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Red Spots on Tongue

Do you have a red spot or patch on the root, tip, side, or under your tongue? Don’t worry, anyone can develop them. There are various symptoms to expect which will include a sore throat and pain. Learn more about causes and treatments. 


These spots could be tiny or small bumpy on the tip, under, side and back or dorsal tongue surface. For some of the causes to be known, a proper tongue diagnosis is required.


What do they look like? Keep in mind that it could be one red spot on tongue, blotches or patches, or even tiny little dots. 

small red spots on tongue surface
small red spots 


There are various reasons to indicate any observable changes in the color and general appearance of the tongue. Some of these reasons are due to infections or diseases that can affect various organs of humans whereas some are medical. That is to say, medicines and treatments could be another probable cause of this problem.

In this discussion, we shall bring to light symptoms and other signs that are accompanied by red spots or patches. There are also pictures provided to assist you in understanding and getting into the depths of causes and in distinguishing the various tongue problems like tiny or little dots from the patches. 

1. Geographic tongue or Benign Migratory Glossitis, BGM

As an oral condition, this condition can turn tongue color and normal texture. Basically, it is characterized by inflammation including the papillae or taste buds. This inflammation is what is referred to as glossitis. However, it does not make it look bumpy.

What can help one know it is geographic tongue? This condition is also characterized by smooth, red or pink spots and sometimes reddish patches/blotches with white borders.

Depending on the affected regions, the signs shown by the presence of the patches may shift or “migrate’ from one point on your tongue to another. Although it is considered harmless, people who are affected suffer from soreness and feeling of pain brought about by the effects of taking hot meals and spicy foods.

BGM can cause much discomfort in addition to the suffering caused when taking hot or spicy foods – especially if you have sores such as those that form after biting.

In order to get rid of its symptoms, a careful diagnosis should be done by a professional or oral dentist. Furthermore, the problem could be solved by prescription of topical medicines after diagnosis and evaluation.

3. Infections

Can infections lead to the formation these spots, dots or color? While pain, bleeding, white spots, abnormal tongue coating, bad breath, et cetera could be all symptoms of oral infection; what do red spots signify?

i. Hand, foot and mouth disease

To begin, this illness is caused by various viruses. As a disease affecting the majority of the young children, hand, foot and mouth disease can affect both young adults and grownups particularly during the weather conditions of the summer, spring and fall.

A careful study of the symptoms can reveal that presence of painful sores in the mouth that begin as flat red spots (not raised) are due to this disease. According to an article published by Centers for Disease Control and Prevention, CDC, other symptoms, and observable signs include:

  • A sore throat,
  • A sickish or feeling sick,
  • Fever,
  • Reduced appetite,
  • A rash marked by reddish spots. These spots form blister-like spots typically on palms and bottom of feet.
  • Presence of “painful blisters and red spots on the roof of the mouth,” [colgate.com] on hands and feet as well.

Like most human viral diseases, this infection can spread from one infected individual or source of infection to the other especially in the first week of infection. Modes of transmission could be air, fluids or when one comes into contact with the virus and then the virus enters the body. This implies that anyone is at risk though children are easily victimized.

ii. Scarlet fever

Scarlet fever is the other infection which can turn the tongue meaning that it appears red and swollen or bumpy. This infection is due to bacteria. Just like hand, foot and mouth disease, scarlet fever is contagious too (the bacteria can be transmitted from an infected person) but there are medicines that will help clear its symptoms.

4. Canker sores

Canker sores are not contagious but studies have shown that they may appear as red sores anywhere in the mouth which includes the inner cheeks, on gums, on tongue and under it.

According to Healcure.org, they could be due to cancer sores if they have a yellow or white center and a red ring surrounding it.

Generally, canker sores may be termed as being complex or simple. Those complex ones are thought to be caused by certain complex health conditions, diseases like Crohn’s disease or problems arising from nutrition such as iron deficiency. On the other hand, the simple canker sores may appear “three or four times a year and last up to a week.” [wemd.com] and are common in young people mostly those in the teens.

