Red Spots on Tongue, Under, Back, Tip of Tongue

by Annie Shuler

Why do I have red dots on my tongue or what causes red spots on my tongue? Get insight on possible causes of red spots on tongue that could be small (little, tiny) or big, painful or painless and on tip of your tongue, under tongue, side or back of the tongue as well as some symptoms that accompany them.

Anyone can have red spots on tongue i.e. the problem can affect children (babies, infants, newborns or toddlers) as well as adults. However, some causes such as Kawasaki disease or hand foot and mouth is known to affect children, especially those below 5 years.

The appearance of the red dots on tongue might vary in size, shape and color (e.g. light red, bright red or dark red spot on tongue). Most people have reported small red spots on their tongue while a few report big red spots or dots. Furthermore, the dots or spots may be many (clustered or evenly distributed on the tongue), a few or even just one small or two dot on the tongue.

Finally, the red tongue spots might be bumpy (raised above tongue surface) or flat and they can be located on any part of the tongue including the tip of the tongue, side of the tongue, back of the tongue, under the tongue or even on the entire tongue surface. In some instances, the red spots can also be on the tongue and roof of mouth, on gums, inner cheeks, inner lips, or even on your lips.

Symptoms of red spots on tongue

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The obvious symptom or sign is the appearance of the red spots or dots on the tongue. They could be painful or painless or have a burning sensation (feeling like you got burnt). Other symptoms will depend on what is behind the appearance of the spots. We will give you specific symptoms often accompanied with red spots on tongue while looking at each of the possible causes. This will make diagnosis much easier.

Why do I have red dots on my tongue or red spots on tongue causes

A red spotted tongue is nothing anyone wants to have especially due to the many rumors associating such spots with STDs like HIV or cancer. Before you worry yourself to death for no reason, here are some of the most possible causes of the red dots on your tongue.

Inflamed papillae

img source: healthline.com

A more common cause of red dots on tongue that hurt (painful red spots on tongue) is inflamed papillae. This can be due to “burns, traumatic injury, eating spicy/hot food or beverages, or accidentally biting your tongue. Smokers commonly get these dots that usually resolve themselves”.

Strawberry tongue

One of the most common cause of red dots on tongue is condition known as strawberry tongue. When you have it, your tongue will change from normal pink color to red or have the strawberry color “with enlarged, red taste buds dotting the surface” i.e. your taste buds enlarge making them appear as red dots on your tongue surface.

Possible causes of strawberry tongue include lack of vitamin B-12 and folic acid, benign migratory glossitis, or scarlet fever.

Scarlet fever

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One of the possible cause of the red spots on your tongue could be scarlet fever. Scarlet fever is a bacterial throat infection caused by the various strains of streptococcus. When you have scarlet fever, your “tongue may become pale but coated with red spots”.

The small red rash will normally begin showing on your upper chest and neck before spreading to other body parts including your tongue, lips, nose, etc. and they feel like sand paper. Other symptoms of scarlet fever include a sore throat, fever, headache, feeling unwell, nausea, among others.  Treatment is by a 10 day phenoxymethylpenicillin course or other antibiotics.

Kawasaki Disease

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This is a viral disease that affects mainly children who are below the age of 5 years that affects their lymph nodes, skin and mouth. It causes fever, swollen feet soles and palms that turn purple, swollen lymph nodes, “swollen tongue with a white coating and big red bumps”, red, dry cracked lips, rash on chest, genital, and stomach, severely red eyes, etc.

If untreated, it could cause complications including blood vessels inflammation or arrhythmias where heartbeat pattern is interfered with. Treatment is by “intravenous (IV) doses of gamma globulin (purified antibodies)”.

Oral cancer

img source: wikimedia.org

Oral cancer tends to affect various parts on your mouth, lips and two thirds of your front tongue including the under your tongue. Cancer on the back of the tongue or base is considered part of neck and throat cancer.

In early stages, mouth cancer does not cause any pain and it can start as a small (tiny, little) spot or sore on any part of your mouth including your tongue i.e. “flat, painless, white or red spot or a small sore”. It is easy to confuse cancer with a cold sore mouth that won’t go away.

To be certain it is cancer, the symptoms you should look for include:

  • Sores in your mouth including sores tongue that won’t go away easily and tend to bleed quickly.
  • Tenderness, pain, and numbness on any part of your mouth or lips
  • Eating, chewing, speaking and jaw and tongue movement problems and pain
  • “A sore throat or feeling that something is caught in the throat that does not go away”
  • Squamous cells (flat cells on mouth surface).

