“I may seem crazy, but … does anyone notice that their tongue doesn’t look like a normal tongue? And does it get irritated easily?” asked a MyPsoriasisTeam member.

When most people think of psoriasis, they picture skin symptoms — not the tongue. But psoriasis and related conditions can affect the tongue too. These changes may cause pain, make eating uncomfortable, and impact your quality of life.

Read on to learn more about tongue psoriasis and how it may affect your mouth.

What Is Oral Psoriasis?

Psoriasis is an inflammatory condition that can affect different parts of the body. It most often shows up on the skin and in the joints, but in rare cases, it can affect the mouth. This is known as oral psoriasis. Symptoms may appear on the tongue, the inside of the cheeks, the lips, or the gums. Because oral psoriasis is easy to miss, people don’t always get the right treatment or relief.

What Does Psoriasis Look Like on the Tongue?

Tongue psoriasis can be difficult for healthcare providers to identify because there are no defined criteria to diagnose it. Oral psoriasis is generally considered extremely rare. However, people on MyPsoriasisTeam have reported having tongue symptoms: “When I first got this as a teen, my tongue went raw. Like someone had shaved off all my taste buds, my tongue went smooth,” one member shared. “It hurt to eat anything flavorful. Every doctor back then refused to accept or believe it was psoriasis, but I believed it was. It came and went a few times, but has been gone for a while now.”

“I have had my tongue swell and get blisters or ulcers,” said another member.

“My tongue is a wreck,” wrote another. “I have red, shiny patches on my tongue. It’s so painful. I’ve lost 5 pounds in less than a week since I’m not eating much. It really hurts to eat and talk.”

1. Oral Thrush

You may assume that every new skin symptom is a form of psoriasis, but white patches on the tongue could be a sign of another condition called oral thrush. Psoriasis can affect the body’s natural balance of bacteria, raising the risk of thrush — a yeast infection in the mouth caused by Candida. Although it’s not tongue psoriasis, thrush is an oral condition that can be more common in people with psoriasis.

“Has anyone experienced psoriasis on their tongue? The doctor suggested a biopsy, but I’ve looked into this. I don’t know why my tongue is yellow … even after using hydrogen peroxide toothpaste and brushing my tongue, it’s still yellow,” said a MyPsoriasisTeam member.

There’s some evidence that psoriasis may raise the risk of fungal infections such as oral thrush. Treatments for psoriasis, including biologic or steroid drugs, can also weaken the body’s natural defenses against these infections.

MyPsoriasisTeam members have described ongoing challenges with oral thrush.

“I have experienced oral thrush for over 10 to 15 years,” said one member. “The most annoying area in my mouth is on the hard palate (directly behind my front teeth). Behind the front teeth, it stays swollen, irritated, and uncomfortable.”

Another member said, “I’ve been battling a recurrent problem with my mouth. After months of showing it to every doctor and my dentist, the best conclusion was oral thrush. I used the prescribed mouth rinse. My mouth would get better, but never resolve.”

Tongue symptoms aren’t always easy to manage. But it’s important to keep seeking answers and discussing your concerns with your healthcare team.

2. Geographic Tongue

Geographic tongue is an inflammatory condition that can change the way your tongue looks. It leads to red areas surrounded by white borders, creating a pattern resmbling a map. Fortunately, it isn’t usually painful. Studies have shown mixed results on whether psoriasis raises the likelihood of geographic tongue. Either way, the condition may affect up to 9 percent of the general population.

3. Fissured Tongue

Another type of tongue lesion, called fissured tongue, has been linked to psoriasis. One study found this condition in 14.5 percent of people with psoriasis and just 7.5 percent of the general population. However, other studies have found an even bigger difference.

In fissured tongue (also called lingua plicata), a long groove forms down the center of the tongue. The condition usually doesn’t cause symptoms, but food can get stuck in the grooves and lead to irritation or bacterial growth. There’s no specific treatment for it, but good oral hygiene is important. Regular dental cleanings and avoiding smoking, sugary foods, and sweet drinks can help keep your tongue and mouth healthy.

4. Burning Mouth/Tongue Syndrome

People with autoimmune diseases (conditions where the immune system attacks the body) have a higher risk of developing burning mouth syndrome. It can also be linked to other mouth issues, like thrush or geographic tongue, or to anxiety or depression, which are more common in people with psoriasis.

“My palmoplantar pustular psoriasis is clear. But internally, the disease wreaks havoc,” said a MyPsoriasisTeam member. “I’m starting to get nerve damage. It has taken my gallbladder, caused stage 3 kidney disease, gastrointestinal difficulties, and burning tongue syndrome.”

In burning mouth syndrome, the mouth feels like it’s on fire from eating spicy foods. It can also become dry and numb and may tingle or sting. It may affect just the tongue or additional areas like the insides of the cheeks and lips. Taste changes, like bitter or metallic tastes or a loss of taste, can also happen with burning mouth syndrome. You can’t usually see any physical changes on the tongue.

Symptoms can start gradually (most often) or suddenly, and may follow daily patterns. Mouth discomfort can last for months or years and happens daily or comes and goes.

How Do You Treat Psoriasis on the Tongue?

It’s unusual for psoriasis to show up directly on the tongue, but it’s not unheard of. Let your dermatologist know if you develop symptoms anywhere, especially in your mouth. They can help you figure out the problem and offer different treatment options.

To treat psoriasis on the tongue or other symptoms of oral psoriasis, your doctor may recommend certain rinses for your mouth. As with other psoriasis flares, corticosteroids could help get tongue psoriasis under control. If psoriasis affects more than just the tongue, other medications may be recommended.

If you think you have psoriasis on your tongue, it’s important to get it checked by a healthcare professional who will provide an accurate diagnosis. For example, other oral conditions, like lichen planus, can seem like tongue psoriasis, but they’re not. Getting the right diagnosis will help you find treatment that works.

Join the Conversation

On MyPsoriasisTeam, people share their experiences with psoriasis and psoriatic arthritis, get advice, and find support from others who understand.

Have you noticed oral lesions, red patches, candidiasis, or a case of oral psoriasis? Let others know in the comments below.