What Causes Bumps on Your Tongue? Photos & Treatment

There are many reasons you can develop bumps on your tongue. Often, these growths are common, not serious, and tend to resolve without intervention.

Studies have found over 50% of people experience a temporary and benign form of tongue bumps called transient lingual papillitis, or “lie bumps.”

However, if bumps on the tongue become chronic, spread, or change shape, they can be symptoms of more serious conditions, such as oral cancer or certain viruses. Treatment depends on identifying the cause.

Bumps on the tongue are growths that appear on the top, tip, sides, underside, or base of the tongue. Their appearance depends on the underlying cause and can vary by person.

• Transient lingual papillitis: This causes one or more papillae (the tiny bumps on the outside of the tongue) to become inflamed and grow. These bumps may be normal-colored, white, yellow, and darker red and can become stained brown or black due to food or smoking. Affected areas can itch, burn, sting, or tingle.
• Blisters, sores, or ulcers: These bumps can also become painful and fill with fluid. They have an elevated white, gray, or yellow center and can be red around the edges.
• Oral cancer sores: These are typically gray, pink, or red and bleed when touched.
• “Strawberry tongue”: This appears swollen, bumpy, and red. It is often a symptom of scarlet fever (a bacterial infection).

Bumps on the tongue vary considerably in duration and severity. They may clear within a few days or persist for weeks, months, or longer. Depending on the underlying cause, they may cause difficulty eating and present alongside swollen lymph nodes, sore throat, headache, and other signs of infection.

Injuries, stress, infection, and oral cancer can cause bumps on the tongue. Here is an overview of the common causes:

Injury and Irritation

Transient lingual papillitis and canker sores can occur due to injury or irritation of the tongue, gums, or mouth. Common causes of these bumps include:

• Biting the tongue or irritation from damaged teeth
• Burns due to hot food or drink
• Certain mouthwashes, toothpastes, or tooth whiteners
• Orthodontics, such as braces or retainers
• Smoking and excess alcohol intake
• Poor oral hygiene
• Acidic foods

Emotional Stress

Other triggers for canker sores and transient lingual papillitis are emotional stress and anxiety. These mental health conditions can lead to bruxism (teeth grinding), which can affect the tongue. Repeatedly chewing on the tongue—which can cause bumps—can also be a sign of an anxiety disorder.

Stress and anxiety impact your immune system, worsening these conditions.

Infections

Sometimes, bumps on the tongue are signs of viral, bacterial, or fungal infections. Researchers have found some evidence that eruptive transient lingual papillitis may be linked to certain viral and bacterial infections. Other causes include:

• Herpes simplex (HSV): Cold sores are oral manifestations of the herpes simplex virus 1 (HSV-1). This virus affects up to 90% of the population and rarely causes symptoms. Highly contagious when active, HSV-1 is different than herpes simplex 2, the sexually transmitted infection (STI) that causes genital warts.
• Human papillomavirus (HPV): HPV is an STI that can cause irregularly shaped, benign growths on the tongue called squamous papilloma. HPV is generally asymptomatic but raises the risk of certain cancers.
• Syphilis: Syphilis, a sexually transmitted bacterial infection, causes sores, which can spread and develop into rashes and bumps on the tongue. These sores often affect the genitals, with other symptoms including swollen lymph nodes, fever, and fatigue.
• Streptococcus infection: Streptococcus (or “strep”) bacteria often starts with a distinctive sore, red throat and white spots on the tonsils. This condition can develop into scarlet fever, causing rashes on the body and a swollen, bumpy “strawberry” tongue.
• Human immunodeficiency virus (HIV/AIDS): HIV/AIDS is an STI that weakens the immune system, triggering canker sores and other tongue symptoms. HIV can include candidiasis (a fungal infection causing white dots) and hairy leukoplakia (hairy patches).
• COVID-19: In addition to fever, coughing, and loss of taste and smell, lesions in the mouth or tongue are symptoms of severe coronavirus-2, the virus that caused the COVID-19 pandemic.

Systemic Conditions

A range of health factors and diseases impacting digestion, nutrition, and the body as a whole can also lead to canker sores, lingual papillitis, and other types of bumps on the tongue:

• Vitamin deficiency: Low iron, folic acid, vitamin B3, vitamin C, and vitamin B12 may cause recurrent canker sores.
• Behcet’s disease: Behcet’s disease causes inflammation in your blood vessels, leading to neurological symptoms like stroke, blindness, and memory problems. It can also trigger canker sores.
• Inflammatory bowel disease (IBD): Conditions that cause chronic inflammation in the intestines, such as Crohn’s disease or ulcerative colitis, can also trigger canker sores, abdominal pain, blood in the stools, diarrhea, and other symptoms.
• Celiac disease: Celiac disease, a severe gluten intolerance, can also manifest as canker sores. It also causes bloating, fatigue, diarrhea, gas, and anemia (low iron in the blood).
• Hormonal fluctuations: Changes in levels of estrogen, the female sex hormone, due to menstruation or menopause can cause outbreaks of lingual papillitis or canker sores.

