When someone has a sore throat, one of the first things they may do is check the back of their mouth.

The tonsils, which are part of the lymphatic system, are located on the back of the throat. If white spots are present on the tonsils, it is understandable to be concerned.

The good news is that several conditions can cause white spots on the tonsils. Most of them are easily treated. When white spots appear on the tonsils, they may present as blotches or streaks. They may also contain pus.

The most common symptom that occurs is a sore throat. White spots on the tonsils usually indicate an infection. Treatment varies depending on the cause.

Fast facts on white spots on tonsils:

Here are some key points about white spots on tonsils. More detail and supporting information is in the main article.

  • White spots may be confined to the tonsils or located throughout the mouth.
  • If the white spots do not go away in a few days, or are accompanied by a sore throat, it is advisable to see a doctor.
  • Treatments vary, but gargling warm salt water several times a day may help ease the pain.
  • A doctor may diagnose the cause of white spots after a review of symptoms and a physical exam, or blood tests.

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White spots on the tonsils are usually caused by an infection.

The most common cause is an infection. Infections may be due to bacteria, a fungus, or a virus.

Although anyone can develop an infection that leads to white spots on the tonsils, having a weakened immune system puts a person at a higher risk.

Some of the more common infections that can cause white spots include:

Strep throat

Strep throat is a bacterial infection caused by Streptococcus.

Complications of strep throat can develop if the bacterium causing the infection spreads to other parts of the body, such as the heart. Complications include rheumatic fever and ear, and sinus infections.

Additional symptoms that may indicate strep throat include:

Strep throat is a common infection, especially in children. According to the Centers for Disease Control and Prevention (CDC), up to 6 out of every 20 children with a sore throat have strep throat.

Oral thrush

Oral thrush is a fungal infection in the mouth. Oral thrush can develop in anyone but is most common in babies. It can also occur as a side effect of medications, such as oral steroids.

People with a weakened immune system are at an increased risk of a fungal infection, including oral thrush.

White spots may be the only symptom of oral thrush, but when additional symptoms develop they may include:

  • sore throat
  • pain when swallowing
  • loss of taste

White spots may also appear on the cheeks, tongue, and roof of the mouth.

Viral tonsillitis

Tonsillitis involves inflammation or swelling of the tonsils. Although the Streptococcus bacterium can lead to tonsillitis, it is not the only cause.

Tonsillitis can also develop due to a viral infection. Symptoms may include:

  • swollen tonsils
  • painful swallowing
  • fever
  • ear pain
  • nasal congestion

Common viruses that may cause tonsillitis include rhinovirus, adenovirus, and respiratory syncytial virus.

Infectious mononucleosis

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Infectious mononucleosis, or mono, is usually accompanied by fatigue.

Mononucleosis is a viral infection caused by the Epstein-Barr virus, which affects certain blood cells.

Along with white spots on the back of the throat, symptoms may include:

Infectious mononucleosis spreads easily from person to person.

Tonsil stones

The tonsils have several crevices. Bacteria and mucus can become stuck in them. When this material gets trapped, the debris may harden and calcify, which causes white spots.

Symptoms may include:

Some people may not even notice they have tonsil stones, especially if the stones are small.

Rare causes of white spots

There are also other causes that are less common than those listed above. Additional causes include a pre-cancerous condition called leukoplakia, oral herpes, and oral cancer.

A medical exam will aid diagnosis and may include looking in the back of the throat and feeling the lymph glands in the neck.

In some cases, doctors may recommend blood tests and a throat culture. Blood tests indicate if certain antibodies are present, which helps identify specific infections.

A throat culture involves rubbing a cotton swab across the back of the throat to collect a sample from the tonsils.

The cells and secretions collected are analyzed to identify the presence of bacteria and determine the type of infection.

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Resting and drinking warm liquids can speed up the recovery time.

There are a variety of causes of white spots, so there is a range of treatments. For example, if spots are due to tonsil stones, treatment may include removal of the stones.

Spots due to strep throat require an antibiotic. White spots on the tonsils due to an oral yeast infection may need antifungal medication. If recurrent infections of the tonsils are an issue, surgery may be recommended to remove the tonsils.

A doctor will not usually prescribe antibiotics for white spots on the tonsils due to a viral infection, such as mononucleosis or viral tonsillitis.

Recommended treatment at home may include:

  • drinking warm liquids to decrease throat pain
  • taking over-the-counter pain relievers. Many popular pain relievers, such as ibuprofen, are available to buy online.
  • getting plenty of rest, which allows the body to fight an infection
  • using a humidifier to reduce throat swelling and irritation. Various humidifiers are available to purchase online.
  • sucking on throat lozenges to ease discomfort. Search different brands online and compare their benefits.

The time it takes for white spots to clear up may vary based on the cause and treatment used. Most of the causes of white spots on the tonsils are treatable or clear up on their own in a few weeks.

Hand-washing is one of the most important ways to reduce the spread of viral and bacterial infections that may lead to white spots.

Keeping the immune system strong by getting enough rest, eating a well-balanced diet and getting regular exercise can also decrease a person's chances of developing an infection.

Covering the nose and mouth when coughing, and limiting close contact with others until their symptoms have cleared up will also help prevent the infection spreading.