Most people often confuse canker sores to be cancerous since they are painful but that is not the case. Canker sores should heal after two weeks. If they do not go away after that period, you need to see a dentist for extermination. Oral cancer treatment is by chemotherapy, radiation therapy, surgery and targeted drug therapy. Other conditions to watch for include:

  • Erythroleukoplakia – This are red and white patches on the tongue that tend to be cancerous. In case you have them and they last for more than two weeks, get checked.
  • Erythroplakia – This are velvety bright red patches on the mouth and tongue that are precancerous i.e. “75 to 90 percent of cases, erythroplakia are cancerous, so don’t ignore any vividly colored spots in your mouth”.

Digestive disorders such as acid reflux

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Having acid reflux is known to result to red dots or bumps on your tongue when the acid regurgitated from the stomach reaches your tongue surface. Common symptoms of acid reflux include a heartburn, regurgitation, bloating, bloody stool, hiccups, dysphagia, etc.

Allergic reactions

Allergic reaction to various allergens such as pet dander, food, medication, etc. can cause swollen tongue as well as red dots on tongue. Allergic reactions will have other symptoms such as itching mouth, swollen lip, face or throat, wheezing, trouble in breathing, nasal congestion, dizziness, hives, etc.

Vitamin deficiency and pernicious anemia

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Lack of vitamins, especially vitamin B-12 is known to cause red spots on tongue. Ensure you have foods rich in vitamin B-12 that include shell fish, liver, mackerel fish, crustaceans, fortified soy products, fortified cereals, red meat, skimmed milk, cheese and eggs.

There is an association between red spot on tongue and anemia, especially pernicious anemia. The most common symptom of pernicious anemia is a smooth red beefy tongue, heartburn, nausea, depression, confusion, weight loss etc. It is caused by deficiency in vitamin B12 and iron deficiency.

Canker sores

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Your painful blister like red spots on tongue could be due to canker sores especially if they have yellow or white center and a red ring surrounding it. Canker sores will have other symptoms such as malaise, fever, swollen lymph nodes.

Strep throat

If you notice you have prickly tiny red dots (petechiae) on your tongue, especially at the back of your tongue, you could be having strep throat (a bacterial throat infection). These small dots will be either dark red or bright red i.e. “you will commonly see a swollen uvula, tiny red dots along the back of the tongue and throat”.

Common symptoms of strep throat include throat pain, headache, and rash, tiny red spots on hard and soft palate, swollen tonsils with white patches, swallowing difficulties, among others.

Lie bumps or transient lingua papillitis

Another possible cause of little white or red spots or bumps on tongue is lie bumps i.e. “little white or red bumps form when papillae become irritated and slightly swollen”. They are commonly caused by stress, local trauma, splitting taste buds, acidic or sour foods, smoking, menstruation, etc.

Red spots on tongue STD or Dots

img source: medicalnewstoday.com

Sometimes, your red spot on tongue could be caused by STDs. For instance, during initial stages, one is likely to have small (little or tiny) painless sore on the tongue, vulva, vagina, lips, cervix, or the point where the bacteria causing the disease enters the body. The “rash can look like rough, red, or reddish brown spots”. At the secondary stage, lesions and sores in the mouth are also common.

However, red dots on tongue are not a sign on HIV but a weakened or compromised immunity could allow other infections to cause the spots.

Hand-Foot and Mouth Disease

This is a disease that affects children who are under the age of 5 years. Hand foot and mouth disease causes “red spots on the tongue, gums or inside of the cheeks”.  These spots will ten to form ulcers or blisters that are very painful and it has other symptoms that include red rash on feet sole, buttock, palm, sore throat and fever.

Other causes of red dots on tongue

img source: medicalnewstoday.com

  • Eczema – Excessive tongue irritation due to eczema can make bacteria in your mouth to attach your taste buds
  • Geographic tongue – If you have a map like looking tongue that might have red spots. When small, you will have red spot on tongue with white ring bordering it. This problem is painless. In case of pain, see a doctor.
  • Prolonged alcohol consumption or excessive smoking
  • Eating hurt and spicy foods
  • Physical injury or trauma including tongue piercing
  • Asthma
  • Excessive body heat
  • Oral thrush
  • Cold sores
  • Ulcers

These are not the only causes of red dots on tongue. It is advisable to see a dentist for diagnosis and treatment in case your red spots do not disappear quickly.

