Tongue Swelling: Causes and When to Seek Help - Otolaryngology

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Issues with the tongue?


Hello Doctor, since I was a child, the left side of my tongue occasionally swells and turns purple, with some red spots appearing.
Sometimes it reduces in size to almost match the right side and does not appear purple (more normal), but when swollen, it can be nearly twice the size of the right side (though it does not affect my eating or speaking, and there is no pain when pressed).
I am unsure if this could be a hemangioma.
Sometimes I pull off the red spots on my tongue to let the blood flow out, as this seems to reduce the swelling.
What symptoms could this be? I was afraid to seek help when I was younger, but now I want to see a doctor, though I am unsure which specialty or which doctor to consult.

Xiao Pan, 20~29 year old female. Ask Date: 2020/02/16

Dr. Zheng Jueyi reply Otolaryngology


Hello: Commonly, it may be a hemangioma of the tongue.
It is recommended to visit an otolaryngologist for examination.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2020/02/16

More Info


Tongue swelling can be a concerning symptom, and understanding its causes is essential for determining when to seek medical help. Based on your description, it seems that you have experienced recurrent swelling on the left side of your tongue, which sometimes appears purple and has red bumps. While it is good that the swelling does not interfere with your ability to eat or speak, it is still important to investigate the underlying causes.

There are several potential causes for tongue swelling, including:
1. Allergic Reactions: Swelling can occur due to an allergic reaction to certain foods, medications, or environmental factors. If you have noticed a pattern of swelling after consuming specific foods, it may be worth considering an allergy.

2. Infections: Viral or bacterial infections can lead to swelling of the tongue. Conditions such as oral thrush (a fungal infection) or herpes simplex virus can cause localized swelling and discomfort.

3. Angioedema: This is a condition characterized by rapid swelling of the deeper layers of the skin, often triggered by an allergic reaction. It can affect the tongue and may require immediate medical attention if it leads to difficulty breathing.

4. Vascular Malformations: Conditions like hemangiomas or lymphangiomas can present as red or purple lesions on the tongue. These are benign vascular tumors that can cause localized swelling.

5. Geographic Tongue: This benign condition causes patches on the tongue that can appear swollen and may change over time. It is usually harmless and does not require treatment.

6. Trauma or Irritation: Sometimes, trauma from biting the tongue or irritation from dental appliances can lead to localized swelling.

7. Systemic Conditions: Certain systemic diseases, such as autoimmune disorders or vitamin deficiencies, can also manifest as tongue swelling.

Given your history of recurrent swelling and the presence of red bumps, it is advisable to consult a healthcare professional. You may want to start with a visit to a primary care physician or an ear, nose, and throat (ENT) specialist. They can perform a thorough examination and may refer you to a dermatologist or an allergist if needed.

It is important to avoid self-treatment methods, such as removing the red bumps or causing bleeding, as this can lead to infections or further complications. Instead, seek professional evaluation to determine the appropriate diagnosis and treatment plan.

In summary, tongue swelling can arise from various causes, and while some may be benign, others may require medical intervention. It is commendable that you are now considering seeking help, as early evaluation can provide peace of mind and appropriate management. Remember to provide your healthcare provider with a detailed history of your symptoms, including any triggers or patterns you have noticed, to aid in their assessment.

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