Canker sores can cause painful mouth lesions but the pain could be even more painful than cold sores if a person has a weakened immunity or is infected with HIV.

5. Smallpox

Moving on, smallpox was a scare, concern, and health emergency to any nation before it was wiped out of the face of the world through vaccination programs. Perhaps it would be deadly assuming that it would be in existence.

What is the real concern or what was the scare? Any individual reported with smallpox is “sometimes contagious when they get a fever, but the person becomes most contagious when they get a rash.” [emergency.cdc.gov].

What does this mean, therefore? After its outbreak, an infected person already bears the virus but may not show the symptoms and thus smallpox may not spread. After a certain period of time (a few more days) symptoms usually surface. They include:

  • A red rash on tongue and in mouth,
  • High fever,
  • The rash becomes small raised bumps after which it disappears in the second week,
  • Pustules that result from the bumps. These pustules eventually form scabs on the skin.

6. Inflamed papillae

Do you find or get small bumps after a hot meal? That is what is likely to be experienced as any form of heat easily irritates the papillae. In most cases, they look swollen and enlarged. At times they can turn red and may result in a reddish sore tongue if they are severely affected by heat.

Another condition responsible for inflamed papillae is acid reflux. People who have this problem experience heartburns, hiccups, regurgitation, blood spots on a stool, etc.

Other causes

Here is an outline of other possible causes including the back of tongue and throat.

  1. Strep throat,
  2. Strawberry tongue,
  3. Lie bumps or transient lingual papillitis that is thought to be contributed by stress, trauma, splitting taste buds, etc.
  4. Conditions such as oral cancer, eczema, and asthma,
  5. Exposure to certain medications,
  6. Excessive consumption of alcoholic spirits or drinks,
  7. Acid reflux,

In toddlers and children

Do you have some time to check the physical state of tongue your little-loved ones? While many children are victims affected by oral thrush, there are other conditions and diseases which can cause red spots on toddler’s tongue. White patches are at times noticed in young children and those underage. What leads to the appearance these spots and patches in toddlers?

From what we have discussed, foot, hand and mouth disease is a culprit cause of red rash or spots common in young children.

One of the diseases responsible for the formation of red spots amongst the underage children is scarlet fever. Children who have the symptoms as outlined above or at least had a strep throat should be taken to a clinic for testing. Otherwise, scarlet fever can be a serious infection which may result in other complications.

Another cause of small red marks on tongue surface in young children is canker sores that result from bites or injury. In toddlers and young children, canker sores are symptomatic of “small, open and painful sores that are white or yellowish with a red border on the inner lips or cheek, gums or tongue.” [familydoctor.org]

NOTE: A typical nature of canker sores is that they affect the inside of the mouth – unlike cold sores which are fluid-filled blisters that occur as red spots on tongue and lips and around the mouth.

Other things responsible include inflamed papillae. If your baby has a tendency of getting strep throat and recurring small ‘blood’ bumps in the mouth, under the tongue or at the back of throat call your doctor quickly.

Painful spots or those that hurt

I have a red small bump that hurts? What causes red spots in the mouth which are painful? Certain oral infections such foot, hand, and mouth disease would inflict pain in the mouth. Next on are canker sores that may cause pain during chewing, speaking or cleaning. We have already looked at that under causes.

NOTE: it is important to note that though a geographical tongue is primarily considered a benign or harmless condition, NHS Choices states that this condition can cause a soreness especially with increased sensitivity.

With no pain

What could be reasons these red spots without pain? Some conditions may come with symptoms in absence of pain and such is the Geographic tongue that is rarely accompanied by painful experiences unless affected individuals take hot and spicy foods or beverages.

In addition, if it is found out the painless patches and spots are associated with excessive smoking or alcoholism then such people at equally at risk of developing cancerous cell tissues unless they quit.

Yellow tongue with red spots

Is it possible to have a yellow tongue coating with red spots? Some infections such as scarlet fever can be the reason behind a yellowish or white coating besides it looking bumpy or swollen. However, you need to see a dentist to carry out an oral test to confirm that it is not a combination of various mouth problems or symptoms produced by other human infections.

