Overview

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.

Symptoms

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.

Causes

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:

Strep throat

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

Other causes

Less common causes of white spots on the tonsils include:

Risk factors

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.

Diagnosis

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.

Treatment

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.

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 usually an outpatient procedure. You’ll likely have a sore throat for 1 to 2 weeks after the surgery. You should follow a restricted diet to avoid potential infection during this time.

Other treatments

Other universal treatments you can try include:

Outlook

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 your 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 your 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.

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