Pimple on tongue: what it is and how to treat it

A sore white or red bump on the tongue looks like a pimple, and people often call it one. Acne forms in skin pores that hold an oil gland, and the tongue is covered by a moist lining. Two common causes of a pimple-like tongue bump are an inflamed papilla, one of the tiny bumps that cover the tongue, and a mouth ulcer such as a canker sore. Both usually heal by themselves. This guide explains what the bump is likely to be, how to ease it, and which signs mean a dentist or doctor should look at it. Skinli is an acne service and is not a doctor or a dentist. For pimples on the skin, the hub guide should you pop a pimple covers the choices.

Where acne forms, and how the tongue differs

MedlinePlus, from the U.S. National Library of Medicine, explains where acne comes from: "Acne occurs when tiny holes on the surface of the skin become clogged. These holes are called pores." It adds: "Each pore opens to a follicle. A follicle contains a hair and an oil gland."

The tongue is built differently. MedlinePlus says "The tongue is mainly made up of muscles. It is covered with a mucous membrane." A mucous membrane is the moist lining found inside the mouth. "Small bumps (papillae) cover the surface of the back part of the tongue. Between the papillae are the taste buds." Acne needs a pore with an oil gland, and the tongue's surface is papillae and lining.

So the useful question is which of the common tongue bumps you have.

Bumps that are a normal part of the tongue

Everyone's tongue is bumpy. MedlinePlus says papillae "cover the surface of the back part of the tongue," with the taste buds between them. MedlinePlus also describes color changes that look alarming but are harmless: "Sometimes the upper surface of the tongue turns black or brown in color. This is an unsightly condition, but it is not harmful." A bump that is new, sore or growing is the kind worth reading about below.

Lie bumps: transient lingual papillitis

The most common pimple-like bump on the tongue has a long medical name: transient lingual papillitis. Transient means it passes. Lingual means of the tongue. Papillitis means swollen papillae. It was named in a 1996 paper that described "one or more moderately painful, transient, red to yellow papules" on the front and top of the tongue. A papule is a small raised bump.

A 2017 study in the Journal of Clinical and Experimental Dentistry reviewed 11 cases and the earlier research. It says the condition has also been called "lie bumps or liar's bumps," and that it is "common but under-diagnosed." What it found:

• Look. The swollen papillae "may vary in color from normal, erythematous or whitish to yellow." Erythematous means red.
• Where. Often the tip, the sides and the top surface of the tongue.
• Symptoms. Pain, burning, tingling, itching, trouble eating and sensitivity to hot foods. In its own cases, 9 of 11 people had symptoms.
• How long. "Symptoms typically resolve after a few hours or 1 to 4 days." In its cases, the swelling went down in 3 to 10 days.
• Causes. The cause is often unknown. The study links it to "acute or chronic mechanical trauma," meaning biting or rubbing the tongue, as well as "sharp-edged teeth or restorations, orthodontic appliances," stress, lack of sleep, spicy or acidic foods, smoking and alcohol, allergy to foods or oral care products, and "hormonal changes during menstruation or menopause."
• Treatment. "Management of TLP is symptomatic," which means treating the discomfort while it heals. Patients were "advised to avoid tongue friction and irritating foods."

Canker sores and other mouth ulcers

A canker sore is a small open sore. MedlinePlus says: "A canker sore is a painful, open sore in the mouth. Canker sores are white or yellow and surrounded by a bright red area. They are not cancerous." It says they appear most often on the inner cheeks and lips, the tongue, the roof of the mouth and the base of the gums.

MedlinePlus lists things that can bring one on: "Mouth injury from dental work," brushing the teeth too hard, "Biting the tongue or cheek," "Emotional stress," low iron, folic acid or vitamin B-12, "Hormonal changes" and "Food allergies."

On timing, MedlinePlus says "The pain often goes away in 7 to 10 days. It can take 1 to 3 weeks for a canker sore to completely heal." The NHS says mouth ulcers "should clear up on their own within a week or 2."

Could it be the cold sore virus?

The virus that causes cold sores can also cause sores inside the mouth. MedlinePlus says herpes simplex blisters may form on the "Gums," "Lips," "Mouth" and "Throat." The NHS page on mouth ulcers says cold sores "can also appear as a small group of pinhead-sized ulcers inside the mouth." MedlinePlus says "Some people get mouth ulcers when they first come into contact with HSV-1 virus," and that these first symptoms "most often occur in kids between 1 and 5 years old." It also says "A canker sore is not the same as a fever blister (cold sore)." If you get a group of small sores with a cold sore on the lip, or after close contact with someone who has one, ask a pharmacist or doctor. The guide pimple patch on a cold sore covers how cold sores spread and how to protect others.

How to ease a sore bump on the tongue

The sources agree on simple steps while the bump heals:

• Avoid foods that sting. MedlinePlus says "Try not to eat hot or spicy foods, which can cause pain." The NHS says to avoid spicy, salty or acidic food, "rough, crunchy food, such as toast or crisps," and hot or acidic drinks such as fruit juice.
• Rinse with salt water. The NHS says to dissolve "half a teaspoon of salt in a glass of warm water," rinse, and spit it out. MedlinePlus says to avoid mouthwashes that contain alcohol, "which can irritate the area more."
• Drink cool drinks through a straw. The NHS lists this. For mouth sores from the cold sore virus, MedlinePlus suggests you "Gargle with cool water or eat fruit-flavored ice pops." Cold helps sore spots in other places too, as ice on a pimple explains.
• Brush gently. The NHS suggests "a soft-bristled toothbrush" and avoiding toothpaste that contains sodium lauryl sulphate.
• Leave it alone. Biting, rubbing or picking the spot is one of the triggers the 2017 study names.
• Ask a pharmacist. The NHS says a pharmacist can recommend "a painkilling tablet, mouthwash, gel or spray."

A tongue bump is swollen tissue or an open sore, with nothing inside to squeeze out. Pressing on it adds the rubbing that the 2017 study links to the problem.

When to see a dentist or doctor

Most tongue bumps are harmless. The NHS says mouth ulcers "are rarely a sign of anything serious." A few signs need a check. The NHS says to see a dentist or GP if a mouth ulcer:

• "lasts longer than 3 weeks"
• "is different to other mouth ulcers you've had before, for example if it's bigger than usual or near the back of your throat"
• "bleeds or becomes more painful and red," which "may be a sign of an infection"

The NHS mouth cancer page adds these reasons to see a GP or dentist: "a lump in your mouth, on your lip, on your neck or in your throat," "a red or white patch in your mouth," "pain in your mouth that's not going away," and difficulty swallowing or speaking. It says the symptoms "can be caused by other conditions," and that "finding it early may mean it's easier to treat."

MedlinePlus says sudden swelling of the tongue can happen "due to an allergic reaction or a side effect of medicines," and to "Seek medical attention right away if swelling is starting to make breathing difficult."

For canker sores, MedlinePlus says to call your provider if a sore "does not go away after 2 weeks of home care or gets worse," if you get them "more than 2 or 3 times a year," or if you also have a fever, diarrhea, headache or skin rash.

If you also have pimples around the mouth

A bump on the tongue and pimples on the skin around the mouth are separate problems. Spots on the lip line or chin are skin, and they can be acne, a cold sore or something else. The guide pimple on lip explains how to tell them apart, and the free Skinli acne plan looks at acne on the skin from a photo.