Dental/Oral Health

Red & White Patches on Tongue Causes and Treatment

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White & red patches on tongues are forms of tongues discoloration. Does cancer, HIV and fever cause these patches? Why do they occur on side and back of the tongue during pregnancy, on babies and adults? Read on find more including pictures and treatment options.

What causes Red & White patches on Tongue?

Experiencing tongue problems can really frustrate your comfort. A healthy tongue should be pink in color with small nodules known as papillae. Sighting a discoloration or soreness on the tongue especially one that is visible when you speak or laugh may lead to a feeling of distress.

white, red, patches on back, side of tongue causes and treatment

Healthy tongue

A discoloration of the tongue may not seem serious in the beginning and fortunately, do resolve easily. However, some of them are caused by an underlying condition that needs to be diagnosed, identified and treated. Some of the serious causes revolve around vitamin deficiencies, oral cancer, leukoplakia, fungal infection and even AIDS. When you observe an abnormal color on any part of the tongue, it is important to seek medical advice immediately.

Having white spots (leukoplakia) or red spots (erythroplakia) may be shrugged away by recommendation that you consume plenty of water as they may be caused by dehydration. There is more to just dehydration that should be considered. White spots are presumably the least harmful.

The white patches do not just start of as such. They begin as small white dots on the tongue and grow bigger with time until an inconsistent coating on the tongue is formed. This is likely an underlying condition at the organic level and should be immediately addressed.

This material looks at the causes of both white and red patches on the tongue and the possible treatments or management methods available.

Causes when sick

Hairy Leukoplakia

This condition involves the excessive growth of cells in the mouth which may lead to the occurrence of the white patches in the oral cavity. The tongue also falls culprit of this overgrowth. Leukoplakia can play a big role in the pathology of mouth cancer and is therefore important that white patches are diagnosed for their causes. Irritation of the tongue can also result in leukoplakia and especially in those people who smoke tobacco. The fuzzy white patches may also be due to an infection with Epstein-Barr virus (EBV) that lasts a lifetime but triggered by a weak immune system (Mayo Clinic)

Oral thrush

Oral thrush is caused by Candida albicans and is a yeast infection developed in the mouth. It is common to observe white patches in any part of the oral cavity but mostly affecting the surface of the tongue and mouth. This condition is most common and prevalent in infants, the elderly and the immunocompromised patients such as HIV patients. Intake of steroids for an asthma or lung disease also pre-exposes your body to candidiasis infections. This is inclined towards a weakened immune system. People with diabetes can also get the oral thrush. Those patients on long-term use of antibiotics face a higher risk of being infected as the antibiotics wash away the normal gut flora (beneficial bacteria). This favors the growth of fungi. A long term infection with this fungus causes white patches in the mouth, lesions that resemble cottage cheese, cracked corners of the mouth (angular chelosis) and lips and loss of taste.

Scarlet fever

Scarlet fever is due to a throat infection caused by a germ (bacterium) called streptococcus. There are various types (strains) of streptococcus. They cause different infections and a strain called group A streptococcus causes most instances of scarlet fever.

The scarlet fever rash occurs when the streptococcal bacteria release poisons (toxins) that make the skin go red. The toxins get into the blood from the infected throat. Scarlet fever is most common in children aged under 10 years, the most common age being 4 years.

Presents as strawberry-colored tongue and fever. The tongue is red in color and will require immediate attention and treatment with prescribed antibiotics.


Having sexual intercourse without any protection may lead to an infection with Treponema pallidum. Syphilis not only localizes in the genital, but also may occur as small painless sore or even ulcers on the tongue if you have had oral sex. It just requires a span of 10 to 90 days for manifestation. Untreated syphilis leads to white plaques on the tongue known as syphilitic leukoplakia.

Vitamin deficiencies

Folic acid deficiency and vitamin B-12 also has signs of erythroplakia.

