White Spots on Tonsils: Here’s How To Get Rid of Them

White spots on the tonsils can be concerning, as they often signal underlying health issues. Tonsils, essential components of the immune system, play a critical role in filtering bacteria and viruses that enter through the mouth and throat. When these lymphatic tissues become infected or inflamed, they may develop white patches that can indicate various conditions. According to the study, approximately 15% to 30% of sore throats in children and 5% to 15% in adults are caused by bacterial infections like strep throat.

These white spots can vary in appearance, ranging from small dots to larger patches, and are often accompanied by common symptoms like a sore throat, difficulty swallowing, and fever. Understanding the causes behind these white spots on tonsils is crucial for effective treatment. In this blog, we’ll explore the potential reasons for tonsil infections and offer practical solutions to help alleviate discomfort and promote oral health.

Common Causes of White Spots on Tonsils

White spots on the tonsils can appear for several reasons, often signaling infection or other underlying issues. Here’s a breakdown of the most common causes:

Tonsillitis

This inflammation, caused by viral or bacterial infections, leads to white patches on the tonsils. Symptoms include sore throat, fever, and swollen tonsils.

Strep Throat

Caused by Streptococcus pyogenes, strep throat presents with white spots on the tonsils, severe sore throat, and swollen lymph nodes. Antibiotic treatment is crucial to prevent complications.

Oral Thrush

An overgrowth of the fungus Candida albicans can cause white patches in the mouth and on the tonsils, particularly in those with weakened immune systems. It may cause mild pain and a cottony sensation.

Tonsil Stones

Formed from trapped debris in the tonsils, tonsil stones can appear as small white spots. While they may not be painful, they can lead to bad breath and discomfort when swallowing.

Symptoms Associated with White Spots on Tonsils

White spots on the tonsils are often accompanied by a range of uncomfortable symptoms that can indicate the severity and type of underlying issue. Here are some of the most common signs:

• Sore Throat: A persistent sore throat usually signals infection or inflammation. The throat pain may range from mild to intense and can worsen with swallowing.

• Fever: Many infections, like tonsillitis and strep throat, come with a fever as the body fights off bacteria or viruses. High fever, especially in children, should prompt medical attention.

• Difficulty Swallowing (Dysphagia): Inflamed tonsils and throat tissues can make swallowing painful or challenging. Dysphagia is common with strep throat and severe cases of tonsillitis, often due to swollen lymph nodes and surrounding tissues.

• Bad Breath (Halitosis): Chronic bad breath can develop, especially with tonsil stones, as bacteria and food debris accumulate in the crevices of the tonsils.

• Swollen Tonsils: Enlarged tonsils, sometimes accompanied by redness, are typical of infections like tonsillitis and strep throat. Swelling often causes additional discomfort and may feel like an obstruction in the throat.

• Lymph Node Swelling: Swollen lymph nodes around the neck can indicate a systemic infection. Lymph nodes swell when the body mounts an immune response, often making the neck tender to the touch.

How White Spots on Tonsils are Diagnosed

Diagnosing white spots on the tonsils involves several key steps to identify the underlying cause:

1. Physical Examination: A healthcare provider visually inspects the throat and tonsils for swelling, redness, and characteristics of the white spots.
2. Throat Swab Culture: A throat swab is taken to test for bacterial infections, such as strep throat, helping determine the need for antibiotic treatment.
3. Rapid Strep Test: This quick test confirms or rules out strep throat within minutes. A positive result allows for immediate treatment, while a negative result may lead to further testing.
4. Blood Tests: If a viral infection like mononucleosis is suspected, blood tests can indicate elevated white blood cell counts or specific antibodies.
5. Symptom Assessment: A review of symptoms, including fever and swallowing difficulties, assists the provider in narrowing down potential causes and deciding on further tests.

Tonsillitis and White Spots on Tonsils

Tonsillitis, an inflammation of the tonsils, is a common cause of white spots and can be triggered by viral or bacterial infections.

Viral tonsillitis, often caused by the common cold or flu, is milder and usually resolves without antibiotics. Bacterial tonsillitis, primarily from Streptococcus bacteria, results in severe sore throat and requires antibiotic treatment.

Common symptoms include a sore throat, red and swollen tonsils, white patches or pus, swollen lymph nodes, fever, and fatigue.

For viral tonsillitis, treatment focuses on symptom relief with rest, hydration, and over-the-counter pain relievers. Bacterial tonsillitis requires antibiotics, such as penicillin. In chronic cases, a tonsillectomy may be recommended to prevent further infections.

Strep Throat and White Spots on Tonsils

Strep throat is a bacterial infection caused by Streptococcus pyogenes (group A streptococcus) that often results in white spots on the tonsils and severe throat discomfort. Symptoms include a sore throat with white patches, high fever (over 101°F), red and swollen tonsils, and swollen lymph nodes. It is highly contagious and spreads through respiratory droplets from coughing, sneezing, or close contact.

The white spots occur as the bacteria invade the tonsil tissue, triggering an immune response that sends white blood cells to the area, leading to pus formation. Diagnosis typically involves a rapid strep test, and treatment includes antibiotics like penicillin or amoxicillin to reduce the infection and prevent complications. Over-the-counter pain relievers and warm saltwater gargles can help alleviate throat pain.

Oral Thrush and White Spots on Tonsils

Oral thrush, or oral candidiasis, is a fungal infection caused by Candida albicans that leads to white patches on the tonsils and other areas in the mouth. It is most common in individuals with weakened immune systems, recent antibiotic use, or certain medical conditions.