Allergic Reaction

Severe allergic reactions can manifest as bumps and tongue swelling. Tongue swelling is a symptom of anaphylaxis (allergic shock), a severe, and possibly fatal, body-wide response to an allergen. Anaphylaxis causes swelling in the face or limbs, breathing difficulties, hives, chest pains, and loss of consciousness.

Additionally, sensitivities to certain foods, asthma, and allergic rhinitis (hay fever) can trigger transient lingual papillitis outbreaks.

Oral Cancer

Oral cancer is relatively rare, representing about 3% of all cancer diagnoses. Oral cancer bumps typically appear on the gums and tissues inside the mouth or throat. However, a singular, hard bump on the tongue can be a cancerous growth.

Sores, red or white spots, irritated spots, numbness, lumps, and growths in the mouth are common signs of cancer. In addition to a sore throat, you may also have difficulty swallowing or chewing and experience pain.

Bumps on the tongue often aren’t caused by a serious condition and typically resolve on their own. However, you should see a provider if you’re experiencing:

• Ulcers, sores, or growths that persist or get worse after two weeks despite home management
• A persistent lump in the neck for a month or more
• Outbreaks of symptoms two or more times a year
• Fever, diarrhea, headache, nausea, vomiting, or skin rashes alongside tongue symptoms

Dentists and general practitioners can first identify tongue problems. They may refer you to an oral maxillofacial surgeon; ear, nose, and throat (ENT) specialist; or oncologist (cancer specialist) for treatment. Tests and examinations to identify the underlying cause of your symptoms include:

• A complete examination of the oral cavity, as well as affected areas
• Blood tests, which can detect signs of cancer, infections, and other diseases
• A biopsy, testing a sample of tissue for signs of cancer or HPV
• Imaging, such as X-ray, computer tomography (CT), or positron emission tomography (PET) scans

Treatments for bumps on the tongue aim to remove affected areas, prevent outbreaks of symptoms, or manage and minimize symptoms. Treatment depends on the underlying cause and individual case.

Home Remedies

Many bumps, such as transient lingual papillitis, go away within a few hours to a few days. For conditions like canker sores, home remedies can reduce symptoms and prevent flare-ups. Healthcare providers may recommend the following home treatments:

• Swish regularly with salt water
• Avoid spicy, very hot, or acidic foods
• Apply ice to affected areas
• Use antiseptic or anesthetic mouthwash
• Avoid gum, candy, or products that irritate the mouth
• Take iron, vitamin B3, vitamin C, and B12 supplements
• Use over-the-counter (OTC) topical anesthetics, such as Orajel (benzocaine)

Prescription Medications

Healthcare providers prescribe several types of medications for infections and other conditions that cause recurrent bumps on the tongue. These include:

• Topical corticosteroids, such as Triderm (triamcinolone acetonide)
• Antiviral drugs like Valtrex (valacyclovir) and Famvir (famciclovir)
• Antibiotics, including Moxatag (amoxicillin) and Sumycin (tetracycline)
• Systemic (oral) corticosteroids, including Decadron (dexamethasone)

Procedures

If medications and other methods are not yielding results, healthcare providers consider minimally invasive procedures. These include:

• Laser ablation: For laser ablation, providers use directed laser beams to burn off and remove cancerous or benign growths.
• Cryotherapy: Instead of relying on heat, cryotherapy involves applying a specialized liquid to freeze off and remove cancerous and noncancerous bumps.
• Surgery: Surgeons carefully remove cancerous tumors from the tongue to prevent their spread.
• Radiation therapy: Radiation therapy relies on radioactive energy to target and kill cancer tumors. Providers may try it in addition to surgery.
• Chemotherapy: Like radiation therapy, chemotherapy involves regular applications of medications that target cancer cells.
• Immunotherapy: Using substances derived from living organisms, immunotherapies spur the immune system to target cancer cells. Options include immune checkpoint inhibitors, T-cell transfer therapy, and others.

Preventing bumps on the tongue primarily involves avoiding substances that cause issues and promoting your health to prevent attacks. Depending on the condition you have, prevention methods include:

• Avoid acidic, hot, or spicy foods
• Manage stress with meditation, exercise, or other methods
• Ensure you get enough sleep (adults require at least eight hours of sleep a night)
• Practice safe sex
• Maintain oral hygiene by brushing at least once or twice a day and flossing at least once
• Have regular dental checkups and oral cancer screenings
• Eat a well-balanced diet rich in vitamins and iron
• Avoid or quit smoking, and avoid alcohol
• Use sunscreen, which prevents cold sore flares

Even though most cases are benign (noncancerous), some conditions that cause bumps on the tongue can lead to serious complications.

Oral cancer that advances will begin to spread locally and to other parts of the body. This leads to painful, difficult swallowing, speech problems, and mental health conditions like anxiety and depression, among other symptoms.

Canker sores that get severe can spread beyond the mouth, while also causing pain during eating or brushing teeth. Untreated syphilis can spread to the nervous system, brain, eyes, and ears. This can cause dementia, confusion, and visual and hearing problems.

Injury, burns, allergic reactions, infections, or other chronic diseases can cause bumps on the tongue. Depending on the underlying cause, this can manifest as clusters of small bumps, large blisters (lesions), or sores. 

Though many cases resolve, if the bumps last longer than two weeks, you should get medical help. Treatments can range from home remedies to medications and other procedures.