Geographic tongue

Benign migratory glossitis occurs as a pattern of fissures resembling a map with red spots. The red spots then, if left untreated, may consistently cover a larger surface of the tongue. The patches may have a white border around them. Such needs to be checked and investigated so as to determine the correlation of the redness with geographic tongue.  At this point, no treatment is necessary as it will clear on its own.

Dehydration is also associated with white patching on the tongue

During pregnancy

Tongue sores

Tongue sores in pregnancy manifest as bumps, white coating, irregular red patches, white lines on the tongue and painful sores common on and underside of the tongue.

Yeast infections

Fungal infections are common during pregnancy as at this time the immune system of the mother has been suppressed to accommodate the baby. It is estimated that by the age of 25, all American women will have had at least one yeast infection. Thrush may also occur due to hormonal change that occurs during pregnancy. Diseases such as diabetes also raise the risk of experiencing an oral thrush during pregnancy[i].

Vitamin deficiencies

Expectant mothers are likely to experience deficiencies in vitamins and will probably need supplements. This is because they need to take in enough nutrients for her and the proper growth of her developing fetus. Deficiencies of folic acid and vitamin B-12 may lead to red-colored tongue.

Oral lichen planus

This condition shows as white lines on the tongue its shape resembling that of a lace. The white lines may meet up, coalesce and form patches on the tongue.

Babies, Toddlers, and Adults

Breastfeeding babies and toddlers also at times get white spots on their tongues. Oral thrush is the most common cause of white patches on the tongue. It may extend to the lips and cheeks. This is because their immune system is not well developed to fight new infections with the innate (inborn) immune response. They however get the acquired immunity that enables them fight off another occurrence disease of a disease.

Milk residue remaining on the tongue especially the hind milk, may also result in a white patch. You need not worry when this happens. You could test this by touching the patch on the tongue. If it fades away, then you are good.

Adults are more exposed to environmental hazards including stress and pathogens. They are likely to get white or red patches on the tongue due to fungal infections. The oral thrush may also be got from oral sex and kissing.


HIV patients have a weakened immune system. Oral candidiasis is therefore very common especially with the strains of Candida albicans, Candida glabrata and Candida tropicalis. They are normal flora of the mouth but once you have a weakened immune system, you could get infected by them.

Reports describe the oral candidiasis during the acute stage of HIV infection occurring with the falling CD4+ T-cell count in the middle and late stages. According to Deborah Greenspan’s study, most persons with this infection carry a single strain of Candida. This is in both the clinically apparent state and latent stage (hidden)[ii]

Hairy leukoplakia also shows up in HIV patients causing whitening of the tongue. This appears mostly on the side of the tongue and inside the cheeks and lower lip (National Institute of Dental and Craniofacial Research)[iii]

Dry mouth and tooth decay, which are common in HIV patients as they do not produce enough saliva to chew comfortably. This also pre-exposes them to tooth decay.


Sores or ulcers in the mouth that do not heal and pain, do not alleviate are a common sign and symptom of mouth cancer. Before cancer shows up, there must have been an array of change seen on the mouth including the tongue. These indicators include:

  1. White patches on the tongue
  2. Red patches on the tongue

Pictures of patches on tongue-White, Red & Pink

Below are pictures of patches on tongue

White Patches

white-patches on tongue side-back

White patches appearing on tongue

Red Patches

red patches-tongue causes get rid

Red parches

Pink patches on tongue  Pictures

pink patches opm tongue

Pink Patches


White Patches on Tongue; side, and Back of the Tongue

White patches on tongue that come and go

The white patches are consistent covering an area completely. You can see this from the pictures.

Individuals may have varying whites either as patches or dots. The dots may be shiny. Some patches spread past the tongue surface to the underside, the sides and even the cheeks and throat.

White Patches under Tongue

Patching and coating occur on the underside. Though many associate this with AIDS as a complication, there are many other causes that need to be considered.

