White spots on tonsils

If you have frequent throat infections, your healthcare provider may recommend a tonsillectomy (surgical removal of the tonsils.)

Reasons for white spots on the tonsils

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 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.

Often, there will also be a sore throat or swollen tonsils. In some cases, the spots may contain pus.

Possible causes include:

• strep throat
• oral thrush
• viral tonsilitis
• mononucleosis, or “mono”
• tonsil stones

Here, find out about some causes of white spots on the tonsils, when to see a doctor, and which treatment they might prescribe.

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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

The most common cause of white spots on the tonsils is a bacterial, viral, or fungal infection.

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

Strep throat

Strep throat is a bacterial infection caused by Streptococcus.

Additional symptoms that may indicate strep throat include:

• sore throat
• fever
• swollen lymph nodes in the neck
• headache
• inflamed and swollen tonsils

Strep throat is a common infection. According to the Centers for Disease Control and Prevention (CDC), it is most common in:

• children aged 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 spread to other parts of the body, 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.

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

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

Oral thrush can affect anyone but is most common in those who:

• 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.

Fungal spores are often present in the mouth, throat, and digestive tract, but they do not usually cause an infection. However, symptoms can appear if conditions change, for example, if the immune system becomes weakened.

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:

• red and swollen tonsils, possibly with pus
• a white or yellow coating on the tonsils
• a sore throat
• pain and difficulty when swallowing
• swollen lymph nodes in the neck
• fever
• bad breath
• mouth breathing or sleep apnea

Tonsillitis may occur with the following viruses:

• the Epstein-Barr virus, which causes infectious mononucleosis
• the herpes simplex virus
• measles
• cytomegalovirus

It can also occur with strep throat, which is a bacterial infection.

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:

• fever
• sore throat
• severe fatigue
• head and body aches
• swollen lymph nodes in the neck and underarms
• swollen liver, spleen, or both
• a rash

Infectious mononucleosis spreads easily from person to person. Those most at risk are teenagers and young adults.

Tonsil stones

Tonsil stones, also called tonsilloliths, are like hard, white stones that form on the tonsils. Often, a person will not notice they are there, but sometimes they can become large.

One case report from 2005 describes a tonsil stone 2.5 centimeters (cm) by 1.5 cm. However, this is unusual.

Tonsil stones, or tonsilloliths, can form when bacteria and debris, such as mucosa and food, become stuck in crevices in the tonsils. As the debris hardens or calcifies, white spots can become visible 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

Leukoplakia

Some tissue changes can lead to leukoplakia, white or gray areas in the mouth or throat that do not disappear when a person scrapes them.

Common causes include:

• smoking
• chewing tobacco
• dentures that do not fit well
• chewing betel nut

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 tonsil

Other possible causes include:

• oral herpes
• oral cancer
• canker sores in the throat

White spots on tonsils

Tonsils are the part of our body that fights against the virus and bacteria creating infections, playing an important role in maintaining the body’s immune system, focusing on the respiratory system. They contain cells that efficiently trap the infection that tries to enter our body.

However, these very germs end up infecting the tonsils that tried to resist them. This causes painful and swollen tonsil. The tonsil can have white spots across the surface, indicating an oral infection.

What are white spots on tonsils?

White spots on tonsils seem to be straightforward and simple as a problem but it is advised not to be left untreated as the infection might spread and get worse. You should visit a doctor to avoid further complications as sometimes this can lead you to a serious injury.

Some of the on point, prominent symptoms that would warn you of white spots on tonsil are swollen glands on the neck, a dry and sore throat, white spots at the back of throat, unpleasant taste in the mouth and enlarged tonsils.

The causes leading to such a condition along with their remedies are given below:

1. Strep throat

Strep throat leads to white spots on tonsils. Strep throats are the initial signals that can bring the problem into your notice. Streptococcus is a bacterium that causes infection and turns to be a popular reason for these white spots to occur on your tonsil.

This further leads to severe sore throat that can be more painful to a person than tonsillitis. A strep throat can be pointed out through white or yellow spots on the throat and tonsils, a bright red throat on outside and a high fever. This infection usually occurs with a sudden surprise and does not have other symptoms like cold or flu in advance.

Swallowing can turn difficult at times. It is extremely important to remember that natural remedies for a strep throat infection are best if only the infection is in a mild or moderate condition. A serious infection of Streptococcus can lead to complicated diseases, if not treated properly, like rheumatic fever or kidney disease.

