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White spots on your tonsils have many different causes. They can usually be treated with medication or home remedies.

If you suddenly see white spots on your tonsils, you might be concerned. However, in many cases, you can easily treat the underlying cause and avoid surgical removal of the tonsils.

Keep reading to learn more about the possible causes of white spots on the tonsils, as well as treatment options and more.

White discoloration may appear only on the tonsils or it may appear around the tonsils and throughout the mouth. The discoloration may look like streaks in the back of the throat or blotches on or around the tonsils.

In addition to the white spots, your tonsils may feel scratchy and you might find it difficult to swallow.

Other symptoms that often accompany white spots on the tonsils include:

Sometimes, you may also have difficulty breathing. This can occur if your tonsils become extremely swollen and partially block your airway.

White spots on the tonsils often occur due to an infection in the throat. Whiteness in your throat can have several possible causes.

Infectious mononucleosis

The Epstein-Barr virus causes infectious mononucleosis, or mono. It’s an infection that spreads through saliva, which is why it’s sometimes called “the kissing disease.”

People who develop mono will frequently experience white patches of pus around the tonsils. Other symptoms include:

Also, if penicillin family antibiotics are prescribed for mono, they may cause a rash.

Strep throat

Strep throat, or streptococcal pharyngitis, is a contagious disease. The bacteria Streptococcus pyogenes causes it. It’s most common in children, but it frequently occurs in teenagers and adults as well.

It causes white streaks or spots in the throat. Other symptoms of strep throat include:

  • weakness
  • fatigue
  • inflammation and swelling of the throat
  • difficulty swallowing
  • a fever
  • a headache
  • flu-like symptoms

The bacteria often spread through contact with droplets from someone else’s sneezes or coughs.

Tonsillitis

Tonsillitis is a general term that refers to an infection of the tonsils. This infection usually occurs due to S. pyogenes, but other bacteria or a virus can also cause it.

When your tonsils try to fight the infection, they swell and can produce white pus. Other symptoms of tonsillitis include:

  • a fever
  • a sore throat
  • difficulty swallowing
  • a headache

Oral thrush

Oral thrush is a yeast infection that occurs in your mouth. The fungus Candida albicans is the most common cause.

People with suppressed immune systems are at increased risk of yeast infections in the mouth. People who have been on antibiotics or who have uncontrolled diabetes are also at increased risk. It can also be caused by using inhaled steroids without a spacer or rinsing.

The white patches can also appear on the inside of the cheeks, on the tongue, and on the roof of the mouth.

Tonsil stones

Tonsil stones, or tonsiliths, are calcium deposits that form in small cracks in the tonsils. They occur due to a buildup of food particles, mucus, and bacteria. They may appear as white or sometimes yellow spots on the tonsils.

Additional symptoms include:

  • bad breath
  • a sore throat
  • a sensation of a foreign body in the throat
  • difficulty swallowing if the tonsil stones are large

Does COVID-19 cause white spots on tonsils?

COVID-19 may cause ulcerative lesions in the mouth or throat, according to some case studies.

The lesions may be an early symptom of COVID-19. Some people who have them may be otherwise asymptomatic, but most people experience other COVID-19 symptoms such as fever and coughing.

If you have a sore throat or other symptoms, the Centers for Disease Control and Prevention (CDC) recommends getting tested to rule out COVID-19.

Can white spots on tonsils be an STD?

Although sexually transmitted diseases (STDs) spread by oral sex generally do not cause white spots on the tonsils, the following STDS may cause sores in the throat:

  • Human papillomavirus (HPV): Low-risk strains of this virus may cause painless, non-cancerous lesions in the throat.
  • Chlamydia: Although it’s rare, chlamydia may cause mouth sores that don’t heal.

Wearing a condom or other barrier lowers the risk of transmitting or contracting an oral STD.

Other causes

Less common causes of white spots on the tonsils include:

People with a weakened immune system are at an increased risk of white spots on the tonsils.

Other risk factors depend on the specific condition. For example, being in close quarters, such as in a school or childcare facility, can increase your risks of strep throat and mono.

Your doctor will ask about your other symptoms and will likely run a swab over the white spots on your tonsils.

They’ll then test the swab to see if the sample contains any pathogens. They’ll also perform a physical exam and gently feel your lymph nodes to see if they’re swollen or tender.

Your test results will help your doctor determine which medication, if any, is best suited to treat your condition.

Your treatment will depend on the cause of the white spots.

For infectious mononucleosis

Doctors don’t usually prescribe medications to treat mono. Your doctor may prescribe corticosteroids for severe inflammation, as well over-the-counter medications such as ibuprofen.

Your best course of treatment will be good home care. Get plenty of rest and fluids while the infection runs its course. Avoid contact sports if your spleen is enlarged.

For strep throat

Your doctor will prescribe an antibiotic. Your doctor may also recommend over-the-counter medications, such as ibuprofen (Advil, Motrin IB), to reduce swelling and pain.

In addition to taking medication, get a lot of rest. You may also try gargling warm salt water, which can help reduce swelling and pain.

For oral thrush

Doctors usually prescribe antifungal medications to treat thrush.

Gargling salt water and rinsing your mouth with water may help prevent the yeast from spreading beyond your mouth.

For tonsil stones

Treatment for tonsil stones usually isn’t necessary unless the discomfort is extreme. Your body will naturally eliminate the stones.

You can try at-home methods such as eating crackers or other crunchy foods and spraying salt water to clean up the deposits.

For severe inflammation

If your tonsils are inflamed to the point where they cause you difficulty breathing, your doctor might recommend removing them.

This procedure is called a tonsillectomy. It’s typically only done after other treatments have failed to reduce inflammation in the tonsils. Your doctor wouldn’t use it just to treat white spots.

Tonsillectomies are ideally performed after any illness is resolved. On rare occasions they may be performed while you have an infection, but there is a greater risk of bleeding.

Tonsillectomies are usually an outpatient procedure. You’ll likely have a sore throat for 1 to 2 weeks after the surgery.

Other treatments

Other universal treatments you can try include:

White spots on your tonsils could have many different causes. Usually, the conditions causing whiteness in the throat can be managed easily either with medications prescribed by a doctor or with home therapies, such as gargling salt water, getting plenty of rest, or drinking warm liquids.

The treatment will depend on the cause. In extreme or recurrent cases, a doctor might recommend removal of the tonsils.

You should call a doctor to set up an appointment if you’ve had the white spots for several days or if they are very painful or make it difficult for you to swallow. You may have an infection that requires medical treatment.

If you’re also having trouble breathing, you should seek immediate medical attention because you’re at risk of an airway obstruction.