This infection occurs when Candida overgrows, typically due to disruptions in the natural balance of oral flora. It appears as soft, white patches that can be scraped off, often leaving red, inflamed areas underneath. Symptoms may include a burning sensation, oral discomfort, changes in taste, and a dry mouth.

Risk factors include antibiotic use, weakened immune systems from conditions like HIV/AIDS and diabetes, poor oral hygiene, wearing dentures, and smoking. Diagnosis is usually made through a visual examination, with possible throat swabs for confirmation.

Treatment involves antifungal medications, such as nystatin or fluconazole, along with good oral hygiene practices, salt water rinses, and limiting sugary foods to promote healing.

Tonsil Stones and White Spots

Tonsil stones, or tonsilloliths, are small, calcified formations in the tonsils that appear as white or yellowish spots. They develop when food particles, dead cells, and bacteria accumulate in the tonsil crypts and harden. Contributing factors include poor oral hygiene, chronic tonsillitis, and large tonsil crypts.

Common symptoms include visible white or yellow lumps, bad breath due to trapped bacteria, mild throat discomfort, and difficulty swallowing if the stones are large.

To remove tonsil stones, smaller ones can often be dislodged at home with a cotton swab or by gargling with salt water. If they are recurrent, an ENT specialist can use specialized tools for removal or recommend procedures like laser tonsil cryptolysis. In severe cases, a tonsillectomy may be advised.

Preventing tonsil stones involves maintaining good oral hygiene through regular brushing and gargling with antibacterial mouthwash, staying hydrated, avoiding sticky or sugary foods, and gargling with warm salt water to cleanse the tonsils.

Less Common Causes of White Spots on Tonsils

White spots on the tonsils can indicate various conditions beyond common infections. Here are some rare causes to consider:

Leukoplakia

This condition features painless white patches on the tonsils, often caused by irritation from smoking or alcohol. A biopsy may be needed to rule out precancerous changes.

Mononucleosis

Often caused by the Epstein-Barr virus (EBV), mononucleosis presents with white spots on the tonsils, fatigue, fever, and swollen lymph nodes. A blood test can confirm an active infection.

Tonsil Cancer

Although rare, tonsil cancer can show as persistent white spots, alongside symptoms like difficulty swallowing and unexplained weight loss. An ENT evaluation is important for diagnosis. Tonsil cancer is rare, with an incidence of 1 per 100,000 in the United States. 

Rare Infections

Uncommon infections, such as invasive fungal infections in immunocompromised individuals or viral infections like cytomegalovirus (CMV), can also cause white spots on the tonsils.

Home Remedies for White Spots on Tonsils

White spots on the tonsils can be uncomfortable. Here are some effective home remedies to alleviate discomfort and support recovery:

Saltwater Gargle

Mix 1 teaspoon of salt in 8 ounces of warm water. Gargle for 30 seconds several times a day. This remedy reduces swelling, kills bacteria, and promotes healing.

Honey

Take 1 to 2 teaspoons of raw honey or mix it into warm tea. Honey has antimicrobial properties and soothes throat irritation.  Studies show it reduces cough frequency in 85% of children with respiratory infections.

Hydration

Drink plenty of water, herbal teas, and broths to stay hydrated. Proper hydration helps thin mucus and supports immune function.

Warm Fluids

Consume warm liquids like herbal teas or broths. These can ease pain and keep the throat moist.

Apple Cider Vinegar

Mix 1 tablespoon of ACV in warm water and gargle or drink it with honey. ACV may help balance throat pH and fight infections.

Ginger Tea

Steep fresh ginger slices in boiling water for 10 minutes. Ginger can reduce inflammation and soothe throat discomfort.

Medical Treatments for White Spots on Tonsils

White spots on the tonsils can indicate various conditions, necessitating appropriate medical treatment. Here are common options healthcare professionals may recommend:

Antibiotics

For bacterial infections like strep throat, antibiotics such as penicillin or amoxicillin are prescribed to eliminate the bacteria and alleviate symptoms. If your provider does not prescribe antibiotics or antiviral medications, you can still get some relief from over-the-counter medications, like acetaminophen, or lozenges.

Antifungal Medications

If oral thrush is the cause, antifungals like nystatin or fluconazole may be necessary to target and clear the fungal infection.

Symptomatic Relief Medications

Over-the-counter medications, such as ibuprofen or acetaminophen, can relieve pain and inflammation associated with white spots.

Surgical Options: Tonsillectomy

In cases of recurrent infections or complications, a tonsillectomy may be recommended to remove the tonsils entirely. The procedure is common, with over 500,000 tonsillectomies conducted annually in the U.S., primarily in children.

ENT Specialist Consultation

For severe or persistent cases, consulting an ENT specialist is essential for a comprehensive evaluation and tailored treatment plan.

When to See a Doctor for White Spots on Tonsils

White spots on the tonsils may signal conditions requiring medical attention. Seek help if the spots persist for more than 48 hours, cause severe throat pain, or are accompanied by a fever over 101°F (38.3°C). Difficulty breathing or swallowing, swollen lymph nodes, and additional symptoms like a rash or fatigue also warrant a doctor’s visit. If you have a history of recurrent tonsillitis, consult an ENT specialist. Lastly, concerns about complications, such as abscess formation, should prompt immediate medical advice.

Frequently Asked Questions

– Disclaimer –
This blog is for informational & educational purposes only, and does not intend to substitute any professional medical advice or consultation. For any health related concerns, please consult with your physician, or call 911.