REMEDIES: There are various effective home remedies to get rid of these mild infections like white spots on tonsils that are caused by the problems of the strep throat like for example cayenne pepper. Cayenne pepper can be used as a medicine to cure strep throat. Cayenne pepper contains capsaicin, a strong ingredient to cure throat infections.

Studies have also found that ingredient like capsaicin helps to reduce pain and calm nerves down. Mix half cup of coconut oil and 1 teaspoon of cayenne pepper to make a home remedy of sore throat as capsaicin is strong enough to hurt your throat. Capsaicin paste can be applied on the skin of the throat as it absorbs well and help to cure the swollen lymph.

2. Tonsillitis

Tonsillitis is another reason commonly found for white spots on the tonsils. This is mainly caused when a certain bacteria or viral infection acts as an active component for the tonsils to be inflamed and infected by it.

Chronic tonsillitis. Pus on the tonsils.

The main symptoms according to the studies are white or yellow coating on the inflamed tonsils, difficulty in swallowing, white patches on throat, sore throat, enlarged lymph nodes and severe headaches.

REMEDIES: Emphasizing again on the fact that tonsillitis can be cured with simple home remedies if the bacterial infection has not caused a serious effect or else antibiotics will be prescribed by your doctor. Salt water gargle can be the easiest way to treat an inflamed tonsil.

Echinacea tea also helps to treat tonsils with white spots on the throat along with boosting your immune system. You could make a delicious recipe out of Echinacea tea by adding a 1 inch chopped ginger piece in hot water along with cover and leave it steep for a while. Cool this tea remedy down and to boost its medicinal value add some honey and lemon to it. To cure your tonsils faster drink this twice to thrice time a day.

DIET: If you have been affected by tonsillitis quite often it is advised to maintain a few days diet. For the initial days switch over to liquid diet which can ideally within five days. Fruit juices help to boost our immune system and help to fight off the infection. Until the symptoms causing pain subsides drink water and orange juice only.

You can shift to consuming fruits in the upcoming days and gradually introducing solid foods to the daily meal. Ensure that the balanced and healthy meals with the fresh vegetables, fruits, nuts and grains to boost the body from the infection re building its immunity system. Ensure drinking plenty of liquids to prevent problems of dehydration and keep the throat well moisturized and safe from continuous itching.

Strictly avoid too much of hot drinks like coffee and tea and other carbonated drinks as they can heighten the crisis of the condition. Ice cream and popsicles can sooth a sore throat! (Sounds strange, doesn’t it?). A sore throat can be calmed through an ice cream as it can be galloped easily at one swallow. Sour and spicy foods are to be avoided while one is suffering from this. Food such as sour cream, hot sauce, yogurt and fried foods disturb the throat and can end up causing more pain.

3. Tonsilloliths

Close up tonsillolith

A whitish stone like bumps appearing on the tonsils are usually caused by Tonsilloliths or tonsil stones. They are white stones embedded within the tonsils and does not appear to be a problem until and unless it is followed by a throat infection.

Along with an infection it might cause fever. When mucus, bacteria and dead cells are trapped, white spots at the back of your throat are formed. Apart from white spots on the throat, the other symptoms of Tonsilloliths that are commonly found are sore throat and bad breath caused by bacteria. Other side effects like ear pain and difficulty in swallowing may appear.

REMEDIES: Salt water gargle is an effective measure that kills the bacteria and heals your throat from this painful infection.

4. Oral thrush

Oral thrush is a fungal infection that basically causes white patches on the tonsils affecting both your tongue and the back of the mouth. When an imbalance of good and bad bacteria is brought about, the yeast infection makes way to causes the oral thrush.

White coating on tongue baby. Oral thrush.

Oral thrush is commonly caused due to a heavy course of antibiotics. Antibiotics usually destroy the balance of micro organisms in the body and lead to the overgrowing yeast and end up affecting the mouth. There are several measures to restore the balance of the digestive system and heal the symptoms leading to oral thrush.

REMEDIES: Coconut oil works as antifungal naturally and helps to remove the white spots from your tonsils and also from the back of the throat. To make coconut oil as more of an effective remedy, you can mix one or two drops of clove or cinnamon oil along with a tablespoon of coconut oil.

For a few minutes, swish the remedial mix for a few minutes. Be careful not to swallow it down. At last spit out the mixture and rinse your mouth, preferably with warm water and brush the teeth. Keep repeating the process until all the white patches have healed from your mouth.

5. Mononucleosis

Mononucleosis is a type of viral infection that leads to affect the back of the mouth. It creates white spots on the tonsils. Mononucleosis or mono is sometimes transmitted by the virus known as Epstein-Barr virus (EBV).

