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Dermatology  (Expert Forum)
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Painful White Spots on Tongue
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
Welcome to the DERMATOLOGY FORUM! Questions in this forum are answered by Dermatologists from St. Luke's Roosevelt Hospital, under the direction of Andrew Alexis, M.D., M.P.H.

Painful White Spots on Tongue

by Eric1444256, Dec 03, 2005 12:00AM
Background:

I'm 45 and have Herpes Simplex II for about 10 years and due to laziness, have just now begun being treated for it with daily suppression therapy using Acyclovir.  It works fine.  

Ironically, I'm one of those with Simplex II who only suffers oral symptoms.  (You may know that due to the prevelance of oral sex, the line between I and II has blurred.)

I have performed oral sex on women who were suffering from yeast infections, in the past.  I am single, and have had multiple sex partners.

About 6-8 years ago I began suffering from a symptom: various taste buds on the top of my tongue turning white and becoming painful, each feeling like tiny pin pricks on my tongue.  I always thought that this was a symptom of herpes (even though I was suffering pain - and everyone knows that pain does not accompany herpes outbreaks).  My tongue symptoms are worse when I was under stress, and after I ran the Chicago Marathon my tongue broke out with about a dozen such white "spots" that were very painful indeed.  

I went to see an ENT specialist, but the spots went away before the appointment and there was nothing for him to see or diagnose, so he just sent me home without a diagnosis.  

I'm writing this because the suppression therapy took away my herpes symptoms, but the tongue pain outbreaks are still going on.  I am also under a lot of stress at work.

There is no pain were the white taste buds are not - only pain traceable to the whitened spots.  

Also, the white taste bud like spots come and go in different areas of the tongue, like chicken pox - again, suggesting a herpes connection.

A friend suggested Epstein-Barr.

I'm stumped.  Any ideas?

Thanks.



by Alan Rockoff, MD, Dec 04, 2005 12:00AM
Recurrent-type herpes doesn't usually affect the inside of the mouth.  What you describes sounds like irritation or perhaps so-called geographic tongue.  Neither is infectious.  For proper diagnosis, a doctor is going to have to see you in person.  If your condition is intermittent, try taking a photo when it's there.

Best,

Dr. Rockoff
Member Comments (2)

by Eric1444256, Dec 05, 2005 12:00AM
After I requested this post I found an older woman had made the same inquiry on a British website.  The British doc there suggested gargling with an antiseptic mouthwash and forgetting about it (there was nothing to worry about).  

I tried it, and it worked!  Instantly the pain was gone.  Wow.  It stayed gone, too.

Thanks for your help.

by baymomma, May 19, 2008 11:45PM
A related discussion, white spots on tongue was started.

by deb669, Aug 02, 2008 02:04AM
A related discussion, pain on the bottom of my tongue was started.

by shahyau, Jan 31, 2009 05:52PM
A related discussion, urgent help was started.
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