What Causes White Spots on the Throat?

Medically reviewed by Beth Holloway, RN, MEd on December 2, 2016Written by Kimberly Holland

Overview

Your throat can provide many clues to your overall health. When you have a sore throat, it’s a sign that you may be ill. A mild, short-term irritation could be a symptom of an infection or another condition. Other symptoms that may occur with a sore throat are:

  • nasal congestion
  • fever
  • difficulty swallowing
  • white spots on your tonsils, which are inside your throat

White spots on the inside of your throat are usually caused by an infection. Your doctor can diagnose the exact cause for these white spots.

What causes the white spots on your throat

Several types of infections may cause white spots on your throat. These include infections from bacteria, viruses, and fungi.

Strep throat

A sore throat could be a sign of a strep throat infection. Some people with this contagious bacterial infection will also have white spots on their tonsils or in their throat. Other symptoms of strep throat include:

  • nausea and vomiting
  • abdominal pain
  • fever
  • pain when swallowing
  • redness and swelling of your throat or tonsils
  • swollen neck glands
  • headache
  • rash

Infectious mononucleosis

This highly contagious viral infection, also called mono, can cause white spots on your tonsils and in your throat. Additional symptoms of mono include:

  • fever
  • fatigue
  • enlarged tonsils
  • sore throat
  • swollen lymph glands

Oropharyngeal candidiasis

Oropharyngeal candidiasis, or oral thrush, is a yeast or fungal infection of your mouth and throat. It can cause white spots in these locations. Thrush is more common in babies, as well as people with weak immune systems. Additional symptoms include:

  • redness
  • sore throat
  • pain when swallowing

Oral and genital herpes

Oral herpes (HSV-1) is a common viral infection. It can spread through kissing, oral sex, or sharing utensils or cups with an infected person. Genital herpes (HSV-2) is an infection that’s spread through sexual contact.

The most common symptom of oral herpes is a sore on your lip. The most common symptom of genital herpes is a sore in your genital area. Both infections may occur without symptoms.

Both types of herpes can cause sores and white spots to appear on your throat and tonsils. Some additional symptoms are more common with the first episode of an infection, and may include:

  • tingling or itching in the area of your sores
  • fever
  • flu-like symptoms
  • sore throat
  • urinary symptoms (HSV-2)

What to expect when you visit your doctor

When you notice your spots aren’t disappearing on their own, make an appointment to see your doctor, even if the spots aren’t causing discomfort.

Diagnosis may be as simple as your doctor taking a look at your throat and doing a brief physical examination. This may include asking questions about your personal health and any symptoms you’ve been experiencing.

Your doctor may order lab tests including blood tests and cultures. Figuring out what’s responsible will help your doctor prescribe the right medication for you.

Treatment for white spots on your throat

Depending on the cause of your white spots, you may not need treatment. For example, if a virus is responsible, the spots should clear up on their own. If the spots are caused by a bacterial or yeast infection, your doctor may prescribe antibiotics or antifungal medications.

Treating strep throat

Strep throat can only be diagnosed with a throat culture. If you have strep throat, your doctor will prescribe antibiotic medication. In addition, your doctor may suggest you take an over-the-counter pain reliever, such as acetaminophen (Tylenol) or ibuprofen (Advil), to help reduce pain, swelling, and fever.

Untreated strep may lead to serious complications like acute rheumatic fever or peritonsillar abscess.

Treating mono

Treatment of mono focuses on reducing symptoms. Secondary infections may require antibiotics. Get plenty of rest and use an over-the-counter pain reliever, such as those used for strep throat, to relieve headache, fever, or sore throat. Your doctor may prescribe oral steroid medicine if symptoms are severe.

Treating oral thrush

To treat oral thrush, your doctor will likely prescribe an antifungal that you’ll need to swish around your mouth and then swallow. Nystatin is commonly prescribed. Oral medication, like fluconazole (Diflucan) or itraconazole (Sporanox), may also be used.

Babies with oral thrush can be treated using liquid antifungal medication. Doctors may also recommend nursing mothers apply antifungal creams to their nipples and areolae before feeding such babies.

Treating oral and genital herpes

Herpes has no cure. Anti-viral medications, like acyclovir (Zovirax), valacyclovir, (Valtrex), or famciclovir (Famvir) may be prescribed. Topical anesthetics may help lessen throat pain. Lidocaine (LMX 4, LMX 5, AneCream, RectiCare, RectaSmoothe) is one of them.

Learn more: The 6 best cold sore remedies »

Outlook

Many of the conditions that cause white spots on your throat are treatable with a prescription from your doctor. The sooner you make an appointment to see your doctor, the sooner they can diagnose the cause and start treatment.

Next steps

If you’ve noticed white spots on your throat that don’t go away within a few days, it’s time to make an appointment with your doctor. If you have other symptoms, like a high fever or severe pain, call your doctor right away.

Here are some tips to help you prepare for your appointment:

  • Write down questions you have. Take the list with you to your appointment as a reminder of what questions you want to ask your doctor.
  • Take photos. The spots on your throats may appear worse some days or better on others. If you can, take photos to show the changing appearance of your throat.
  • Take notes. Your time with your doctor may be limited, so it may be helpful to write down instructions.
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