Have you noticed your tongue lately to be substantially red, a bit swollen, and with its bumps larger than usual? Then you probably suffer from what the doctors call “strawberry tongue”. 

"Strawberry tongue”, also known as “blueberry tongue” because it resembles the skin of these juicy fruits, is not a condition but a symptom of an underlying health issue. 

Understanding the various causes and the appropriate treatment for each cause is crucial for recovering and having your tongue return to its normal appearance. 

And this is what this article is about. 

 

Diagnosing a Strawberry Tongue

To diagnose whether you have a strawberry tongue or not, you must first check your tongue in the mirror and feel it in your mouth. A healthy tongue is typically pink with small bumps.

As already mentioned, if you detect instead that it is bright red, swollen, and bumpy, thus a bit more enlarged than usual, then you have your “diagnosis”. 

You have to visit a healthcare provider to verify your diagnosis and further diagnose the underlying condition. 

Notice also, that your tongue may be white or with white patches a few days before turning red and often feel irritable or painful, making it difficult to eat.

What Causes a Strawberry Tongue?

Several diseases or other health issues can cause this symptom. Some of them can be serious, especially if not treated on time, while others can be less serious. 

Here is a list of the most common causes of a strawberry tongue: 

 

1.Scarlet Fever 

Scarlet Fever is a bacterial illness caused by group A Streptococcus. The bacteria release toxins in the body that lead to the characteristic red, bumpy tongue. Children aged between 5 and 15 are more prone to suffer from this infection.

If you have scarlet fever you may also experience symptoms like a red rash, fever, headache, flushed cheeks, swollen tonsils, and sore throat.

2. Kawasaki Disease

Kawasaki disease is a condition most common in children below the age of 5 with unclear causes. 

Apart from a strawberry tongue, it involves inflammation of the blood vessels and presents with fever, red or pink eyes, swollen hands and feet, chapped lips, and peeling skin (first noticed around the nails).

It requires prompt medical attention to prevent complications in your child’s blood vessels. 

 

3.Toxic Shock Syndrome 

Toxic shock syndrome (TSS), is a rare but life-threatening condition caused by bacteria toxins produced prominently by Streptococcus (strep), Staphylococcus, and Clostridium bacteria if left uncured in the body. 

It is often associated with tampon use, skin wounds, or surgery. And even with tissue stuffing in a nose that is bleeding. Although rare, it may lead in some cases to a distinctive tongue appearance.

Symptoms include a sudden high fever, rash, headache, nausea or vomiting, diarrhea, and low blood pressure and develop fast usually within the first 48 hours.

4. Allergies

Allergic reactions to food, medications, or other substances can also cause the tongue to swell and turn red. 

They are often accompanied by other signs such as hives or difficulty breathing which can be soothed by antihistamines’ prescription. If not treated promptly may lead to anaphylactic shock which is a life-threatening symptom. 

5. Vitamin Deficiencies 

Deficiencies in certain vitamins, such as vitamin B12 and folic acid, can lead to glossitis, which can give the tongue a swollen and red appearance.

Symptoms like fatigue, weakness, memory difficulties, numbness, and balance issues come also with vitamin B12 and other vitamin deficiencies.  

Though not always presented as a classic strawberry tongue, the deficiency can cause a similar look.

6. Other Causes

There are a few other causes, mostly of viral origin, which are rarer yet serious and can also make your tongue red and strawberry-like. 

These include Yellow Fever, a viral disease transmitted by mosquitos.  Recurrent Toxin-Mediated Perianal Erythema, a Strep bacteria infection most common in young adults. Recalcitrant Erythematous Desquamating Disorder, a staphylococcal bacterial infection, and Yersinia Pseudotuberculosis an animals’ bacterial infection that can be transferred to humans through contaminated water and food.

The Difference Between a Strawberry Tongue and a Glossitis Tongue

Although similar in appearance, these two conditions have distinct differences. 

In glossitis, the tongue is red and swollen too but is not bumpy.  It’s glossy and you can’t see the tiny bumps. It also doesn’t feel itchy. 

Glossitis like a strawberry tongue is a symptom of another underlying condition, most often of B-12 deficiency. 

How to Treat a Strawberry Tongue?

Treatments vary and depend on the underlying health issue. Curing the cause will also lead to curing the red and swollen tongue. 

Your healthcare practitioner will take your medical history, ask for other symptoms, and order some tests for you (or your child) to diagnose the condition and prescribe you the medication you need. 

These may include: 

- Antibiotics

For bacterial causes such as scarlet fever and certain cases of toxic shock syndrome, antibiotics are the core treatment. 

Penicillin or amoxicillin is commonly prescribed for scarlet fever.

- Intravenous Immunoglobulin (IVIG)

IVIG and aspirin treat Kawasaki disease since they reduce inflammation and prevent coronary artery complications. 

In Kawasaki disease cases early diagnosis is critical and the treatment usually takes place in a hospital.

 

- Antihistamines and Corticosteroids

Antihistamines and corticosteroids treat food, medication, or other substance-related allergies. Doctors prescribe them to reduce inflammation and alleviate the full range of symptoms. 

In cases of anaphylactic shock, an injection of epinephrine (adrenaline)  may be necessary.  

 

- Nutritional Supplements

This treatment relates to addressing vitamin deficiencies and resolving both symptoms of glossitis or strawberry tongue. 

Supplements can be oral or can come in injections and usually, a change in diet is required too.

 

- Supportive Care

Treatment for TSS in particular, involves aggressive supportive care, including intravenous fluids and medications to stabilize blood pressure. 

It is also crucial to identify and eliminate the source of bacterial toxins, such as removing infected tampons or draining abscesses.

FAQs

1. What Is Strawberry Tongue?

Strawberry tongue refers to a condition where the tongue appears red and bumpy, resembling the skin of a strawberry. It is a symptom of various underlying health issues and not a condition in itself.

2. What Are The Common Causes Of Strawberry Tongue?

The common causes include:

• Scarlet fever
• Kawasaki disease
• Toxic shock syndrome
• Vitamin deficiencies (e.g., vitamin B12, folic acid)
• Allergic reactions
• Other viral infections.

3. What Should I Do If I Notice Symptoms Of Strawberry Tongue?

If you or someone you know exhibits symptoms of strawberry tongue, seek medical advice promptly. A healthcare professional will provide you with a proper diagnosis and appropriate treatment plan based on the underlying cause.