 7 weeks and the doc”s remedy (Magic Mouthwash $40) didn’t do a thing. Decided to do more online research before making an appointment with my dentist. Stumbled across your blog and this article on WebMD: http://forums.webmd.com/3/oral-health-exchange/forum/1933/32?pg=1 so now I’m going to try to undo all the helpful things I’ve been doing, which were furthering the irritation. I’m 60 years old and this is the first time it’s gotten this bad! Feels wonderful to have a diagnosis. Wouldn’t the doctor flip to know I found it on the Internet? 😉

    4. I’m glad you liked the article! I hope its advice helps end the irritation you’re suffering. For me, changing my toothpaste made SO much difference–I’ll never use whitening stuff again! (Do check with your dentist at your next cleaning appointment, though–they can use different polishing pastes to help avoid the burning mouth feeling, as well as advise you on specific products for sensitive mouths.)

    5. It started with pineapple (fresh or canned) for me, a couple of years ago. Then I noticed eggplant had the same effect; feeling like the sides of my tongue had been slashed. Fresh garlic sauce from the Mediterranean restaurant was next. Just this past week, fresh tomatoes ! And just yesterday, a banana left hints of this annoying sensation. Very frustrating! I AM older (61), and female, so I fit the given profile, I guess!

    6. I just ate some mango and had a flare up and decided to looks up ‘geographic tongue’. I have always had flare ups since I was young (32 years old now). I as well always hated cinnimin gum because it was way to strong and hurt my tongue. Strange thing though, tomatoes on there own are the worst for me. The raised bumps last for about 30 to 40 minutes, yet I can eat lemon slices whole (something my grandpa taught me, I know I know, bad for enamal) and drink orange juice all day long. Melons are fine but pineapple is horrible. I used to think citris concentration but tomatoes vs lemons don’t make sense. Good article. Kinda good to know there’s nothing wrong and I’m not alone. My trick to deal with it is water and folding my tongue back on itself and rub it back and forth. Still hurts but aeems to go away quicker.

    7. Good to hear about your experience! Tomatoes are definitely on the list as a HUGE trigger food for most people–I’ve not heard of too many people outside my family who have the particular sensitivity to tomato + citrus. I usually use ice/ice water to try to calm my tongue down, too…must be something about removing the irritant and calming inflammation. I hope someday scientists will study this and figure out what exactly is in tomatoes, cinnamon, citrus fruits, etc. that drives our tongues crazy! 😀

    8. All of the foods you mentioned are on the high histamine food list. Look up this condition, there can be two parts to this. And there are many other health problems that can clear up by avoiding these foods. My geograhic tongue is better after three weeks of this, after suffering it continuously for 12 years.

    9. I checked out high histamine on MindBodyGreen–very interesting! I’ve never had bad reactions to peanuts, spinach, or mayonnaise, but definitely to citrus fruits, bananas, shellfish, chocolate, and cured meats. WOW…wonder if the two conditions are connected??

    10. I’m so glad that you posted this! I have been wondering what is going on for years. I now understand why my mom has the same thing happen to her. I have put some things on my “do not eat” list, but there are some that are worth the pain. (One being pineapple) Thanks for the info!!

    11. Thank you for posting this. I have it, was really scared at first. I love ketchup and didn’t understand why it was hurting the tip of my tongue. I never could drink oj. My tongue just looked really strange all the sudden one day.
      Glad to know I’m ok and not all alone in this. Again thank you.

    12. I got my diagnosis 5 years ago after a very awful dental experience which can be a trigger. It has been a nightmare. I use Toms clean and gentle SLS free toothpaste, a must buy! I also take Niacinimide ( non-flushing) everyday, and zinc. It’s daunting to know that this is with me 24/7. I got it when I was 55. It’s also possibly a relative of an auto immune disorder. My dental procedure was nerve damage. I hate ordering food in restaurants. I loved spicy, sour foods, chocolate and a nice glass of Chardonnay so all those things if I eat them come at a miserable price. You all are not alone. Thanks for sharing.

    13. I’ve 25 and have suffered with this for several years during my teens. The doctors didn’t know and it wasn’t until Insaw a new dentist just over a year ago that someone diagnosed this condition. I get very angry and upset when I hear people say it’s not serious and is a minor irritation!!!! My tongue constants burns with pain and I can not longer taste hardly any of my food. It controls my life with what I can and can’t eat or what I dare even try. It gets me more stressed the more it hurts because it makes me want to bite my tongue off!! None of any remedies I have tried so far have worked, and the doctors/dentist refuse to refer me to anyone else who can help and tell me to just avoid things and it will pass :'(

    14. My 12 year old daughter is dealing with this. It flares up after eating avocados. It also flares up when she eats guacamole, which has the tomato/citrus combination irritant. I’m glad to have found this page via Pinterest. I don’t really know how to help her, except have her avoid these foods. Its sad though because we love them! I have lots of food sensitivities, so her having a type of reaction is not surprising. It’s just good to finally have a name for what has been frequently happening to her tongue. Yes, her tongue doesn’t constantly look like the above, only after ingesting the above foods.

