White spots on tonsils causes, symptoms, and treatment options

white spots on tonsils in the mouthWhite spots on tonsils can be an alarming sight to see, but many of the causes are not a reason for you to fret. Tonsils are located at the back of the throat, and you can actually see them if you open your mouth wide and look into a mirror. Some individuals develop a condition that impacts their tonsils so they have to remove them, but the majority of people go their whole lives with them.

When you’re sick, your tonsils may become red, sore, or even swollen, and sometimes when this occurs you may notice white spots, which may be filled with pus. Finding out the underlying cause of the white spots on tonsils is important for you know how to properly treat them. In many cases, they will go away on their own, but other conditions do require medical intervention.


Here we will outline the many different causes of white spots on tonsils along with symptoms and treatment options.

What are causes and symptoms of white spots on tonsils?

Tonsil stones: Tonsil stones are hardened white deposits of fragments compiled of bacteria, food particles, dead cells, and mucus. Tonsils normally contain cells to fight off infection, but they can still become infected when the tonsil stones get trapped.

Common symptoms of tonsil stones include bad breath and ear aches. The good news is that tonsil stones don’t normally require treatment, but if they cause discomfort or distress your doctor may have to remove your tonsils.

Tonsillitis: Tonsillitis is the inflammation of the tonsils, accompanied by fever and swallowing difficulty. Pus inside the white spots on tonsils indicates either a bacterial or a viral infection. Other symptoms of tonsillitis include headache, stiff neck, and fever.

If the cause of the infection is bacterial, your doctor will prescribe antibiotics. If tonsillitis is recurring, then your doctor will remove your tonsils.

Strep throat/pharyngitis: Strep throat and pharyngitis are similar conditions that can cause white spots on tonsils. Strep throat is more serious than pharyngitis because it is brought on by the strep bacteria, which can cause extreme sore throat, fever, difficulty swallowing, chills, and in some causes nausea and vomiting.

To treat strep throat, your doctor will prescribe antibiotics. If strep throat is left untreated it can get progressively worse, and the bacteria may even enter the bloodstream making the condition deadly.

Pharyngitis is caused by a virus, so antibiotics cannot be prescribed. Treatment for pharyngitis usually involves gargling salt water.

Oral thrush: Oral thrush is a fungal infection in the mouth and throat area. The fungus responsible for oral thrush is candida albicans – yeast infection. We always have some level of candida albicans in our body, but when the levels rise and there is an imbalance that is when infection can occur. White spots will develop along the cheeks and tongue, so your taste will be altered.

Mononucleosis (kissing disease): Mononucleosis, also known as the kissing disease or mono, is a viral infection, which causes headache, fever, and persistent tiredness. Severe sore throat and pus-covered swollen tonsils are also characteristic of mono.

Diphtheria: Diphtheria is a respiratory infection that affects the nostrils and throat. It is caused by bacteria. Symptoms include inflamed lymph nodes, fever, and difficulty swallowing and breathing.

At first, the tonsil may appear to have a grey-white layer, and in other incidences it appears in white patches covering the tonsils. Children over the age of five are at highest risk for diphtheria. The good news is, there is a vaccination for this condition that can prevent it.

Vincent’s angina: This is an ulcer formation on the oral cavity, pharynx, and tonsils. The ulcers will begin on the gums and continue to spread. Eventually, they will bleed even with the slightest touch and white spots will develop on the tonsils. Antibiotics are the common mode of treatment for Vincent’s angina.

Viral pharyngitis: This is an infection of the pharynx causing the pharynx and tonsils to swell. Pus will form on the tonsils appearing as white spots. If the infection is bacterial you will be prescribed antibiotics. If it’s viral, it will clear up on its own.

STDs: Some sexually transmitted diseases (STDs) can cause white spots on tonsils. STDs that can cause white spots on tonsils include chlamydia, gonorrhea, herpes simplex virus, and HIV. Symptoms may include nausea, allover pain, fever, reduced appetite, sore throat, mouth sores, itchy mouth, swollen gums, swollen uvula, and swollen lymph nodes.

Smoking and leukoplakia: Smoking can increase the risk of oral cancer and leukoplakia, which is a precancerous condition. Early signs of leukoplakia include white patches on the mouth, tongue, and tonsils. Smoking cessation often resolves the white spots, but your doctor may need to scrape them off if they are cancerous.

Other miscellaneous conditions

tongueWhite spots on tonsils – no fever: Sometimes, tonsillitis can occur without the presence of a fever and tonsil stones can also develop without any other symptoms except for notable white spots on tonsils. Even if you don’t have a fever but notice white spots, you may still want to go in and have your doctor confirm diagnosis of tonsil stones.

White spots on tonsils – no pain: White spots without the presence of pain could be a viral infection or a malignant growth. Generally, viral infections will clear up on their own, so there is no need to worry. Simply gargling with salt water can help clear up the white spots on tonsils.

White spots on tonsils – not strep: A negative test result for strep in the presence of white spots on tonsils could be a result of any other of the conditions listed above. Your doctor will have to run further testing to determine the cause.


White spots on tonsils – allergies: In some cases, seasonal allergies can cause white spots on tonsils as a result of a post-nasal drip. You may find that treating your allergies may resolve the white spots on tonsils.

How to get rid of white spots on tonsils?

If you have a specific cause for white spots on tonsils stemming from a bacteria or fungus, your doctor will prescribe antibiotics or antifungal medications as a treatment. If your condition is caused by a virus or something else non-threatening, there are some general tips you can use in order to get rid of the white spots on tonsils.

  • Get plenty of rest
  • Gargle salt water
  • Drink warm or cold fluids to ease throat pain
  • Eat smooth foods like ice cream or yogurt
  • Use a cool mist humidifier in your room
  • Suck on lozenges
  • Use over-the-counter pain relievers
  • Avoid irritating foods, like spicy food, chips, raw vegetables, highly acidic food, etc.
  • Avoid smoking
  • Use a cotton swab to dislodge tonsil stones
  • Limit alcohol consumption

By utilizing some of these tips you can help reduce or even get rid of the white spots on tonsils, as well as reduce the associated pain.

Author Bio

Mohan Garikiparithi got his degree in medicine from Osmania University (University of Health Sciences). He practiced clinical medicine for over a decade before he shifted his focus to the field of health communications. During his active practice he served as the head of the Dept. of Microbiology in a diagnostic centre in India. On a three-year communications program in Germany, Mohan developed a keen interest in German Medicine (Homoeopathy), and other alternative systems of medicine. He now advocates treating different medical conditions without the use of traditional drugs. An ardent squash player, Mohan believes in the importance of fitness and wellness.


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