What Causes White Spots on the Throat

Prevention for strep throat is similar to prevention for other viral infections:

What Does Throat Cancer Look Like?

Jennifer Welsh is a Connecticut-based science writer and editor with over ten years of experience under her belt. She’s previously worked and written for WIRED Science, The Scientist, Discover Magazine, LiveScience, and Business Insider.

William Truswell, MD, is board-certified in otolaryngology and facial plastic and reconstructive surgery. He is president of the American Board of Facial Plastic and Reconstructive Surgery.

Throat cancer is a subgroup of head and neck cancers. It typically refers to cancers that originate in the pharynx (the throat). Thickened white patches on the lining of the throat are usually the earliest signs of cancer or a precancerous condition in the throat.

The most common type of throat cancer is called squamous cell carcinoma (SCC). This and other types of throat cancers are most often caused by environmental factors, including smoking or chewing tobacco. Infection with human papillomavirus (HPV) is an increasing cause as well. Additional exposures that increase the risk for throat cancers include alcohol and betel quid, a stimulant used in Asia.

In studies, the artificial intelligence (AI) technology used in some online health services for preliminary screening before connecting patients with a doctor actually outperformed real physicians in terms of reaching an accurate diagnosis, CNN AI technology correctly diagnosed conditions in 81% of patients, compared to a 72% average for accurate diagnoses among real physicians over a five-year period.

According to the National Cancer Institute, there were more than 53,000 cases of oral and pharynx cancer in 2020. Approximately 10,000 patients who have been diagnosed with these cancers died. The five-year survival rate for these cancers is about 66%.

This article reviews the appearance of several types of throat cancers and briefly describes their symptoms.

A White Patch

Some throat cancers begin as oral leukoplakia, a general term for a white lesion in the mouth of an unknown cause.

Leukoplakias are premalignant lesions, which means they’re not cancerous yet, but could develop into cancer. About 3% to 17.5% of these lesions are or will become cancerous in 15 years, while others go away independently.

Common symptoms of oral leukoplakia include a persistent cough and sore throat lasting for more than three weeks.

A Red Patch

Other throat and mouth cancers show up as red patches called erythroplakias. These are rare, isolated, velvety patches in the mouth and/or throat that typically show up in older patients.

Erythroplakia lesions are usually premalignant, but most of these red patches become cancerous, so it’s important to get them checked out. They typically affect middle-aged and elderly people, and are usually linked to tobacco and alcohol use.

Sometimes, lesions are a mix of red and white, referred to as erythroleukoplakias or “speckled leukoplakias.” Although the lesions most commonly occur on the floor of the tongue, they can also develop on tissues behind the back teeth, including the upper throat.

Throat Ulcers

A classic sign of oral cancer is a persistent rough patch that looks like a sore and has a raised border. Unlike some ulcers and other lesions like canker sores, these are minimally painful.

A Lump in the Throat

A primary tumor of the throat can appear as a nodular mass on the floor of the mouth, tongue, tonsil, or wall of the throat. The mass will tend to be irregular, fixed, and relatively painless, but can interfere with swallowing and make you feel like you have something caught in your throat. This is most common in people with a long history of smoking.

A Lump in the Neck

Metastasis is the spread of cancer from its original location. Head and neck cancers can spread through the lymphatic system, which is another circulatory system of the body. In the lymphatic system, fluid flows to lymph nodes, where white blood cells act to remove or neutralize foreign substances and invaders such as bacteria, viruses, and cancer cells.

If throat cancer spreads through the lymph vessels, it will likely land in the lymph nodes of the neck. There, it can produce non-tender masses (lymphadenopathy) and then seed new tumors in other parts of the body.

When a primary tumor grows to a large size, it can cause difficulty swallowing or talking, earaches, headaches, spitting up blood, and sometimes partial airway obstruction.

A Swollen Tongue

Some throat cancers, specifically those associated with a human papillomavirus (HPV) infection, cause a swollen tongue.

Infection with HPV is one of the major causes of throat cancer. About 10% of men and 3.6% of women have oral HPV. Many cases clear on their own, but some persist for years, which is when cancer can develop.

HPV-related oropharyngeal cancers are limited to the throat, while those caused by smoking, tobacco use, or other environmental triggers are found in the mouth and lips as well.

The characteristic symptoms of HPV-associated throat cancer include a swollen tongue, tiny lumps inside the mouth, and mouth numbness. The persistence of symptoms is a telltale sign, particularly in younger people who do not smoke.

Human papillomavirus is an infection that we can prevent. The HPV vaccine is very safe and effective at preventing infections, genital warts, and precancers.

Hardened Tissues

Another type of throat cancer, submucous fibrosis, is defined by the hardening of mucosal tissues. It is most often caused by the chewing of betel nut in Southeast Asian cultures, but also sometimes seen in people who chew tobacco.

Submucous fibrosis is typically a precancerous disorder, but can become malignant in between 1.5% and 15% of cases.

