White Spots on the Tonsils: Causes, Symptoms and Treatment

White spots appearing at the level of your tonsils may raise multiple concerns. It may seem a bit scary to notice white spots on the tonsils, but there is nothing serious to worry about. There are multiple underlying causes that may exhibit themselves in the form of white spots on the tonsils.

Tonsils are an important structure of lymphatic drainage. They are just located on the backside of the pharynx or throat. Any change in size or appearance may indicate the body’s reaction to any kind of infection. White spots on the tonsils are usually the result of the defense mechanisms of the body against any infectious agent.

This article deals with information related to the white spots on the tonsils. In addition, it covers the underlying causes and associated problems to make a proper treatment plan to cure these white spots.

What are the common causes of white spots on tonsils?

White spots on the tonsils usually indicate any active infection of the throat or associated structure. There are multiple types of infections that may induce whiteness in the area of the throat or tonsils. The most common causes are as follows:

Infection mononucleosis

Epstein-Barr virus is the main antigen to cause infectious mononucleosis. This infection usually transmits through saliva. Therefore, it is also known as a kissing disease. People having this infection may also show white patches of pus around the tonsils. Other associated symptoms are as follows:

  • Headache
  • Flu-like symptoms
  • Fever
  • Body rash
  • Fatigue
  • Swollen lymph nodes

Patients with infectious mononucleosis also have an allergic reaction to the penicillin class of antibiotics. It may induce body rash.

Strep throat

Group A strep bacteria usually reside in the areas of the nose and throat. Streptococcal pharyngitis is a bacterial disease. It can easily transmit through respiratory droplets as someone sneezes or coughs. Though, it is more common in children. But teenagers and adults can also suffer from strep throat. This bacteria can induce whitish streaks or spots on the throat. Other common symptoms of strep throat include:

  • Miniature red spots on the roof of your mouth
  • Pain during swallowing
  • Sore throat
  • Swollen lymph nodes
  • Inflammation of the tonsils and throat
  • Weakness
  • Fatigue
  • Fever
  • Headache
  • Flu-like symptoms


Tonsillitis indicates a general infection of the tonsils. It may be due to any bacteria like streptococcus Pyogens. Besides bacteria, different viruses can also cause infection of the tonsils. These infections may produce white pus-like spots on the tonsils. It indicates that being part of the lymphatic system, your tonsils are trying to fight against these infections. Viral tonsillitis induces a variety of symptoms. These are as follows:

  • Swollen or red tonsil, filled with pus
  • Whitish or yellowish membranous coating over the tonsils
  • Strep throat
  • Sore lymph nodes
  • Sound changes
  • Trouble in swallowing
  • Bad breath
  • Fever
  • Sleep apnea

Oral thrush

Oral thrush is a fungal infection of the mouth mainly caused by yeast. Candida albicans is the main source of infection to induce oral thrush in the mouth. Oral thrush is a whitish patch-like infection in the area of the oral cavity. Immunocompromised people are more prone to such kinds of infections. In addition, people on antibiotics or uncontrolled diabetes mellitus have a greater risk of inducing oral thrush.

There are white patches that can cover the sides of the mouth and tongue region. People describe these white patches as having a cottage cheese-like appearance. You may feel like you are having cotton in your mouth. If you try to scrape them, they may bleed, leaving red spots on the mucosa.

Tonsil stones

Tonsil stones are calcium deposits that are of a stony feel and present in the tonsils. These stones usually form due to the excessive buildup of the mucosa, bacteria, or any food items. They usually appear as white spots on the tonsils. But, sometimes, these stones may show a yellowish color. The other common symptoms include:

  • Halitosis or bad breath
  • Strep throat
  • A feeling of a foreign body in the pharynx area
  • Difficulty in swelling may occur due to the larger size of tonsil stones.


Leukoplakia is the whitish appearance of the mucosa due to any tissue modifications. It may occur in the oral cavity or throat, appearing as white spots on the tonsils. The common causes of leukoplakia include

  • Chewing tobacco
  • Smoking
  • Ill-fitted dentures
  • Chewing betel nuts

Leukoplakia may indicate any cancerous changes in the tissue. The white patches do not disappear on scraping. It may bleed on scraping. If you find such tissue, you must consult your doctor to avoid any consequences.

Is there any connection between COVID-19 and white spots on the tonsils?

Some studies suggest that COVID-19 may cause ulcers in the oral cavity or pharynx. These ulcerative lesions are the early signs of COVID-19. These ulcers may be asymptomatic for some people. But some people may show symptoms of fever and cough. These ulcerative lesions may get fibrosed and leave an appearance of white spots on the tonsils. If you have the symptoms of COVID-19, go for different testing procedures to prevent critical conditions.

White spots on the tonsils because of an STD:

Sexually transmitted diseases may have transmission through oral sex but do not cause white spots on the tonsils. These STDs can cause sore throat or different other problems but do not cause white spots on the tonsils.

