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Q. My tongue papillae are enlarged with redness and burning sensation. What is my problem?

Answered by
Dr. B Vageesh Padiyar
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Sep 16, 2020 and last reviewed on: Sep 19, 2020

Hello doctor,

I am a 31-year-old male. I do not use any medications except vitamin B complex for three weeks now. But the problem is my tongue has enlarged papillae (taste buds), and it is red on the sides and the whole front of the tongue. It is also a bit white on the top (it was more white in color all my life). And almost all the time, my tongue feels burning. Also, the tongue's centerline sometimes is more painful, and feels like I cut myself here. My partner sometimes used to have candidiasis, and I used to have oral sex with her. My symptoms started five months ago, and was better or worse but never gone away. I thought it was because of smoking, but I stopped smoking for three weeks and did not improve. I try to drink a lot of water. I drink coffee also and do not feel stressed. I tried to gargle with salt water for a week with no improvement at all. I stopped using a tongue brush for two months now, but I see no difference. I drink alcohol moderately. What should I do?

Dr. B Vageesh Padiyar

Otolaryngology (E.N.T)


Welcome to

Thanks for briefing the problem in concern. I had a detailed look at the pictures you have sent (attachment removed to protect patient identity).

There are no abnormalities that I can see on the dorsal or ventral aspect of your tongue. It does not look like candidiasis either. The only functional problem that could be there is what we call burning mouth syndrome and is usually attributed to vitamin B12 deficiencies, anxiety, or depression.

Please understand that if the cause has been a vitamin deficiency and it takes around four to five months time for the entire problem to get resolved. The other classical feature is its transient improvement for a few days, returning to its original state in the next few days.

Smoking could also be a factor. Even though you stopped three weeks ago, tobacco effects do exist in the body for at least six months, and often I have observed that this problem can exist until then.

The other possibility could be due to acid reflux. Kindly avoid having any oily, spicy, and junk food items as much as possible, eat on time, and focus on including lots of fruits and vegetables in your diet. Continue the saltwater gargles six to eight times a day and keep sipping on boiled warm water every two hours.

I would still recommend you to wait for a few more months and follow the above advice. This is a very common entity that I come across, and it can take months for this issue to resolve. At the same point of time, do not get too anxious about this issue as anxiousness causes stress levels to rise and delay the healing process.

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