White Spots on Tonsils, Meaning & how to get Rid

Having white spots on tonsils can mean a lot. The marks can be swollen with pus, with no pain , fever or strep, large or small in size, a single one near throat etc. This article explores the meaning, causes, pictures and how to get rid of these white patches.

Why White Spots on Tonsils? Meaning & Pictures

Why do I have white spots on my Tonsils?

When you feel pain when swallowing down with inflammation that is palpable on the surface of the skin just below your jaw, where the tonsils are located, you might want to observe this. It is not effective doing this alone and therefore the best way to known if you have white spots on your tonsils will be to ask someone or visit a doctor.

white spots/patches on tonsils and throat, meaning causes and how to get rid

Whether you have spots on your tonsils or not will be answered by a wooden tongue suppressor, a medical examination torchlight and a trained medical personnel. This will raise concern of course especially since there are many causes to this. This article will enable you learn more about the causes of white spots on the tonsils and how you can even treat at home.

If you suddenly see white spots on your tonsils, you might be concerned. However, in many cases, you can easily treat the underlying cause and avoid surgical removal of the tonsils. Keep reading to learn more about the possible causes of white spots on the tonsils, as well as treatment options and more.

Why do you have white spots on your tonsils? There are many causes of this. Some are common and less serious while others are rare but serious and vice versa. White spots are generally a sign of an infection and you should therefore not disregard them. When you consult your doctor, be keen to mention any medication you are taking as some lower your immune system while others directly lead to infections.

What does white patches on your tonsils mean

As aforementioned, there are a variety of reasons for having white spots on the tonsils. Fortunately, they are treatable. There are a few stuff you need to know about spots on tonsils;

  1. The tonsils may be affected alongside other parts of the mouth or throat.
  2. The tonsils are the first point of immune attack along the respiratory tract and hence swelling means that they are fighting. Most are times, you need painkillers and bed rest.
  3. White spots could be anything from a list of more than 10 causes and there is need to investigate other options given that the white spots do not go away in a few days.

When the tonsils try to fight off infections along the throat, they mobilize white blood cells and this causes accumulation of pus. When you have white spots on the tonsils alone, it could mean that you are having a strep throat.

Fungal infections could also explain white spots on the tonsils but this usually occurs alongside white patches along the cheeks, gums, palate and gums.

White patches indicating fungal infections could mean that you are either immunocompromised or are undergoing a side effect of medication you are taking. This could point out to more tests, withdrawal from the culprit drug or its substitution.

White spots tonsils pictures

An illustration of white spots on tonsils

What causes White Patches on Tonsils & Throat?


Allergens or substances that cause body reactions such as itchiness, swelling and redness among other signs of an allergic reaction could result in white spots on your tonsils.

When your tonsils reacts to the allergen, it thrusts antibodies towards the antigen and in the process, swells. Blood flow to the tonsils is increased and the white blood cells are multiplied and generated faster to counter this foreign body. In the process, white streaks are formed on the tonsils.

Infectious mononucleosis

This is a disease that results in extreme fatigue, sore throat, enlarged tonsils and lymph nodes, fever and muscular pain. It is a viral infection that is caused by the Epstein Barr Virus (EBV) which is a type of herpes virus.

While there are other viruses that could cause this such as the adenovirus, EBV is the most common. When you have the mono, you will most likely get an enlargement of the tonsils accompanying pharyngitis as the most prominent presentation.

To add, the tonsil not only swells, but may become exudative meaning that is produces pus such as that seen in tonsillitis caused by Streptococcus pyogenes. Normally, the white patches on the tonsils are accompanied by other surface manifestations such as formation of red/purple spots on the palate or roof of the mouth.

Strep throat

This disease is caused by the group A streptococcus, Streptococcus pyogenes, which is a bacteria. This bacteria is the most common cause of swollen tonsils in infants and children though this means that it doesn’t occur in young adults and adults.

This bacteria is responsible for other diseases that also occur with white spots and swelling of the tonsils. It is therefore important that the actual infection identified so as to treat other associated clinical presentations.

For instance, scarlet fever is caused by this bacteria and presents with a rash that appears red and feels rough. On top of this, the tongue acquires a characteristic strawberry color. It also presents with a sore throat, swollen tonsils and lymph nodes.