Other causes

There are also some other possible causes to induce white spots on the tonsils. These are as follows:

  • Oral herpes
  • Oral malignancy
  • Canker sores in the throat region

What are the common risk factors for white spots on the tonsils?

Immunocompromised people have a strong incidence of developing white spots on the tonsils due to any active infection. Viral infections are contagious and can spread from one person to the others. So, there are also some specific conditions that increase the risk of white spots on the tonsils. For example, people residing in close quarters gave a great risk to induce strep throat and associated symptoms.

When is there a need to visit a doctor?

If you are having the following symptoms, you must visit your doctor for immediate care. People may have only one symptom or a combination of these symptoms. Consider visiting your doctor to get rid of them.

  • Continuous symptoms leading to the severity
  • Strep throat symptoms
  • Recurring throat infection
  • Breathing problems
  • Hoarseness of the voice for about more than one week
  • Fever greater than 101°F
  • Blood in the phlegm or saliva
  • Any lumpy appearance on the neck
  • Pain in ears

How to diagnose white spots on tonsils?

Your doctor will thoroughly examine the neck region by properly looking into the throat. He may palpate to feel any lumps or swelling in the neck region. Moreover, a detailed history will guide your doctor to reach an accurate diagnosis. Your doctor may take a swab from your white spots on the tonsils to examine them under a microscope. The swab test results will guide your doctor to medicate you according to the pathogens.

How to get rid of these white spots on the tonsils?

White spots on the tonsils are because of multiple reasons. Every cause needs a different treatment to heal. Let us have a detailed look at the treatment plan for every cause.

Management of infectious mononucleosis:

There are no such specific medications to treat infectious mononucleosis. Doctors usually prescribe corticosteroids to relieve inflammation. Moreover, your doctor may suggest ibuprofen to relieve pain and fever type symptoms. The best management for infectious mononucleosis is to take good care of yourself. Take enough rest and fluids to stay hydrated.

Management of strep throat:

Strep throat is mainly because of bacterial infections. Antibiotics are enough to treat strep throat. Besides antibiotics, your doctor may suggest over-the-counter medications like ibuprofen to relieve any kind of pain and inflammation. Taking rest and proper medication is the overall treatment for strep throat. Gargling warm salt water can also help to reduce pain and swelling.

Management of tonsillitis:

Viral tonsillitis may clear up on its own within a time period of about seven days. Whereas, for bacterial tonsillitis, your doctor may suggest antibiotics to get relief from tonsillitis.

Management of oral thrush:

Oral thrush is a fungal infection of the throat. Doctors usually recommend antifungals to manage oral thrush. Gargling with salt water or saline and rinsing your mouth with water can help to prevent the spread of yeast to other body parts.

Management of tonsil stones:

Smaller tonsil stones usually break without any proper medication. Treatment for tonsil stones is necessary only if there is extreme discomfort in the throat region. Home-based remedies for tonsil stones are usually eating crackers or crunchy foods and spraying salt water to clear up calcium deposits.

Management of leukoplakia:

Leukoplakia may be an early sign of oral malignancy. If the conditions are irritating, your doctor may suggest a minor surgical procedure or laser surgery for treating white patches of the mucosa. The other treatments follow the results of the biopsy investigation.

What are the other home-based treatments for managing white spots on the tonsils?

You can also manage the symptoms at home to get temporary relief. But, for permanent relief, you must visit your doctor. These treatment options are as follows:

  • Intake of warm liquids can help you relieve throat pain.
  • Take a soft diet if there is any difficulty in swallowing the food.
  • Avoid smoking or tobacco
  • Eating popsicles can help to relieve sore throat.
  • Take over-the-counter painkillers like acetaminophen.
  • Get enough rest to give proper time to your body to fight against infectious agents.
  • Suck throat lozenges can relieve throat discomfort. But, it is not recommended for the age below 4 years.


White spots on the tonsils may be because of different bacterial and viral infections, fungal infections like oral thrush, tonsil stones, or leukoplakia. These infections are also associated with multiple other symptoms other than just white spots. These symptoms usually include sore throat, pain, difficulty in swallowing, or respiratory problems. Sometimes, these white spots go away without any medical care. If these white spots last more than 2 to 3 weeks, there is a need to seek medical advice.

Some home remedies can also help to get rid of temporary pain and swelling. You can use warm saline water to get relief from pain and swelling.

Frequently asked questions (FAQs)

When is there a need to worry about these white spots on the tonsils?

White spots can be for any reason. If these white spots are associated with severe and persistent symptoms, you must visit your doctor. Moreover, if these white spots last more than 2 weeks, it is important to get medical care.

Do white spots always indicate infection?

White spots are not always because of any viral or bacterial infections. These white spots on the tonsils may indicate tonsil stones or any leukoplakia changes in the oral mucosa.


World of Medical Saviours (WOMS) is a website formed by a group of medicos who are embarking to provide facts, tips and knowledge related to health and lifestyle. This website proves to be a great platform for the medical enthusiast and also for those medicos searching to outgrowth their knowledge about the medical field.

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