White In Back Of Throat

White spots in your throat may seem a little scary, but they’re not usually a sign of anything too serious.

What Causes White Spots in Your Throat?

White spots in your throat may seem a little scary, but they’re not usually a sign of anything too serious.

Lots of different health conditions can cause them. Some go away on their own in a week or so, while your doctor will need to treat others with medicine.

Strep Throat

When you think about the symptoms of this bacterial infection, a sore throat and trouble swallowing probably come to mind first. But it commonly causes white patches on your tonsils, too. You might also have these:

• Fever
• Headache
• Swollen or sore neck glands
• Swollen and red tonsils
• Red spots on the roof of your mouth
• A rash (called scarlet fever)

With strep throat, the sore throat comes on suddenly and you usually don’t have a cough. Children sometimes have a stomachache and rash, feel nauseated, and may vomit.

A group of bacteria called streptococcus causes strep throat. Your doctor can take a throat swab and do a quick test to tell if you have the infection. If the sample comes back positive, they’ll give you antibiotics to kill the bacteria. You may start to feel better in as little as a day, but the antibiotics need about 10 days to finish the job.

Tonsillitis

The two tonsils at the back of your throat filter out germs to keep you healthy, but those germs can get trapped inside and cause an infection.

In addition to a white or yellow coating in your throat, you also might have:

• Red tonsils
• A sore throat
• Sore lymph nodes on the side of your neck
• Changes in the sound of your voice
• Fever
• Trouble swallowing
• Bad breath
• A stiff neck

Most of the time, viruses cause tonsillitis, so there’s no cure or treatment. The illness usually runs its course in 3 or 4 days. Make sure you drink lots of fluids and rest. If bacteria caused your tonsillitis, your doctor can give you antibiotics to treat it.

Oral Thrush

This is a yeast infection in your mouth, and it happens most often in babies and older adults.

The white patches can stretch back into the sides of your mouth and tongue — some people say they look like cottage cheese. If you try to scrape them off, you’ll see red spots and possibly have bleeding underneath.

You may also feel like there is cotton in your mouth. Your tongue may hurt or burn, making it hard to swallow or speak easily or to taste food and drinks.

See your doctor if you think you or your baby has oral thrush. They’ll give you antifungal medications and check you out to make sure you don’t have an illness that caused it.

Mononucleosis

Along with white areas in your mouth, mononucleosis can make you feel really tired and bring on other symptoms like:

• Fever
• A sore throat
• Swollen and sore lymph nodes
• Head and muscle aches

These are worst in the first 2 weeks.

Because viruses (especially the Epstein-Barr virus) cause most cases of mono, there’s no real treatment. It’s best to rest, drink lots of fluid, and take ibuprofen or naproxen for fever and aches.

Show Sources

CDC: “Strep Throat,” “Candida infections of the mouth, throat and esophagus,” “Epstein-Barr Virus and Infectious Mononucleosis.”

Mayo Clinic: “Strep throat,” “Tonsillitis,” “Oral thrush.”

KidsHealth from Nemours: “Strep Throat,” “Tonsillitis.”

National Health Service, UK: “Tonsillitis.”

Informedhealth.org: “Oral thrush (oral candidiasis): Overview.” Cleveland Clinic: “Thrush,” “Mononucleosis.”

American Sexual Health Association: “Oral Herpes,” “Herpes treatment.”

American Dental Association: “Sexually Transmitted Diseases and Your Mouth.”

American Academy of Dermatology: “Herpes simplex: Diagnosis and treatment.”

University of Michigan University Health Service: “Infectious Mononucleosis.”

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.

Updated on October 09, 2022

William Truswell, MD, is a board-certified facial plastic surgeon and otolaryngology (head and neck) surgeon. He is president of the American Board of Facial Plastic and Reconstructive Surgery and treats skin cancer patients as part of his practice.

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.

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.

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