These lesions typically start in the mouth and gums, but can also involve the throat. They can cause burning sensations after eating spicy foods, and cause pain when eating and difficulty opening the mouth.

Advanced Symptoms

Coughing up blood is extremely rare. It can result from timor cells eroding into blood vessels. This is a sign of end-stage disease with a grim prognosis. An additional symptom is loose teeth, which can develop as the tumor spreads to the bones of the jaw and teeth.

You may also notice changes in the voice if cancer spreads to the larynx. Large primary tumors can prevent swallowing, leading to poor nutrition. Weight loss and persistent fatigue may result from this or be the result of widespread metastasis.

A Word From Verywell

Symptoms alone cannot diagnose throat cancer. If you’re worried about cancers of the head and neck, perform periodic oral self-exams. Making regular dental visits can also be a good way to monitor for any unusual growths or lesions.

A diagnosis of throat cancer is made after much testing and examination by your doctor. Tests will include a physical exam, where your doctor will use their hands to feel for swollen lymph nodes and other nodules. They’ll also test to see if you have HPV.

They will do an endoscopy (a procedure in which a tiny camera is fed into your mouth through a tube), a biopsy of any suspicious lesions, and imaging like a computed tomography (CT) scan or magnetic resonance imaging (MRI).

If you’re a smoker and have unusual or persistent symptoms aligned with those above, speak to your doctor about getting further testing.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. National Cancer Institute. Oropharyngeal cancer treatment (adult) (PDQ®)–patient version.
2. Centers for Disease Control and Prevention. HPV and oropharyngeal cancer.
3. National Institutes of Health, National Cancer Institute, Surveillance, Epidemiology, and End Results Program. Oral cavity and pharynx cancer—cancer stat facts.
4. World Health Organization International Agency for Research on Cancer. Leukoplakia.
5. World Health Organization Interational Agency for Research on Cancer. Erythroplakia.
6. Centers For Disease Control and Prevention. Reasons to get vaccinated against HPV.
7. Shih YH, Wang TH, Shieh TM, Tseng YH. Oral submucous fibrosis: a review on etiopathogenesis, diagnosis, and therapy. Int J Mol Sci. 2019;20(12):2940. doi:10.3390/ijms20122940
8. American Association of Oral and Maxillofacial Surgeons. Warning signs of oral cancer.

By Jennifer Welsh
Jennifer Welsh is a Connecticut-based science writer and editor with over ten years of experience under her belt. She’s previously worked and written for WIRED Science, The Scientist, Discover Magazine, LiveScience, and Business Insider.

What Causes White Spots on the Throat?

White spots on the throat can result from a viral, fungal, or bacterial infection. You may experience other symptoms including throat pain.

White spots on the inside of your throat are usually caused by an infection. A mild, short-term irritation could be a symptom of an infection or another condition. These often occur along with a sore throat.

Other symptoms that may occur with a sore throat can include:

• nasal congestion
• fever
• difficulty swallowing
• white spots on your tonsils, which are inside your throat
• throat pain

A doctor can diagnose the exact cause of these white spots. Keep reading to learn the different causes of white spots on the throat.

Several types of infections may cause white spots on your throat. These include infections from bacteria, viruses, and fungi. Specific causes can include:

Strep throat

A sore throat could be a sign of a strep throat infection. Some people with this contagious bacterial infection will also have white spots on their tonsils or in their throat.

Infectious mononucleosis

This highly contagious viral infection, also called mono, can cause white spots on your tonsils and in your throat. It can be spread through body fluids, commonly saliva.

Oropharyngeal candidiasis

Oropharyngeal candidiasis, or oral thrush, is a fungal or yeast infection of the mouth and throat. It can cause white spots in these locations. Thrush is more common in babies, as well as people who may be immunocompromised.

Oral and genital herpes

Oral herpes (HSV-1) is a common viral infection. It can spread through kissing, oral sex, or sharing utensils or cups with someone who has an active infection. Genital herpes (HSV-2) is considered a sexually transmitted infection (STI). It’s spread through skin-to-skin contact. Sex without a condom or other barrier method may increase the risk of STIs, such as HSV-2.

In addition to having white spots on the throat, you may experience other symptoms. Along with testing, these symptoms may help determine your diagnosis. Common symptoms that may occur with white spots on the throat can include:

• sore throat
• pain or difficulty when swallowing
• white spots on your tonsils
• nasal congestion
• fever

Each condition can also have specific symptoms as well.

Strep throat symptoms

Strep throat is caused by a bacterial infection. Symptoms may include:

• fever
• pain when swallowing
• redness and swelling of your throat or tonsils
• swollen neck glands
• headache
• rash
• nausea and vomiting
• abdominal pain

Symptoms of mono

Mono can cause a number of symptoms other than white spots in your throat. Additional symptoms can include:

• fever
• fatigue
• enlarged tonsils
• sore throat
• swollen lymph nodes

Oral thrush symptoms

Along with white spots in the throat, oral thrush can other symptoms.

