The normal tongue has a pink appearance. There are often innocent causes that cause a tongue to turn red, such as eating certain foods. However, a red tongue discoloration is occasionally a sign of an underlying medical condition. In the vast majority of cases, these underlying problems can be easily treated at home and/or remedied with medication. However, very rarely, further examinations and extensive treatments are necessary to treat the underlying condition of a red tongue, such as toxic shock syndrome or tongue cancer. In the vast majority of cases, the prospects for a red tongue discoloration are excellent and it will disappear on its own by following some lifestyle advice in combination with good dental and oral hygiene and/or with a short medical treatment.

• Cyanosis and red tongue color
• Erythroplakia and red-colored tongue
• Infections and tongue that is colored red

• Candidiasis and tongue that is colored red
• Cold sores and red tongue discoloration
• Scarlet fever and red tongue

• Map tongue and red appearance of tongue
• Papillitis and red tongue appearance
• Tongue cancer
• Tongue inflammation
• Toxic shock syndrome
• Vitamin deficiencies
• Power supply
• Kawasaki disease

Cyanosis and red tongue color

In a number of lung diseases and heart defects, the tissues and organs sometimes do not receive enough oxygen. Low oxygen levels in the blood cause cyanosis, the medical term for a blue discoloration of the skin, nails and lips. This causes the patient’s tongue tip to take on a red or purple appearance, which is characteristic of the condition.

Erythroplakia and red-colored tongue

Erythroplakia is a red area or lesion on the surface of the tongue that the patient is unable to wipe away. The tongue abnormality is similar to leukoplakia (thickened white spots in the mouth and cheeks). Patients with erythroplakia are more likely to develop tongue cancer compared to patients with leukoplakia. That is why the oral surgeon or ear, nose and throat doctor performs a tongue biopsy to rule out oral cancer.

Infections and tongue that is colored red

Candidiasis and tongue that is colored red

Various infections can affect the tongue. The most common infection is candidiasis. This fungal infection, caused by the fungus Candida albicans , causes inflammation of the tongue surface. The tongue then takes on a red color and is covered with a white coating. Once the coating is removed, the bright red color of the tongue is visible.

Cold sores and red tongue discoloration

Cold sores (oral herpes or cold sores) are viral mouth infections caused by the herpes virus type 1. Most children are infected by the herpes virus through a kiss from an infected adult. The virus remains dormant in the body and later causes occasional infections after exposure to a lot of sun or emotional/physical stress. The viral infection is contagious if an outbreak occurs. The main symptoms include:

• burning pain on the outside of the lips
• an itchy mouth
• a red tongue color
• numbness of the lips
• oral lesions
• pain on the outside of the lips

Simply staying at home is sufficient because the viral infection often disappears on its own. Balm mint cream (1%) or topical rhubarb-sage cream improve symptoms in some patients.

Scarlet fever and red tongue

Scarlet fever is a bacterial infection caused by streptococcal bacteria that mainly affects children. This infectious disease is accompanied by a sore throat, fever, a red skin rash with red dots and a strawberry tongue (bright red tongue). The patient normally recovers from the condition on its own, but sometimes a doctor prescribes antibiotics.

Map tongue and red appearance of tongue

Map tongue (benign migratory glossitis) is one of the most common tongue disorders in which a map-like pattern of reddish spots develops on the tongue surface. The spots are variable in size and occasionally a white border appears around the spots. The red spots sometimes move to another tongue area after a few days, weeks or months. Most patients do not experience tongue pain, but in some patients the spots are painful or tender when consuming certain foods or drinks. In principle, treatment is not necessary for map tongue, but if the patient experiences complaints and discomfort, the doctor prescribes topical medicines (applied to the skin).

Papillitis and red tongue appearance

With papillitis, the papillae in the tongue are inflamed. This causes painful, red dots on the tongue. The condition results from, for example:

• burns caused by the consumption of extremely spicy and hot food or drinks
• accidental tongue biting
• injuries to the tongue

Smokers most often experience these tongue spots, which sometimes disappear on their own.