This is created amongst teens through saliva in their mouth. It is difficult to understand the difference between mono and strep throat and becomes difficult to diagnose. Other symptoms of mono include tonsils and lymph nodes, sore throat, loss of appetite, fatigue and pain under the left ribs. Sore throat causes white spots on tonsils.

If a baby who is still feeding on her mother’s breast develops oral thrush then it spreads to the mother’s nipples. It would require immediate attention of both a pediatrician for the baby’s oral thrush and an oncologist for thrush on the mother’s nipples.

REMEDIES: Drinking loads of fluids and taking plenty of rest helps our body to recover from virus. In case of abdominal pain, one must avoid lifting heavy materials as this can damage the spleen.
You can gargle with salt water in addition to plenty of rest to reduce the pain of sore throat. In case of excessive pain, doctor’s referred pain killers would be the best solution.

6. Leukoplakia

Leukoplakia is a much less important cause for white spots on the tonsils in respect to the others. It usually affects people with smoking tendencies or ones who chew tobacco or people with poor fitting dentures by causing irritants in the mouth.

Leukoplakia is mostly mild but it is linked with oral cancer. The Epstein-Barr virus can also create oral hairy Leukoplakia to people with weak immune systems. This usually causes white spot not only on the throat, but also on the mouth, tongue and other areas of the mouth.

7. Tonsillar cancer

Tonsillar cancer is a type of cancer that affects the tonsils and is commonly known as squamous cell carcinoma that usually cause white patches on your tonsils. The sores at the back of the throat caused by tonsillar cancer do not usually heal.

A sore or a white patch is not the only symptom of tonsillar cancer however. Symptoms that should make you aware are pain in the mouth, severe ear pain, blood in the saliva, lump in the neck and a persistent sore throat.

White Spots on Tonsils

Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.

Published on October 06, 2022

John Carew, MD, is board-certified in otolaryngology and is an adjunct assistant professor at New York University Medical Center.

Table of Contents
Table of Contents

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.

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:

• Infectious illnesses (tonsilitis, strep throat, mononucleosis )
• Oral thrush
• Tonsil stones

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.

Frequently Asked Questions

Does white on tonsils mean infection?

Not always. White spots could be due to a viral infection (tonsillitis, mono), a bacterial infection (strep), or a fungal infection (oral thrush) or a noninfectious cause like tonsil stones.

How do I get rid of the white stuff on my tonsils?

That depends on what’s causing them. If you suspect tonsil stones, gargle vigorously with warm salt water to see if they go away. If not, see your healthcare provider for diagnosis and treatment.

Can I scrape off white spots on tonsils?

That’s not a good idea. If they’re caused by tonsil stones, you’re better off either gargling or having a healthcare provider remove them. Spots from other causes will go away as you recover from the illness.

15 Sources

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. Nemours TeensHealth. Tonsillitis.
2. Centers for Disease Control and Prevention. Strep throat.
3. Centers for Disease Control and Prevention. About infectious mononucleosis.
4. Centers for Disease Control and Prevention. Candida infections of the mouth, throat, and esophagus.
5. Scripps. Are tonsil stones causing your bad breath?
6. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Tonsillitis.
7. Australian Government, Department of Health and Aged Care: healthdirect. Tonsil stones.
8. Morad A, Sathe NA, Francis DO, McPheeters ML, Chinnadurai S. Tonsillectomy versus watchful waiting for recurrent throat infection: A systematic review. Pediatrics. 2017;139(2):e20163490. doi:10.1542/peds.2016-3490
9. National Health Service: NHS Inform. Tonsillitis.
10. University of Pennsylvania Medical School, Penn Medicine. Strep throat (streptococcal pharyngitis).
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12. Bongomin F, Gago S, Oladele RO, Denning DW. Global and multi-national prevalence of fungal diseases-estimate precision. J Fungi (Basel). 2017;3(4):57. Published 2017 Oct 18. doi:10.3390/jof3040057
13. Alfayez A, Albesher MB, Alqabasani MA. A giant tonsillolith. Saudi Med J. 2018;39(4):412-414. doi:10.15537/smj.2018.4.21832
14. Dykes M, Izzat S, Pothula V. Giant tonsillolith – a rare cause of dysphagia. J Surg Case Rep. 2012;2012(4):4. Published 2012 Apr 1. doi:10.1093/jscr/2012.4.4
15. National Health Service. Tonsillitis.

By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.

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