Birthmarks are common markings often seen on the skin at birth or shortly after. While most frequently found on the body’s surface, these spots can also appear in less common locations, including the tongue. A birthmark on the tongue is possible, though less common than those on skin. These oral markings result from developmental variations rather than external factors.
Common Types of Tongue Birthmarks
Tongue birthmarks generally fall into two main categories: vascular lesions and pigmented lesions. Vascular lesions arise from abnormalities in blood vessel development. Hemangiomas are a type of vascular lesion that can appear as raised, reddish-blue masses on the tongue, often growing rapidly in infancy before gradually regressing. Vascular malformations, another type, typically present as flatter, purplish spots that tend to grow proportionally with the child and do not usually regress.
Pigmented lesions result from an accumulation of pigment-producing cells. Congenital nevi, or moles, are examples of pigmented birthmarks that can manifest on the tongue as flat or slightly raised brown or black spots. Lentigines are similar, appearing as small, flat, dark spots. These pigmented markings are often benign, but their color and size can vary.
How Tongue Birthmarks Form
Tongue birthmarks develop due to localized irregularities during fetal development. Vascular lesions, such as hemangiomas and vascular malformations, result from errors in the formation of blood vessels. Hemangiomas are caused by an overgrowth of blood vessel cells, while vascular malformations involve abnormally formed blood vessels that do not regress.
Pigmented lesions occur when melanocytes, the cells responsible for producing pigment, accumulate in a specific area of the tongue. These developmental variations are generally not inherited.
Distinguishing Birthmarks from Other Oral Spots
Many common oral conditions can resemble birthmarks, making differentiation important. Geographic tongue, also known as benign migratory glossitis, presents as irregular red, smooth patches often surrounded by a white border, creating a map-like appearance that can shift over time. Oral thrush, a fungal infection, appears as creamy white, slightly raised patches on the tongue that can sometimes be wiped away, revealing a red, sore area underneath.
Canker sores are yellow or white spots with red borders, while oral fibromas are firm, smooth, dome-shaped lumps that develop from chronic irritation or trauma. Benign hyperpigmentation can also cause harmless dark spots on the tongue. Given the varied appearances of oral lesions, professional diagnosis is important to differentiate between benign conditions and those that might require medical attention.
When to Seek Professional Advice
Seek professional medical or dental advice for any new or changing spots on the tongue. Signs that warrant a visit to a healthcare provider include changes in the size, shape, color, or texture of a tongue mark. Persistent pain, bleeding, or discomfort associated with a spot also signals a need for evaluation.
Difficulty with eating or speaking, or the appearance of any new, unexplained spots, particularly in adults, should prompt a medical consultation. A doctor or dentist may perform a visual examination and might recommend a biopsy for definitive diagnosis. While many tongue birthmarks require only monitoring, treatment options like laser therapy or surgical removal may be considered if they cause functional issues or cosmetic concerns.