Strawberry tongue is used to describe a tongue that is swollen, and bumpy. Having a strawberry tongue is a symptom of an underlying condition.

When a person has strawberry tongue, their tongue is typically red. It may also be white and appear swollen. The color and the taste bud bumps on the surface may make it look like a strawberry or raspberry.

This article explores the symptoms and underlying conditions that may cause strawberry tongue. It also looks at how to treat the conditions that cause strawberry tongue.

Fast facts on strawberry tongue:

  • When a person has a strawberry tongue, their tongue looks more bumpy than usual.
  • Strawberry tongue may be a symptom of a food or drug allergy.
  • The treatment for strawberry tongue will depend on the underlying cause.
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Strawberry tongue is when the tongue is red and bumpy, making it look like the skin of a strawberry.

If a person has a strawberry tongue, their tongue may look:

  • red or red with white patches
  • swollen
  • enlarged
  • covered in bumps

Their tongue may feel irritated or painful. A person with strawberry tongue may also be experiencing other symptoms.

These are related to the underlying condition that has caused it.

Some underlying conditions that may cause strawberry tongue are explored below.

Kawasaki disease

Kawasaki disease is a condition that usually affects children. It causes certain arteries to become inflamed.

As well as a strawberry tongue, Kawasaki disease may cause:

  • red eyes
  • high fever
  • skin rash
  • skin peeling

Scarlet fever

Scarlet fever is a bacterial infection that may develop when a person has strep throat. It most commonly affects children aged 5 to 15.

As well as a strawberry tongue, scarlet fever may cause:

  • a red rash that covers most of the body
  • bright red areas in the folds of the skin
  • a flushed face over the cheeks
  • high fever
  • a sore throat
  • a headache

Food or drug allergy

Allergic reactions cause inflammation, which is why a person’s tongue may appear enlarged and bumpy.

Antihistamines help to reduce the symptoms of an allergic reaction.

Toxic shock syndrome

Toxic shock syndrome (TSS) is a rare complication that has been associated with using tampons and nasal gauze packing.

Contrary to popular belief, simply leaving in a tampon for a long time does not cause TSS.

TSS is usually caused by infection with the bacterium Staphylococcus aureus, but TSS also can be caused by the same bacterial species of group A Streptococcus, which causes scarlet fever. The makeup of the tampon allows the bacterium to multiply.

A 2011 study suggested synthetic, higher-absorbency tampons made it easier for the bacterial infection to spread.

As well as a strawberry tongue, TSS may cause the following symptoms to come on suddenly:

  • high fever
  • a headache
  • a sore throat
  • aches
  • pains
  • nausea
  • vomiting
  • diarrhea

If a person suspects they may have TSS they should seek emergency treatment. This condition can be life-threatening if a person does not seek treatment.

Vitamin B12

A deficiency in vitamin B12 may cause a strawberry tongue.

Other symptoms of this vitamin deficiency include:

  • tiredness
  • weakness
  • memory problems
  • trouble balancing
  • numbness or tingling
  • glossitis
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A doctor will be able to diagnose the cause of strawberry tongue.

If a person develops a strawberry tongue, it is a good idea for them to speak to a doctor. A doctor can diagnose the underlying condition.

Some conditions that cause a strawberry tongue are not always severe at first. For example, a strawberry tongue caused by a vitamin B12 deficiency can be dealt with fairly easily.

Other conditions that cause a strawberry tongue may be more serious. TSS and certain allergies can be life threating.

If a person thinks they may have TSS or a severe acute allergic reaction, they should seek emergency treatment.

A severe acute allergic reaction is called anaphylaxis, which can progress to anaphylactic shock. Other symptoms include:

  • facial and throat swelling
  • trouble breathing
  • chest pain
  • fast heart rate
  • low blood pressure

When a person has a swollen tongue, it may make it harder for them to eat. It may also make them more likely to bite their tongue.

If the conditions causing strawberry tongue are left untreated, complications may arise. These conditions include:

Kawasaki disease

If left untreated Kawasaki, disease may cause a coronary artery aneurysm (CAA) and other problems within the heart.

CAA is a weakness with excessive dilation that causes bulging in an artery in the heart. This could increase one’s risk of cardiovascular disease later in life, according to a 2016 study.

Scarlet fever

If left untreated, scarlet fever may lead to a person developing:

  • rheumatic fever (which can involve the heart, joints, and nervous system)
  • kidney disease
  • severe middle ear infection
  • skin infection
  • abscesses
  • lung infection

Toxic shock syndrome

Left untreated, TSS causes the whole body to go into shock. This may cause vital organ damage and could be fatal.

Anaphylactic shock

If a person does not receive treatment, anaphylactic shock can be fatal. This is typically due to circulatory and breathing problems.

If a person has a strawberry tongue, a doctor will ask them when they first noticed it.

The doctor will then ask questions about any other symptoms. This helps the doctor to determine the underlying cause.

The doctor may order further tests if they need to reach a diagnosis.

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The treatment for strawberry tongue will usually depend on the underlying cause.

Treatments for the underlying causes are explored below:

  • Kawasaki disease: Doctors think that Aspirin helps reduce artery inflammation. Intravenous administration of a protein that supports the immune system helps to reduce the risk of damage to the arteries.
  • Scarlet fever: This is treated with antibiotic therapy.
  • TSS: This is treated with antibiotics, intravenous fluids, and other medicine-based treatment to stabilize blood pressure.
  • Allergies: Anaphylactic shock is typically treated with an injection of epinephrine, intravenous glucocorticoid, and intravenous antihistamine.
  • Vitamin deficiency: Supplements, dietary changes, or possibly an injection of vitamins can help resolve any deficiency.

Sometimes strawberry tongue gets confused with glossitis. There are key differences between the two conditions.

Glossitis is an inflammatory process that affects the tongue. When a person has glossitis, their tongue appears red, glossy, and swollen.

A healthy tongue has tiny bumps on it called lingual papillae. If a person has glossitis, these bumps are no longer visible. This is because their tongue is inflamed, causing a thick and sore tongue that looks smooth on the surface.

Strawberry tongue looks like a strawberry, with swollen-looking taste buds on a tongue that has surface inflammation and redness.

Strawberry tongue and glossitis are not diseases. Both are symptoms of an underlying condition.

Although a vitamin B12 deficiency can cause both glossitis and strawberry tongue, they are both caused by a different set of conditions.

The outlook for a person with strawberry tongue depends on what underlying condition is causing it.

TSS and anaphylaxis can be immediately life-threatening, but both are very treatable. If a person suspects either, they should seek emergency medical treatment.