Red Smooth Spots on Tongue: Causes and Treatment Options

There are smooth red spots about 1.5 centimeters on the tip of the tongue accompanied by a burning sensation?

Hello Doctor, three days ago I noticed a red patch on the tip of my tongue, resembling geographic tongue as seen online.
It started at about 1 cm and has expanded to 1.5 cm, with a smooth center and a clearly defined white border.
There are signs of gradual enlargement each day.
Additionally, I am experiencing a burning sensation on my tongue (not just at the site of the red patch, but also a tingling sensation on the left and right posterior parts of my tongue).
I have attached images for reference.
I would like to inquire about possible diagnoses and recommended treatment options (as I am currently studying in the United States).
I am also concerned whether this could be a sexually transmitted infection.

Relevant medical history includes:
1.
Chronic gastroesophageal reflux for 2 years, currently taking 15 mg of Tecta daily for the past year and a half, with a recent exacerbation of reflux symptoms.
2.
Engaged in unprotected oral sex on August 4, but tested negative for HIV and syphilis at National Taiwan University on September 16.
3.
Occasionally experienced nasal allergies with runny nose and itching during winter, and have had skin rashes after drinking alcohol and eating seafood.
4.
Recently arrived in the United States and am experiencing dry mouth due to the dry climate.
5.
Prone to anxiety, and I take Ambien before bed each night.

chu, 20~29 year old female. Ask Date: 2018/10/22

Dr. Li Jiaxuan reply Otolaryngology

For tongue inflammation and ulcers, it is recommended to maintain a balanced diet, supplement with vitamin B, and drink plenty of water.
Ensure oral hygiene for 2-3 months; if there is no improvement, further evaluation for geographic tongue should be considered.
Geographic tongue may indicate potential immune system issues, which would require further immunological blood tests (ANA, RF, C3, C4) for confirmation.
Additionally, please avoid other infections.
Wishing you good health.

Reply Date: 2018/10/22

More Info

Red smooth spots on the tongue can be concerning, especially when accompanied by symptoms such as burning or tingling sensations. Based on your description, it seems that you are experiencing a condition that resembles "geographic tongue," which is characterized by irregular patches on the surface of the tongue that can change in shape and size. The smooth center and white borders you mentioned are typical features of this condition.
Geographic tongue is generally considered benign and is not associated with any serious underlying health issues. However, it can sometimes be linked to other conditions such as nutritional deficiencies (particularly vitamin B deficiencies), stress, or even certain food sensitivities. Given your history of chronic gastroesophageal reflux disease (GERD), it is also possible that the acidity from reflux could be irritating your tongue, contributing to the discomfort and changes you are experiencing.

In terms of treatment, there are a few approaches you can consider:
1. Symptomatic Relief: Since you are experiencing burning sensations, avoiding spicy, acidic, or irritating foods may help alleviate discomfort. Over-the-counter topical anesthetics or mouth rinses designed for oral pain relief can also provide temporary relief.

2. Nutritional Assessment: If you suspect that your geographic tongue may be related to nutritional deficiencies, consider consulting a healthcare provider or a nutritionist. They can evaluate your diet and recommend appropriate supplements if necessary.

3. Managing GERD: Since you have a history of GERD, it is crucial to manage this condition effectively. This may involve lifestyle modifications such as avoiding trigger foods, eating smaller meals, and not lying down immediately after eating. If your current medication (Tegaserod) is not adequately controlling your symptoms, discussing alternative treatments with your healthcare provider may be beneficial.

4. Stress Management: Given that you mentioned feeling anxious, incorporating stress management techniques such as mindfulness, meditation, or yoga could be helpful. Stress can exacerbate many conditions, including those affecting the oral cavity.

5. Regular Monitoring: Keep an eye on the changes in your tongue. If the spots continue to expand or if you develop additional symptoms (such as fever, difficulty swallowing, or persistent pain), it is essential to seek medical attention. A healthcare professional can perform a thorough examination and may consider further testing to rule out other conditions.

Regarding your concern about sexually transmitted infections (STIs), while some STIs can cause oral lesions, the characteristics you described are more consistent with geographic tongue rather than an STI. However, if you have any doubts or if new symptoms arise, it is always wise to consult a healthcare provider for appropriate testing and reassurance.

In summary, while geographic tongue is typically harmless, it is essential to manage any underlying conditions, such as GERD, and to monitor your symptoms closely. If you have any concerns or if your symptoms worsen, do not hesitate to seek medical advice.

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