Smooth Red Spots on the Tongue: Causes and Remedies

(Continuation of question #140703) There are smooth red spots about 1.5 cm on the tip of the tongue accompanied by burning pain?

Hello Doctor, thank you for your response.
I am a patient from #140703.
The smooth area on the tip of my tongue has improved, but I still experience burning pain on both sides of the base of my tongue.
Since you previously mentioned that it could be a case of erythema multiforme, I have taken a photo of the burning areas on the side of my tongue for further confirmation.
https://upload.cc/i1/2018/10/24/GvEjHp.jpeg The image shows that there is a stabbing pain near the base of my tongue (the photo only shows one side, but both sides have a stabbing sensation).
I cannot pinpoint the exact pain location, and I also have mild stabbing pain in my throat on both sides, alternating between the left and right, but not simultaneous.
This throat pain is not as severe as the pain I experienced during past colds; it is just a mild foreign body sensation.

(1) Does erythema multiforme typically accompany other symptoms that can be observed? There is very little discussion online about isolated lesions on the tongue or in the oral cavity.

(2) Since I am studying in the United States, should I take medication for these symptoms? Perhaps I can consult a local pharmacist.

(3) How long does it typically take for this condition to resolve on its own since the onset? This would help me have a clearer timeline for observation and reduce my anxiety.

(4) Based on the photo, could the lesions on the side of my tongue be indicative of HPV? I noticed that the symptoms began exactly 12 weeks after unprotected oral sex.
Thank you, Doctor.

chu, 20~29 year old female. Ask Date: 2018/10/24

Dr. Lin Jiayong reply Dentistry

(1) The diagnosis of erythema multiforme requires comprehensive and long-term examinations, particularly including blood tests.
(2) Do not take any medications indiscriminately before a definitive diagnosis is made.
The area behind the base of the tongue is the tonsils, and mild inflammation can cause pain, which is a normal phenomenon.
Please trust in your body's immune response, or seek medical attention to confirm whether it is a viral or bacterial infection before taking any medication.
(3) Photos cannot provide a definitive diagnosis; please understand this.
There is no need to worry excessively.
(4) Photos cannot provide a definitive diagnosis; please understand this.
A diagnosis of HPV or HIV cannot be made solely based on photos or symptom descriptions.
If you are truly concerned about HPV, there are vaccines available for prevention and treatment.
If you are worried about HIV, there are also preventive medications such as PrEP.
However, it is recommended that you consult a physician for professional evaluation! Sincerely, Lin Chia-Yung, Director of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2018/10/24

More Info

Understanding smooth red spots on the tongue can be quite concerning, especially when accompanied by discomfort or pain. Based on the symptoms you've described, including the burning sensation on the sides of your tongue and mild throat discomfort, there are several potential causes to consider.

1. Possible Causes:
- Erythema Multiforme: This condition can manifest as red spots or patches on the skin and mucous membranes, including the tongue. It is often triggered by infections, medications, or other factors. While it can be painful, it typically resolves on its own.

- Oral Thrush: A fungal infection that can cause red, inflamed areas in the mouth, including the tongue. It may not always be painful but can lead to discomfort.

- Allergic Reactions: Certain foods, medications, or dental products can cause localized reactions in the mouth, leading to redness and irritation.

- Human Papillomavirus (HPV): While HPV can cause lesions in the oral cavity, it typically presents differently and is less likely to cause smooth red spots without other symptoms.

2. Observation and Monitoring:
- It's essential to monitor the symptoms closely. If the red spots persist or worsen, or if you develop additional symptoms such as fever, difficulty swallowing, or significant pain, it would be prudent to seek medical attention. Erythema multiforme can sometimes be associated with systemic symptoms, and a healthcare provider can help determine the best course of action.

3. Medication Considerations:
- If you suspect that your symptoms may be related to an allergic reaction or infection, it might be beneficial to consult with a local pharmacist or healthcare provider in the U.S. They can recommend over-the-counter treatments or prescribe medications if necessary. For example, antihistamines can help with allergic reactions, while antifungal medications may be needed for oral thrush.

4. Healing Time:
- The duration for self-resolution can vary significantly based on the underlying cause. Erythema multiforme may resolve within a few weeks, while oral thrush may take longer if not treated. Keeping track of your symptoms and their progression can help you gauge when to seek further medical advice.

5. HPV Concerns:
- Regarding your concern about HPV, while it is possible for HPV to cause lesions in the oral cavity, the smooth red spots you describe do not specifically indicate HPV. If you have concerns about sexually transmitted infections, it would be wise to discuss these with a healthcare provider who can offer testing and guidance.

In conclusion, while smooth red spots on the tongue can be alarming, many potential causes are manageable. Observing your symptoms, consulting with healthcare professionals, and considering over-the-counter treatments can help you navigate this situation. If symptoms persist or worsen, do not hesitate to seek medical attention for a thorough evaluation and appropriate treatment.

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