Small red spots on tongue or little or tiny red dots on tongue

img source: medicalnewstoday.com

The common causes of small (tiny or little) red spots on tongue include scarlet fever, initial stages of oral cancer, lie bumps, STDS, strep throat, geographic tongue and or any other cause we have already discussed above. In most instances, the little red spots on tongue are not caused by oral cancer unless accompanied by other symptoms discussed above.

In case of having small red spots on tongue and metallic taste, it might be due to allergic reactions (especially as a result of use of some medications) or excessive exposure to alkaline or acids. Cancer treatment, pregnancy and gum diseases are also associated with metallic taste in the mouth.

To know what could be behind the small red dots on tongue, you need to look at the accompanying symptoms such as fever, sore throat, fever, soreness (whether the tinny red spots hurt or not), etc.

Red spots under tongue or dots

Some of the common probable cause of red dots under tongue include general irritation of the tongue, canker sores, allergic reaction, trauma or injuries (especially with red blood spots under tongue), salivary duct stones and oral cancer. Any of the other causes of red spotted tongue discussed above could also be behind the problem.

Effective treatment requires correct diagnosis of the underlying cause. Once you are certain what causes it, you need to ensure it is treated. Furthermore, proper oral hygiene is paramount.

Red dots on tip of tongue or spots

img source: medicalnewstoday.com

If you have dots on the tip of your tongue which could be small (tiny or little) or big, they can be due to a number of causes. Some of the likely causes of such spots include inflamed taste buds, trauma or injuries,  cold sores, scarlet fever, geographic tongue, oral herpes, earlier stages of syphilis (uncommon), allergic reactions, cancer, etc. Carefully look at other accompanying symptoms to be able to tell the cause.

Red spots on back of tongue or dots on back of tongue

Why do I have red dots on the back of my tongue? It is normal to wonder. Having red spots or dots on the back of your tongue can be due to a number of causes. The common ones being strep throat,  trauma, allergies, canker sores, syphilis, cold sores, Kawasaki disease (in children), leukoplakia, scarlet fever, throat cancer, among others.

To be able to tell what causes the dots on the back of your tongue, you need to look at the other symptoms accompanying the dots (e.g. sore throat, swallowing difficulties, fever, etc.,) as well as their size and appearance i.e. big red spots, dark red spots, etc. For instance, if you have red spots on back of tongue and a white coating, it is likely you have oral thrush while big red ones can be canker sores or Kawasaki disease.

Red spots on tongue toddler

img source: babycenter.com

Red spots on baby tongue or children could be due to canker sores, inflamed papillae, Kawasaki disease, strep throat, and hand foot and mouth disease, among other conditions. They can make feeding difficult for the child. See a pediatrician for diagnosis if the red dots on a child do not go away after a few days.

Red spots on tongue and sore throat

Having red spots on tongue and sore throat could indicate a throat infection such as strep throat which is known for small red spots back of the tongue and sore throat. It is accompanied with other symptoms such as fever, headache, swollen neck lymph nodes, throat pain, cough, etc. Other conditions including oral cancer, scarlet fever and Kawasaki disease are also known to cause red tongue dots accompanied with a sore throat.

Red dots on side of tongue

img source: lsuhsc.edu

Having red dots on the side of tongue is not specific to a certain disease or condition but it could be caused by any of the many causes we have discussed including trauma and injuries from tongue biting and dental appliances.

Red sore spots on tongue or painful dots on tongue

Having red sore spots on tongue could be an indication of a number of diseases and conditions that will include oral cancer, canker sores, foot-hand and mouth, inflamed papillae, trauma (injuries), etc. Try various home remedies such as chewing ice to sooth your red spots on tongue that hurt as well as taking anti-inflammatory medications.

Painless red spot on tongue

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Painless red spots on the tongue can be due to a number of cases. In fact most of the causes we have discussed except cancer, canker sores, inflamed papillae or injuries, foot-hand and mouth, do not cause any pain. Causes such as excessive smoking, alcohol consumption, a geographic tongue, etc. are not commonly accompanied with pain.

Big red spots on tongue

If you have big red spots, the most probable cause is Kawasaki disease if the affected person is a child. Otherwise it could be tongue cancer, canker sores, geographic tongue, among others.

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