    15. Yeah, it’s a struggle to deal with sometimes because the tastiest foods end up setting off the tongue reaction! I’m sorry to hear she’s dealing with this 🙁 I hope one day there will be some kind of alleviation for the condition, and hopefully even ways to prevent it besides restricting the diet!

    16. I have had the condition for 6 months . For periods it has been very severe. Seen 4 GPs , with no improvement. Tried everything , I had read about that might help without success. Finally got to see a consultant. He did not have a cure but suggested fizzy vitamin c tablet on the tongue once a day . Also thought food allergy tests would probably result in too many foods being off the menu. My symptons are milder with vitamin c and with vitamin b 6 and b12 my symptons improved dramatically . I still feel certain foods increase symptons but still narrowing them down. Agree about certain toothpastes being better and had it confirmed by my dentist, Something that seems to stop a flare up from getting worse seems to be sugar free polo mints. I notice if I suck a few over an hour or two symptons subside .

    17. That’s great that vitamins and the sugar free mints have helped reduce your flare-ups! I hope one day we’ll find out what causes this and how to keep it from happening altogether 🙂

    18. Flip, Flip it .! I recently noticed my tongue getting sore, tried aloe vera, changing toothbrushes, mouthwash and thought ‘Have I got mouth cancer??’
      I grow a lot of tomatoes in my polytunnel and I’ve been popping the sweet cherry ones straight down and then having the beef type ones in sandwiches. It was only today after eating nearly ten cherry toms that I thought about an allergy and came across your post.
      Heck, I’m going to have to cook them. Thanks! No really , thanks – I don’t have mouth cancer.

    19. I had never heard of this condition prior to my last doctors appointment. I went to a new doctor, and she took one look in my mouth and said “oh look, you’ve got a geographic tongue!”. It is blowing my mind that not everyone’s tongue feels strange after they eat pineapple! I love cinnamon gum, but have never been able to chew it for too long. Now I know why!

    20. Nice article! Minor irritation…I don’t think so!!! One can’t understand it if they haven’t experienced it. I felt compelled to comment because I was diagnosed with Celiac Disease about 15 years ago. Since following the gluten free diet strictly, my geographic tongue “flare ups” are nothing like they used to be. It was a daily (and painful) struggle but now the occurances are much less often. Don’t get me wrong, following the gluten free diet doesn’t mean I can drink 2 glasses of orange juice and have a BLT. But the occurrences and severity have definitely lessened. Certainly not trying to be a know-it-all or instilling fear, but I’d suggest getting tested for Celiac if you are suffering from this condition. Seems many Doctors don’t have a clue, as you’ve noted 😉
      (gf is not easy, but definitely manageable!)
      Sorry for the long comment!

    21. I’ve had GT all of my life….the foods that trigger it for me are walnuts, pecans, tomatoes,pineapple,aubergine and oranges. When I was pregnant my symptoms went through the roof, after seeing my Doctor and having blood tests I learnt my B12 levels were seriously low.
      If you’re pregnant and your GT is bad its worth talking to your doctor, and checking your B12.

    22. Has anyone been treated with amitriptyline? I saw a doctor recently at Guy’s Hospital in London who explained to me that certain foods are not the real problem, it’s the fact that parts of the tongue are regenerating at a faster rate than others and so are more sensitive to things like acidic fruit. He said to treat my geographic tongue he would have to examine the underlying cause, which he believed to be nerve damage (!). He recommend taking amitriptyline 10mg every day for 12-18 months. This apparently calms the nerves down so the tongue is less over-active in terms of regeneration. The hope is that after that time, the nerves will have resolved and the tongue won’t flare up again. For now, I am trying a steroid mouthwash (it’s doing diddly squat), but I return in two months time and the doctor will prescribe me amitriptyline. It’s probably better know an an anti-depressant, although the 10mg dosage is much much lower than what would be described for people with mood disorders. The random diagnosis threw me a little, I felt like Charlotte in Sex and the City when she was diagnosed with a depressed vagina! In fact, i think her prescribed course of treatment was the same ??

      But the doctor’s explanation kind of makes sense, as I went through a period of bad health for about 4 years and I felt like my body was misfiring. I had shingles, and I’m pretty sure that left me with mild nerve damage in my torso, because I still get shooting pains there from time to time. My asthma also flared up, so I wouldn’t be surprised if the nerves supplying my tongue also started misfiring. I never had these tongue problems growing up, they only developed in my late twenties. I’m now 30.

      If you are reading this and have used this drug to treat geographic tongue, I would love to hear from you 🙂

      p.s. tomatoes, spinach, garlic and champagne are the worst for me, all things I love!!

    Leave a Reply

    Your email address will not be published. Required fields are marked *