Tongue cancer

Large red spots on the tongue very rarely indicate the presence of tongue cancer. This also causes other symptoms, such as:

• persistent palpable tongue ulcers or lumps on the tongue
• foul-smelling breath (halitosis)
• a (white tongue)
• a visible swelling or a tongue bump
• numbness in the mouth
• swollen lymph nodes in the neck) (indicates metastases in the lymph nodes = lymph node metastases)
• a sore throat
• pain when chewing
• swallowing pain)
• tongue bleeding (not the result of tongue biting or other tongue injury)
• tongue pain
• pain radiating to the ear (earache), the neck (neck pain) or the jaw (jaw pain) (uncommon)

Tongue inflammation

An inflammation of the tongue (glossitis) occurs for unknown reasons, but a number of conditions and environmental factors increase the risk of acute or chronic tongue inflammation, such as:

• alcohol consumption
• allergic reactions to mouthwash, toothpaste, … trauma, such as burns, rough teeth or a poorly fitting denture
• the Plummer-Vinson syndrome (swallowing problems and iron deficiency)
• medications such as medication for the treatment of diabetes mellitus, diuretics (water pills), ACE inhibitors (medicines against high blood pressure), etc.
• malnutrition due to, for example:
  • celiac disease (stomach and intestinal problems due to eating gluten
  • pellagra (form of malnutrition with niacin deficiency with symptoms in the skin, stomach, intestines and brain)
  • pernicious anemia (failure of absorption
• smoking)
• vitamin deficiencies such as vitamin B12 deficiency with symptoms of anemia and neurological signs)
• hot food, hot spices or other irritants

With glossitis, problems with the mouth and tongue develop quickly or gradually, such as aphthous mouth ulcers, a slippery tongue surface, tongue pain, tongue tingling, changes in the sense of taste, a swollen tongue, chewing problems, swallowing problems and eating problems, as well as a red tongue. Good dental and oral hygiene is required. In addition, the doctor sometimes uses medication to treat a tongue infection. The doctor also treats the underlying problem.

Toxic shock syndrome

Toxic shock syndrome is one of the more serious causes of a red tongue. A toxin (poisonous substance) from a staphylococcal bacteria causes an immune reaction in the body. This potentially life-threatening condition leads to numerous possible complaints, such as a rash, fever, blood pressure problems, bleeding and organ failure. A bright red tongue or a raspberry tongue (strawberry tongue: bright red tongue with bumpy papillae) may be evident.A healthy diet with various nutrients and vitamins is necessary to meet the body’s needs / Source: Jill111, Pixabay

Vitamin deficiencies

Vitamin deficiencies, such as a deficiency of folic acid, an iron deficiency in the blood (ferriprieve anemia) and a deficiency of vitamin B12, may cause a reddish appearance of the tongue. In some cases, due to a vitamin deficiency, the tongue even resembles the appearance of a strawberry with enlarged, red taste buds. The patient must ensure that the vitamin intake meets the needs of the body.

Power supply

The patient may have eaten red-colored foods such as strawberries or beetroot. Also, some acidic foods cause a temporary red color. In addition, foods containing food colorings sometimes cause a red tongue color. Another temporary cause of a red tongue color is a burnt tongue, which is caused by consuming food or drinks that are too hot. Severe burns to the tongue require immediate medical attention. A milder tongue burn heals spontaneously.

Kawasaki disease

Kawasaki disease is a condition in which inflammation of the blood vessels in the body occurs for unknown reasons (form of vasculitis). Most often, this disease affects children under five years of age, usually boys. The condition also causes a red appearance of the tongue in some children.

read more

• Yellow tongue: Causes and symptoms of yellowish tongue color
• White tongue: Causes and symptoms of white appearance of tongue
• Glossitis: Inflammation of tongue with smooth & red tongue surface
• Black hair tongue: Change in coating on tongue
• Strawberry tongue: Bright red tongue with bumpy papillae