White Patch on Side of Tongue

Mind boggling questions are if the white patches on the side of the tongue cancers or an STD. it is true that cancers of the mouth mostly affect the sides of the tongue but that does not always apply. The size of the patch does not signify cancer and neither does it say it’s a benign patch.

While general practitioners may rule out cancer and instead go with the possibility of leukoplakia as the cause, a biopsy is necessary. The biopsy is necessary for the determination of the severity of the condition and whether it has gone cancerous.  This will enable administration of treatment appropriately.

Care must be taken when the patches are thought to be of immunologic basis, a malignancy or benign tumors. Trauma may also be a cause of white patches on the side of the tongue.

White Patches on Back of Tongue

According to doctors on HealthTap, precancerous white patches are mostly localized on the back of the tongue. A sore throat could also be a cause among others such as geographic tongue, yeast infection and papillitis.

Do not conclude for yourself that the patch may be associated with a particular condition, but rather visit a doctor you could consult to get the best diagnosis.

Red Patches on Tongue: Painless & Sore throat

Red Patches on Tongue

Red strawberry colored tongue accompanied by a sore tongue, spots on the throat and on the tonsils, is associated with several conditions such as:

  1. Scarlet fever
  2. Tonsillitis – Tonsillitis is painful swelling in the tonsils, causing sore throat, red tonsils, pain, fever, and more.
  3. Hypersensitivity reaction
  4. Viral pharyngitis
  5. Side effects of medications
  6. Kawasaki disease
  7. Thalassemia
  8. Burn by high temperature foods and drinks

Smooth Red Patch on Tongue no Pain

What does a smooth or painless red patch on your tongue mean? Most patients who have had this condition say that it comes and goes without treatment. According to some dentists, this condition is usually benign. You should seek medical attention if;

  • It is accompanied with a burning effect.
  • The patch keeps on growing
  • Causes other problems such as swallowing

Pink Patches on Tongue Indication

The ideal color of a normal tongue is bright pink. Any color contrary to that including those commonly seen are white, bright red and purple are signs of underlying health issues.

It occurs that having a pink patch on the tongue on which the bright red is the predominant color, shows that there exists a health problem too. If the tongue has a red tip with the rest pink, then thyroid or cardiac issues will have to be confirmed. If the sides of the tongue are reddest, then this is an indicator of liver or gall-bladder problems.

The pink patches are parts of the tongue not patched with the discoloration and will most definitely fall between patches of bright red, purple or white.

How Treat and Prevent, white and Red Patches on Tongue

  1. Oral thrush treatment – treatment varies with different people and where you have the thrush. In pregnant women, doctors prescribe medications formulate for children. This is important as they are not harmful to the developing fetus. This happens in the first trimester. Nystatin creams are widely used for oral thrush. If you would like to go natural, then you should be looking at yoghurt (plain. This can be applied directly to the infected section. Treatment for such takes close to 10 days.
  2. Avoid dehydration causes as this lead to dry tongue and eventually white patches. Take plenty of water in a day.
  3. Consume some folic acid supplements that are available in the pharmacy. Consult the pharmacist or a clinician in order to understand how to take it so as not to overdose. Get vitamin C and iron tablets. All these are treatment for the white patches on the tongue.
  4. Limit the use of salty foods as they may irritate the sensitive tongue or dehydrate the tongue off its moisture content.
  5. Maintain proper oral cleaning your oral cavity about three times a day, you will be able to eliminate any harmful microbe in the mouth that may result in another infection.
  6. For white patches caused by mouth cancer, surgery is the most common treatment. The size of the cancer also determines the type of operation to be undertaken. The aim of the surgery is to remove the cancerous tissue and prevent its spread. One type of surgery known as laser surgery is used to eliminate small mouth cancers. This is combined with a light-sensitive medicine known as photodynamic therapy (PDT).
  7. Radiotherapy may also be used to treat the cancers. It utilizes a beam of high energy radiation. It is an effective treatment of malignant cancerous tissues[iv].

Sources and References





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