Another one known as rheumatic fever is an inflammatory condition that attacks the joints, skin and heart. It may be the underlying condition when treating for a strep throat and if not well treated, rheumatic fever may result. This results due to the body’s own immune reaction to itself after the infection.

White spots appear on the tonsils due to the mobilized immune cells alongside a fever, flu-like symptoms, headache and fatigue. The general term that is used to refer to strep throat is tonsillitis. However, this name could mean any other infection that leads to an inflammation of the tonsils.

Oral thrush

This is a fungal infection known as candidiasis. The causative fungi in this case is Candida albicans. This yeast infection is common in people who:

  1. Have a suppressed immune system: a competent immune system is able to prevent the occurrence of a fungal infection. Therefore, if an individual gets this, alarms raise the need to investigate further any loss of competency. Note that immune suppression can also be caused by intake of medication such as methotrexate, steroids and other anti-cancer agents that lower the immune system’s capacity to fight off fungal infections.
  2. Are on a course of antibiotics: antibacterials indiscriminately kill bacteria and allow fungi to thrive. This is the reason as to why fungal infections occur when you are taking antibacterials such as amoxicillin and others.
  3. Use of steroid inhalers in asthma: corticosteroids delivered directly onto the airways in inhalers result in suppression of the immune system and lead to oral thrush. This could occur on the tonsils as white patches. This has been supported by medical professionals in the American Academy of Allergy Asthma and Immunology. Therefore, it is recommended that after inhaling the drug, water be used to swish and gargle to remove the steroid on the epithelial surfaces.

Tonsil stones

These are deposits of food particles and calcium in the ducts/crypts/canaliculi of the tonsils. Bacteria accumulate in the crypts and may result in an infection. The tonsil stones appear as white or yellow spots with other symptoms such as bad breath (halitosis) and ear ache. The stones are known as tonsilloliths and lead to swelling of the tonsils.


This infection can also lead to formation of white spots on the tonsils. The infectious agent in this case is known as Corynebacterium diphtheria. When

Diphtheria is an infection caused by a bacteria called. Usually, diphtheria affects the mucous membranes in the noses and throat. However, this infection can also cause white spots on the tonsils. It often occur among children.

Viral pharyngitis

This is commonly referred to as a sore throat. It is frequently caused by a virus but can also be caused by bacteria. Pharyngitis is a term used to refer to an inflammation of the pharynx. The tonsils are also involved and pus may often form on them. This makes them appear as white spots on the tonsils.


There are drugs that are known to cause white spots on the tonsils and the oral cavity in general. As mentioned earlier, steroidal inhalers that are used by asthmatics can suppress the immune system and predispose to oral thrush. Hence, any medication that is an immunosuppressant can result in an oral thrush and white patches or spots on the tonsils and the oral cavity.

White Pus Pockets on Tonsils, Causes & Meaning

There are various causes of white pockets on tonsils. Pockets point out to a sac filled with pus. This is most often than not caused by bacterial infections. Here are some of the reasons.

Sexually Transmitted Infections

Note that HIV/AIDS is not a sexually transmitted infection since it can be transmitted through other means such as sharing sharp objects. In this class falls the Herpes Simplex Virus 1 and 2 that can both infect the oral cavity. Not only do the sore appear on the lips, but can also appear on the inner mouth and the tonsils too. When the virus infects the tonsils, there is formation of pus and therefore white spots.


This immune-deficiency virus puts you at risk of many infections known as opportunistic infections. Oral thrush is one of them. Oral thrush in HIV, spreads to the tonsils and the esophagus in which the latter is known as esophageal candidiasis. Other conditions known to occur with HIV patients are those caused by bacteria such as Streptococcus pyogenes and Staphylococcus aureus. Infections by other viruses such as Epstein Barr Virus, Adenovirus and Herpes Simplex Virus also become common and result in swelling of the tonsils with white spots and patches on them.

The causes of white spots on tonsils mentioned in the previous sections in this article can also result in white pockets on the tonsils. There are other causes of white pockets including glandular fever and measles.

