White Spot On Tonsil

It can affect infants and babies.

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.

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

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.

LaylaBird / Getty Images

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.

Nemours TeensHealth. Tonsillitis.
Centers for Disease Control and Prevention. Strep throat.
Centers for Disease Control and Prevention. About infectious mononucleosis.
Centers for Disease Control and Prevention. Candida infections of the mouth, throat, and esophagus.
Scripps. Are tonsil stones causing your bad breath?
National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Tonsillitis.
Australian Government, Department of Health and Aged Care: healthdirect. Tonsil stones.
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
National Health Service: NHS Inform. Tonsillitis.
University of Pennsylvania Medical School, Penn Medicine. Strep throat (streptococcal pharyngitis).
Mount Sinai. Mononucleosis.
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
Alfayez A, Albesher MB, Alqabasani MA. A giant tonsillolith. Saudi Med J. 2018;39(4):412-414. doi:10.15537/smj.2018.4.21832
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
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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White Spot On Tonsil