Small or little ones

From the discussion, it is clear that anyone can experience this problem as one of the numerous tongue problems. They may be small or tiny red or white spots some of which may appear raised above your tongue surface.

For the case of the small ones which may also be white, “Eruptive lingual papillitis is most common among children and is likely contagious.” [healthline.com]

Secondly, another reason for their occurrence can be attributed to inflamed tongue papillae, smallpox and canker sores.

There could also be other reasons to account for apart from what we have looked at so far (whether the spots appear as red flat dots or raised).

Under tongue

Red spots under tongue could be an indication of canker sores, reactions produced by an allergic substance among other causes. Moreover, if you have red or dark red bumps on this part or on the floor of the mouth that have lasted longer or keep appearing to see your dentist urgently. It could be a serious condition or mean something bigger than non-malignant tissues.

STDs – is it HIV or Herpes?

Do STDs have any symptoms in the mouth or on the mouth? In advanced stages of infection, HIV can cause dry mouth, tooth decay, enlarged saliva glands, cold sores and shingles among many other problems.

Even though people living with HIV may have recurring sores in the mouth or on lips does not ideally mean that it is caused by HIV virus. Rather, it is due to the fact that HIV greatly compromises the body’s immunity and robs it of its ability to fight infections. Why? When your immunity is weakened or compromised other infections can easily cause the spots.

A relevant example could be fever blisters caused by herpes. You will realize that an HIV patient is more likely to be infected with theses blisters symptomatic of red or raised bumps.

Red or strawberry tongue?

Could there be any difference between just red spots and a red tongue? A normal tongue is one described by pinkish color. Look at these pictures.

geographic tongue with reddish patches
geographic tongue with reddish patches


lie bumps on tongue
lie bumps 


what causes red dots on tongue and roof of mouth
 On the roof of the mouth


Generally, a strawberry tongue is a resultant effect which arises from glossitis giving it an appearance of a strawberry fruit. If the normal white coating is lost a “dark red, the erythematous surface is revealed, interspaced with the hyperplastic fungiform papillae.” [wikipedia.org].

Actually, this condition is what results later from scarlet fever which occurs 4-5 days. The strawberry tongue is also observed in Kawasaki disease which mainly occurs in children of underage 5 years.

Both Kawasaki and scarlet fever gives the bumpy or swollen appearance. If you need to know more about Kawasaki click and follow after it has opened.

When to see a doctor

A single painless and persistent red tongue spot require great attention, proper diagnosis and evaluation in order determine what actually causes and brings them about if they are clustered. This is important since some individuals who have had cases of eczema, asthma is reported to have suffered from glossitis which we saw is associated with tongue conditions.

Some symptoms which accompany big, patchy, bumpy or small red dots all over tongue could be irritating. For a more appropriate method of clearing the symptoms or treating the underlying cause, a clinical test should be carried out.

Our Reference
  1. Hand, Foot, And Mouth Disease in Children, https://www.drugs.com/cg/hand-foot-and-mouth-disease-in-children.html,
  2. Hand, Foot and Mouth Disease: http://www.cdc.gov/features/handfootmouthdisease/.
  3. What are the Symptoms of Scarlet Fever? http://www.webmd.com/a-to-z-guides/understanding-scarlet-fever-symptoms.
  4. What You Should Know About a Smallpox Outbreak, Emergency Preparedness and Response, http://emergency.cdc.gov/agent/smallpox/basics/outbreak.asp.
  5. http://insidetheclinic.com/lie-bumps-on-tongue/
  6. Glossitis: https://en.wikipedia.org/wiki/Glossitis#Strawberry_tongue
  7. Sore or painful tongue: http://www.nhs.uk/conditions/tongue-pain/Pages/Introduction.aspx.
  8. Kawasaki disease, Mayo Clinic Staff, http://www.mayoclinic.org/diseases-conditions/kawasaki-disease/basics/symptoms/con-20024663, last accessed on 23rd August 2016.

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