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Red Spots in the Mouth

Red spots in the mouth can be located on the lips, roof of the mouth, and tongue. They are usually caused by infection from bacteria, a virus, or fungus. Cold sores and oral herpes most commonly cause red spots on mouth. Other causes of red spots on throat and mouth include eating certain foods, smoking, stress, or cancer treatment. Read below for more causes and treatment options.

What are red spots on the roof of mouth, lips, or tongue?

Red spots in the mouth can coincide with pain and discomfort making everyday activities such as eating and talking very difficult. On the other hand, red spots in the mouth may be asymptomatic and go unnoticed for a long period of time. Regardless of the presentation, these spots often signal an underlying infection or systemic condition that requires medical follow-up.

Common characteristics of red spots in the mouth

These spots can also have various appearances. They can be described as any combination of the following:

  • Small and red
  • Large with a red border and a different colored center
  • Softor hard

Common accompanying symptoms of red spots in the mouth

Red spots in the mouth can also be found outside of the mouth on the lips or lower face and may also be associated with symptoms such as:

If you are experiencing red spots in the mouth or any of the associated symptoms, seek medical attention promptly.

What is causing your red spots in the mouth?

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What causes red spots in your mouth?

Red spots in the mouth can have a variety of different causes, many of which are inflammatory in nature. Inflammation can occur from systemic diseases or environmental triggers that irritate the mucosal lining of the mouth. There are many different causes which can most easily be grouped into the following categories:

Infectious cause

The mouth is the body's first line of protection against different pathogens and toxic substances, and as a result, it is exposed to many infectious causes of red spots in the mouth.

  • Bacterial: There are various bacterial infections that are associated with red spots that appear in the mouth, especially the soft or hard palate. For example, streptococci (strep) is a group of bacteria that can result in symptoms such as a cough, sore throat, and fever in addition to the appearance of small, painless red spots in the mouth.
  • Viral: Viral infections often result in an infectious double-hit to the body since they often infect both the structures of the upper respiratory tract such as the nose and sinuses as well as the mouth. Viral infections such as herpes and paramyxoviruses (the virus that causes measles) can cause clusters of small red spots in the mouth. Those related to measles are often painless and are called koplik spots, whereas herpes spots can become large blisters that can erupt and cause significant pain and discomfort. Often viral causes of red spots in the mouth are very contagious, so it is important to be careful and prevent not only infection but also spread.
  • Fungal: There are certain fungi such as candida that have a predilection for infecting warm, damp areas of the body such as the mouth. Spots caused by fungi can range from red and patchy to creamy and white.

Autoimmune causes

Many inflammatory conditions that result in the body attacking itself can also affect the mouth and cause injury and inflammation that results in red spots or sores.

  • Systemic: Systemic autoimmune conditions that affect multiple body parts such as inflammatory bowel disease and lupus often have symptoms that affect the mouth.
  • Dermatologic: Many dermatologic conditions can result in chronic, inflammatory rashes or lesions that prefer the mucosal linings of the body, including the mouth. Conditions such as lichen planus can cause red spots in the mouth that persist and are difficult to treat.

Environmental causes

Environmental causes can be related to certain exposures or lifestyle habits.

  • Diet: The mouth is in direct contact with food and liquids that may cause allergic reactions that result in red lesions in the mouth. Foods that seem to be particularly common allergens or irritants include those that are spicy or acidic like oranges, eggs, strawberries, and even chocolate. On the other hand, diets deficient in certain nutrients such as vitamin B12, folate or iron can also result in red spots or sores in the mouth.
  • Drug use: Tobacco and alcohol can cause significant irritation of the mouth and its structures and even some types of cancer. In fact, tobacco products are heavily associated with oral cancer. Tobacco and alcohol can cause excess cell growth in the mucosal lining of the mouth due to chronic irritation and result in painful sores. Mouth sores are also a side effect of chemotherapy.
  • Stress: Fatigue and emotional stress can also be a strong trigger for the development of red spots or sores in the mouth. Take note if you develop spots in your mouth during stressful times.

This list does not constitute medical advice and may not accurately represent what you have.

Cold sore

A cold sore is a skin lesion on the lips caused by infection with the herpes simplex virus (HSV). Cold sores are extremely common. In fact, most adults are infected with HSV, usually transmitted in childhood by normal close contact with parents, siblings or friends.

While the infection can be entirely unnoti..

Acute lymphoblastic leukemia

Acute lymphoblastic leukemia is also called acute lymphocytic leukemia or ALL. It is a cancer that starts in the bone marrow where new white blood cells, or lymphocytes, are formed. Normal white blood cells are blocked and cancerous cells formed instead, causing the symptoms of the disease.

This blood cancer, or leukemia, can spread quickly through the bloodstream to other organs in the body.

ALL is caused by a genetic abnormality, which can be hereditary or can be acquired through overexposure to radiation. The disease is most common in young children and most are cured after treatment.