These symptoms can include:

• redness
• sore throat
• pain when swallowing

Symptoms of oral and genital herpes

The most common symptom of oral herpes (HSV-1) is a cold sore on your lip. The most common symptom of genital herpes (HSV-2) is a sore in your genital area. Both infections may occur without symptoms.

Both types of herpes can also cause white spots or sores to appear on your throat and tonsils.

Some additional symptoms may be more common with the first episode of infection. These symptoms may include:

• tingling or itching in the area of your sores
• fever
• flu-like symptoms
• sore throat
• urinary symptoms (HSV-2)

If you notice your spots aren’t disappearing on their own, you may want to make an appointment with a doctor, even if the spots aren’t causing discomfort. If you don’t already have a primary care doctor, the Healthline FindCare tool can help you find a physician in your area.

Diagnosis may involve a doctor looking at your throat and doing a brief physical examination. This may include asking questions about personal health and any symptoms you’ve been experiencing.

A doctor may also order lab tests including blood tests and cultures. Figuring out what’s responsible for the white spots in your throat will help a doctor prescribe the right treatment.

Depending on the cause of your white spots, you may not need treatment. For example, if a virus is responsible, the spots should clear up on their own. If the spots are caused by a yeast infection or bacterial infection, a doctor may prescribe antifungal medications or antibiotics.

Treating strep throat

Strep throat can only be diagnosed with a throat culture. If you have strep throat, a doctor will prescribe an antibiotic medication. In addition, a doctor may suggest you take an over-the-counter pain reliever, such as acetaminophen (Tylenol) or ibuprofen (Advil), to help reduce pain, swelling, and fever.

Untreated strep can potentially lead to serious complications like acute rheumatic fever or peritonsillar abscess.

Treating mono

Treatment of mono focuses on reducing and alleviating symptoms. Secondary infections may require antibiotics.

If you have mono, a doctor may recommend plenty of rest and use an over-the-counter pain reliever to relieve headache, fever, or sore throat. A doctor may prescribe oral steroid medication if your symptoms are severe.

Treating oral thrush

To treat mild oral thrush, a doctor will likely prescribe an antifungal that you’ll need to swish around your mouth and then swallow. These medications can include clotrimazole (Lotrimin) and nystatin (Nystop, Nyamyc, Nyata).

A doctor may prescribe an oral medication such as fluconazole (Diflucan) or itraconazole (Sporanox) to treat moderate to severe infections.

Babies with oral thrush can be treated using liquid antifungal medication. Doctors may also recommend nursing mothers apply antifungal creams to their nipples and areolae before feeding such babies.

Treating oral and genital herpes

Herpes has no cure. Antiviral medications, like acyclovir (Zovirax), valacyclovir, (Valtrex), or famciclovir (Famvir) may be prescribed. Topical anesthetics, such as lidocaine (LMX 4, LMX 5, AneCream, RectiCare, RectaSmoothe), may help lessen throat pain.

You might be able to stop white spots before they form. There are actions you can take to limit your chances of contracting certain conditions which cause white spots. For example, basic ways to eliminate harmful germs, such as washing your hands often, should lower your risk for most viral infections. Each condition also has specific prevention steps as well.

Preventing strep throat

Prevention for strep throat is similar to prevention for other viral infections:

• Wash your hands often.
• Cover your mouth when you cough or sneeze.
• Touch your face as little as possible.

Since strep throat is spread through respiratory droplets. You can decrease your chances by not sharing drinks or utensils with others.

Preventing mono

Since mono is spread through saliva, it’s important to limit sharing utensils, drinks, and bottles with others. For example, instead of sharing a water bottle with a friend on a hike, you could lower your risk of mono by bringing one water bottle for each of you.

Preventing oral thrush

Oral thrush is prevented by following good dental health practices:

• Brush your teeth regularly.
• Floss.
• Rinse your mouth after meals.
• Use mouthwash.

Since thrush often affects infants, it’s important to clean pacifiers between each use. If a child is formula fed, it’s also important to wash the nipple between uses.

Preventing oral and genital herpes

Using a condom or other barrier method during sex may help prevent herpes and other sexually transmitted infections (STIs). If you or a partner has HSV-2 and experiences recurrent outbreaks, taking daily suppressive medication can lower the chances of passing the infection to a partner.

Many of the conditions that can cause white spots on your throat are treatable with medication. The sooner you make an appointment to see a doctor, the sooner they can diagnose the cause of your white spots and start treatment.

White spots on your throat can mean that you have a virus. It can often take 1 to 2 weeks to resolve.

If you have persistent, severe, or worsening symptoms, consider making an appointment with a healthcare professional.

For severe symptoms like a high fever or severe pain, you may need immediate medical attention.

Last medically reviewed on July 25, 2022