White Spots on Tonsils: Symptoms, Causes, and Treatment - Verywell Health
Seeing white spots on your tonsils may make you worry about a serious illness. There are several causes for them, though, and white spots don't always need medical treatment.
Sometimes, you may need antibiotics to clear up an infection that causes white spots on the tonsils. In some cases, your tonsils may need to be surgically removed via a tonsillectomy.
This article explores the common causes of white spots on the tonsils, other symptoms to watch for, how white spots on your tonsils are generally treated, and when you need to see a healthcare provider about them.
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Symptoms of White on Tonsils
White spots on your tonsils are frequently associated with other symptoms, which vary depending on the cause of the spots. These may include:
- Sore throat
- Swollen lymph nodes (glands) in your neck
- Hoarse voice
- Fever
- Pain with swallowing
- Red, swollen tonsils
- Tiny red spots on the roof of your mouth
- Fatigue that may be extreme
- Headache and body aches
- Rash
- Loss of taste
- Pain while eating or swallowing
- Cracking and discoloration at the corners of your mouth
- Bad breath
- Ear pain
A sore throat is the most common symptom with white spots on your tonsils.
Causes of White Spots on Tonsils
The primary causes of white spots on your tonsils are:
The white spots can be a sign of infection (sometimes called "pus pockets") or, with tonsil stones, the color of debris that formed the stone.
How to Treat White Spots on Tonsils
The treatment for white spots on your tonsils depends on the cause.
Viral Causes
Tonsillitis (inflammation of the tonsils) is usually caused by a virus. Mononucleosis (sometimes referred to as mono or the "kissing disease") is caused by the Epstein-Barr virus.
These illnesses cannot be treated with antibiotics, so they have to just run their course. Occasionally an oral steroid may be prescribed by your healthcare provider. You may be able to alleviate symptoms with:
- Rest
- Lots of fluids
- Over-the-counter (OTC) pain relievers such as Tylenol (acetaminophen)
- Eating soft foods
- Drinking warm liquids
- Sucking on Popsicles or lozenges
Bacterial and Fungal Causes
Strep throat and some cases of tonsilitis are due to bacteria. They can be treated with antibiotics.
Oral thrush is an overgrowth of yeast, a fungus that occurs naturally in your body. It's usually treated with an antifungal medicine that's applied inside the mouth. For severe infections, you may be given an antifungal in pill form or intravenously (through an IV).
Tonsil Stones
Tonsil stones are clumps of debris that get trapped in the cracks on the outside of your tonsils. If they don't cause symptoms, you don't need to treat them.
If they cause bad breath, a sore throat or cough, or other symptoms, you may want to clear them up. A common home remedy is gargling vigorously with salt water. To make it:
- Mix one-half teaspoon of salt with 1 cup of warm water.
- Allow the salt to dissolve.
If gargling doesn't work, you may consider surgical removal of the tonsils or tonsillectomy.
Tonsillectomy
If you have frequent throat infections, your healthcare provider may recommend a tonsillectomy (surgical removal of the tonsils.)
This surgery is also an option if you have a recurring problem with tonsil stones.
Complications and Risk Factors Associated With White on Tonsils
The causes of white spots on your tonsils are linked with certain complications, such as:
- Tonsillitis: Middle-ear infection, obstructive sleep apnea (breathing pauses while asleep)
- Strep throat: Kidney disease, guttate psoriasis (a skin condition), rheumatic fever, scarlet fever, abscesses (sores) around the tonsils
- Mononucleosis: Anemia, hepatitis (liver inflammation) with jaundice (yellow skin), inflamed testicles, skin rash, enlarged spleen that may rupture (rare), seizures, and other nervous system problems (rare)
- Oral thrush: Systemic infection (in people with chronic illness or an impaired immune system), which can be life-threatening
- Tonsil stones: Swollen tonsils, sore throat, difficulty swallowing (rare)
Getting prompt treatment for these conditions and following your healthcare provider's instructions can help you avoid complications.
Are There Tests to Diagnose the Cause of White on Tonsils?
If you go to a healthcare provider with white spots on your tonsils, your provider may:
- Ask about your symptoms: Giving them a complete list can help them choose a diagnostic direction
- Give you a physical exam that includes checking your throat: May be all that's needed for tonsillitis, oral thrush, or tonsil stones
- Check for strep or another bacterial infection: Swab the back of your throat for a rapid strep test and/or to send it to be cultured in a lab
- Check for mono: Test your blood for markers of infection and liver function
- Check for thrush (in some cases): A small sample is taken from your mouth and throat and sent to a lab for analysis
- Look for tonsil stones that aren't visible: A scan can help determine where the stones are
When to See a Healthcare Provider
You should get medical attention for white spots on your tonsils if you have:
- A severe sore throat
- A sore throat that quickly gets worse
- Swelling in your mouth and throat
- Difficulty speaking, swallowing, breathing, or opening your mouth
- You have symptoms consistent with any of these conditions
- Symptoms that last longer than 10 days
- Abdominal pain
- Persistent high fevers (above 101.5 degrees Fahrenheit)
- Severe headache
- Weak limbs
- Jaundice (yellowing of the skin and whites of the eyes)
- Persistent bad breath despite good oral hygiene
- What looks like a tonsil stone
- Symptoms lasting more than two weeks
When to Call 911
If you have white spots on your tonsils and develop any of the following symptoms, call 911 right away:
- Sudden sharp, severe abdominal pain
- Stiff neck
- Severe weakness
- Difficulty swallowing or breathing
Summary
White spots on the tonsils are common in tonsillitis, strep throat, mononucleosis, oral thrush, and tonsil stones. Accompanying symptoms may provide clues as to which illness you have.
Treatment varies by cause: symptom management for tonsillitis and mono; antibiotics for strep; anti-fungal medicines for oral thrush; gargling or a medical procedure for tonsil stones. Tonsillectomy may be an option for recurrent cases.
Diagnosis is based on symptoms, a physical exam, and sometimes lab tests or imaging scans.
Get medical help for severe or concerning symptoms, especially if they last for 10 days or more.
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