Symptoms include fatigue; shortness of breath; fever; aching extremities; unexplained bruising; and tiny red spots under the skin (petechiae.)

ALL can start and spread quickly, so it is important for the patient to see a medical provider at the earliest symptoms.

Diagnosis is made through blood tests and bone marrow tests.

Treatment involves some combination of chemotherapy and/or radiation therapy. Stem cell transplantation may be an option following the chemotherapy.

Rarity: Ultra rare

Top Symptoms: fatigue, loss of appetite, shortness of breath, fever, severe fatigue

Symptoms that never occur with acute lymphoblastic leukemia: inflamed throat

Urgency: In-person visit

Oral herpes

Herpetic stomatitis is a viral infection of the mouth that causes fever and red and inflamed gums. This typically happens early in childhood.

Rarity: Rare

Top Symptoms: fever, gum pain, painful mouth sore, gum swelling, gum redness

Symptoms that always occur with oral herpes: gum pain

Urgency: Self-treatment

Mouth and throat sores from cancer treatment

Mouth sores are a common side effect of cancer treatment (chemotherapy or radiation therapy). Some types of chemotherapy are more likely to cause this than others. Cancer treatments are used to kill the bad cancerous cells, but unfortunately they also affect healthy cells. The cells of the inner lining of your mouth, esophagus (the tube that carries food from the mouth to stomach) and stomach can get damaged too. This can result in symptoms like red areas or a burning feeling in the mouth, painful sores and painful or difficulty swallowing.

Rarity: Rare

Top Symptoms:

Urgency: Primary care doctor

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How to treat red spots in your mouth

Since the causes of red spots in the mouth are so varied, your treatment plan will depend on the specific cause of your symptoms. Depending on the cause, your healthcare provider may suggest:

  • Antibiotics/Antifungals: If your symptoms are caused by a bacterial or fungal infection, your physician will prescribe medications specific to the pathogen. However, it is important to remember that viruses do not respond to antibiotic treatment and usually only need rest, fluids and other supportive measures.
  • Anti-inflammatory medications: Steroids and specific anti-inflammatory medications are often used in the treatment of multiple autoimmune diseases and may help alleviate some of the inflammation.
  • Diet counseling: Since diet is an important component in the pathogenesis of conditions of the mouth, your physician may suggest starting a dedicated nutrition program in order to help with your symptoms.

FAQs about red spots in the mouth

Are there things I can do to prevent the development of red spots in the mouth?

Since many of the causes of red spots in the mouth are infectious in nature, it is important to protect yourself from pathogens by maintaining proper hygiene such as hand washing. Avoid putting your hands in your mouth especially after touching doorknobs or interacting with sick individuals. In addition, maintaining proper nutrition and avoiding tobacco and alcohol can also go a long way in preventing the occurrence of red spots in the mouth.

Are red spots in the mouth dangerous or life-threatening?

For the most part, red spots in the mouth are more annoying and uncomfortable rather than dangerous or life-threatening. However, a red spot in your mouth may also be a sign of a cancerous process, so never ignore your symptoms. It is always important to follow-up on your symptoms since many of the underlying conditions often require follow-up and treatment.

How long will the red spots in my mouth last?

The duration of your symptoms will depend on the specific cause. For example, bacterial causes of red spots in the mouth often go away with the resolution of the underlying bacteria whereas autoimmune causes of red spots in the mouth may be a lifelong problem.

Are red spots in the mouth an acute or chronic condition?

There are some cases in which red spots in the mouth can be chronic, especially those associated with autoimmune conditions like inflammatory bowel disease. Furthermore, viruses such as herpes can persist within the body and recur in times of physical and emotional stress. Red spots related to chronic habits such as tobacco and alcohol may also persist and become chronic whereas bacterial infections are more acute.

Can red spots in my mouth spread to other parts of my body?

Red spots in the mouth can spread or appear on other parts of the body depending on the cause. For example, infectious causes ranging from bacteria to fungi can cause spots to appear not only in the mouth but also in areas such as the genitalia and under the armpits.

Questions your doctor may ask about red spots in the mouth

  • Do you have a sore throat?
  • Any fever today or during the last week?
  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
  • Look in the back of your throat, does your throat look inflamed and red?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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  1. Measles (Rubeola). Centers for Disease Control and Prevention. Updated February 17, 2015. CDC Link
  2. Hand, Foot, and Mouth Disease. Centers for Disease Control and Prevention. Updated Nov. 1, 2018. CDC Link
  3. Canker Sores. American Academy of Oral Medicine. Updated Dec. 31, 2007. AAOM Link
  4. The Tobacco Connection. The Oral Cancer Foundation. Oral Cancer Foundation Link
  5. Mouth Sores. American Cancer Society. Updated June 8, 2015. American Cancer Society Link