White spots, blotches, or streaks on the tonsils can be a sign of various conditions, including strep throat and oral thrush. Treatment is available for most of these conditions.
The tonsils are part of the lymphatic system and are located on the back of the throat.
Changes to the appearance of the tonsils may be a sign that the body is reacting to an infection. There may also be a sore throat or swollen tonsils. In some cases, the spots may contain pus.
Here, find out about some causes of white spots on the tonsils, when to see a doctor, and which treatment they might prescribe.
Symptoms will depend on the cause, but a person may notice:
- white spots, streaks, or blotches on the tonsils or throat
- a sore throat
- difficulty swallowing
- other symptoms, such as a fever, fatigue, or nasal congestion, depending on the cause
Some of the more common infections that can cause white spots include:
Strep throat
Strep throat is a common bacterial infection caused by Streptococcus. It can cause white streaks or patches of pus on the tonsils.
Additional symptoms that may indicate strep throat include:
- pain when swallowing
- sore throat that starts quickly
- fever
- swollen lymph nodes in the front of the neck
- headache
- inflamed and swollen tonsils
Less common symptoms can include:
- stomach pain
- nausea
- vomiting
- headache
- rash, or scarlet fever
According to the
- children ages 5–15 years
- adults who spend time with school-aged children
- those who spend time in crowded settings, such as day care centers and military training facilities
If a person suspects they or someone they are caring for has strep throat, they should seek medical advice.
While rare, complications can arise if the bacteria spreads to other body parts, such as the heart. They include rheumatic fever, ear and sinus infections, and post-streptococcal glomerulonephritis, which affects the kidneys.
Oral thrush
Oral thrush is a fungal infection that can affect the mouth and throat. It can cause white patches to appear in the throat. They can also appear on the inner cheeks, the roof of the mouth, and the tongue.
Possible other symptoms include:
- pain when swallowing
- difficulty swallowing
- redness and soreness
- loss of taste
- a feeling like cotton in the mouth
- cracking at the corners of the mouth
Oral thrush can affect anyone but is
- use dentures
- have a weakened immune system, as with HIV and some cancers and cancer treatments
- have diabetes
- use antibiotics or corticosteroids for a long-term condition, such as asthma
- use inhale corticosteroids without a spacer
- have a dry mouth or use medications to treat dry mouth
- smoke
It can affect infants and babies, particularly those younger than 1 month in age.
Viral tonsillitis
Tonsillitis involves inflammation or swelling of the tonsils. It usually results from a viral infection but can occur with strep throat.
Symptoms of viral tonsillitis include:
- a white or yellow coating on the tonsils
- red and swollen tonsils, possibly with pus
- a sore throat
- pain and difficulty when swallowing
- swollen lymph nodes in the neck
- fever
- bad breath
- mouth breathing or sleep apnea
Viral tonsilitis
- rhinovirus
- adenovirus
- coronavirus
- respiratory syncytial virus
Infectious mononucleosis
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. Those
Tonsil stones
Tonsil stones, also called tonsilloliths, are hard, white stones that form on the tonsils. Many people with tonsil stones do not notice them, but symptoms can include:
- bad breath
- ear pain
- a feeling of having something stuck in the throat
- painful swallowing
Tonsil stones, or tonsilloliths,
Leukoplakia
Some tissue changes
Smoking can cause leukoplakia on the tonsils.
In rare cases, it can be an early sign of cancer. For this reason, a doctor may recommend a biopsy.
Other causes of white spots on the tonsil
Other possible causes include:
A person should seek medical advice if they have:
- severe or persistent symptoms
- symptoms that may indicate strep throat
- recurrent infections
- difficulty breathing
- any other concerns about white spots on the throat
- hoarseness lasting over 2 weeks
- a fever over 101°F (38.3°C)
- blood in saliva or phlegm
- a lump in the neck
- earache
A doctor will perform a physical examination of the mouth and throat. They will look in the back of the throat, feel around the neck for any swelling, and ask about other symptoms.
They may also take a throat swab or do blood tests for testing in a laboratory. These can show if bacteria are present, in which case they may prescribe antibiotics. These tests can also show viruses or fungi.
Treatment will depend on the cause of the white spots.
A doctor may recommend the following:
| Treatment | Other notes | |
|---|---|---|
| Strep throat | A person can take antibiotics, such as penicillin or amoxicillin. | If a person tests positive but has no symptoms, they will not need antibiotics. |
| Oral thrush | A person can apply antifungal medications in the form of a solution that a person swishes around the mouth and then spits or swallows. They will do this for Examples include: • toclotrimazole • miconazole • nystatin | For more severe infections, a doctor may prescribe fluconazole. |
| Viral tonsilitis | A person can manage symptoms through: • rest • drinking fluids • eating soft food • avoiding exposure to smoke • gargling with salt water • acetaminophen for pain relief | Antibiotics will not help with a viral infection; it usually gets better without medical treatment. |
| Infectious mononucleosis | A person can manage symptoms through: • rest • drinking plenty of fluids • over-the-counter medication, such as acetaminophen for pain and fever | Antibiotics will not help with a viral infection. Symptoms usually go away after |
| Tonsil stones | For mild cases, a person can try home remedies, such as: • gargling with warm salt water • using something soft, like a cotton swab or soft toothbrush, to gently remove the tonsil stones • practicing good oral hygiene | More severe cases may need the removal of the tonsils. |
| Leukoplakia | If necessary, options include minor surgery or laser surgery. | Further treatment will depend on the result of a biopsy, if appropriate. |
A person who has recurrent infections of the tonsils may need surgery to remove them, known as a tonsillectomy.
Depending on the cause, treatment at home can help manage symptoms.
This may include:
- drinking warm liquids to decrease throat pain
- eating only soft foods if swallowing is difficult
- avoiding smoking or exposure to smoke
- eating popsicles to soothe a sore throat
- taking over-the-counter pain relievers, such as acetaminophen
- getting plenty of rest, which allows the body to fight any infection
- using a humidifier
- sucking on throat lozenges to ease discomfort
The time it takes for white spots to clear up will depend on the cause, treatment, and individual factors.
It is not always possible to prevent white spots on the tonsil, but people can reduce the risk of some conditions that cause them.
Tips include:
- washing the hands often to reduce the risk of infections
- boosting the immune system through a well-balanced diet, exercise, and regular sleep
- covering the nose and mouth when coughing to avoid passing on infections to others
- limiting close contact with others who have an infection
- practicing good oral hygiene, including regular dental checkups
- being aware of how the tonsils usually appear and monitoring any changes
- avoiding or quitting smoking
- using a spacer when using an inhaler to avoid thrush
Here are some questions people often ask about white spots on the tonsils.
Should I be worried about white spots on the tonsils?
If white spots occur with severe or persistent symptoms or if symptoms do not disappear after 2–3 weeks, it is a good idea to seek medical advice.
Can you have white spots without having strep throat?
Yes, other causes include viral or bacterial tonsillitis, oral thrush, and tonsil stones.
How can I get rid of white spots on my tonsils?
This will depend on the cause. Often, they go away as an infection clears, either with home remedies or with medical treatment. A doctor can advise on specific options.
White spots can occur on the tonsils for various reasons, including infections, tonsil stones, and oral thrush. Sometimes other symptoms occur, such as a sore throat, bad breath, or difficulty swallowing.
Often, the condition that causes white spots either goes away without medical treatment, but home remedies can help manage symptoms. In some cases, surgery may be necessary.
Anyone who has concerns about white spots appearing on their tonsils should seek medical advice.