Swollen Tonsils with White Spots

A change in the normal size of the tonsils and color tinge on various areas enable the medical examiner to determine the cause and the severity of the condition. Tonsils swelling is known as inflammation and is a cardinal mark or indicator of an inflammation. Cardinal markers of inflammation include redness, swelling, heat and pain.

When your body’s immune system identifies foreign bodies, they are regarded as antigens and antibodies are initiated against them. Inflammatory markers including vasodilators are released from mast cells to allow more blood to flow to the area of interest. In this way, immune cells and anti-inflammatory markers can be delivered rapidly to counter the antigen. Surface adherence molecules help the immune cells pass through the walls of the capillaries. This process is known as extravasation and is what leads to buildup of plasma in the interstitial space surrounding the blood vessels. At this point, it is known as interstitial fluid.

White spots could look like patches or dots. They at times occur as streaks. The shape and presentation of the white on the tonsils provides important information on the causative agent.

The white spots are an indicator of pus. Pus is a fluid that accumulates a lesion which is infected. The white color or yellow in some cases means that there are white blood cells in it. This is therefore a reference to an infection at hand. Infections by viruses and bacteria such as strep form white spots.

The white could also be due to something else other than accumulation of pus alone. Fungal infections are generally white due to the fungal growth and not necessarily due to pus.

White Spots & Pus on Tonsils no Fever & Pain

There are situations in which you can present with tonsils but no associated symptoms such as fever. This should however not be a reason to assume the condition underlying the white spots on the tonsils. You should ensure that you deal with it square just as you would with one that occurs with a fever. Sore throat or a cancerous growth could explain the occurrence of white tonsils without fever. Lack of a fever generally is taken as non-infectious.

Single One White Spot on Tonsil

Single spots on the tonsils could be explained by the presence of a tonsil stone. It is also known as a tonsilloliths and forms either white or yellow colored pouches on the tonsils. When one of the crypts on the tonsils is filled with pathogens and deposited food, it forms a pocket. This is seen as one white spot on the tonsils.

Various calcifications after this result in a number of white spots. Make sure that you consult your doctor when you notice this.

White spots on tonsils not strep

White spots on the tonsils on first sight are normally regarded to as strep, an infection. Strep throat is caused by a group A Streptococcus known as Streptococcus pyogenes. The white indicates that there is formation and production of pus. Pus means an infection.

While there are other causes to having white spots, the first stop over is directed towards a strep throat. There are tests that will be run by your medical professional such as strep test to ascertain this.

However, many medical personnel initiate empirical therapy in lack of resources. Caution needs to be taken by those who diagnose this since strep throat can be linked to other conditions such as rheumatic fever or skin diseases such as seen in scarlet fever, impetigo or cellulitis.

The misconstrue that white spots are always linked to strep should be done away with. This is pertinent in the determination and investigation for the accurate causative pathogen. Remember that fungal infections and other bacteria including that which causes diphtheria can also lead to white spots on the tonsils.

Other causes to white spots on the tonsils include esophageal thrush or candidiasis, sore throat, tonsilloliths, diphtheria and infectious mononucleosis.

In fact, to some medical professionals such as Dr Sindisiwe van Zyl who specializes in primary healthcare, candidiasis or oral thrush is the most common cause of white spots on the tonsils. This is especially if one is immunocompromised such as HIV patients or is an asthmatic who is using an inhaler.

White spots on tonsils sore throat Infection

Sore throat is caused by inhaling dust in the air, smoking and allergies. They are most commonly caused by viruses just as happens in cold and flu.

When there is a white spots on the tonsils in form of streaks associated with runny nose, cough, sneezing and a low grade fever, then it could be a sore throat.  Good thing about viruses is that they are self-limiting and therefore antibiotic therapy would not elicit much benefit in these cases.

Pus & white Spot on tonsil- cancer

Pus and white spot could be linked to cancer. According to Cedars Sinai, tonsil cancer is common in men than women and is common on the tonsils to the sides of the throat. There are three types of tonsils, those that occur at the back of the throat, the adenoids, the palatines, to the sides and the lingual under the tongue.

Cancer of the tonsils is however linked to other associated signs and symptoms such as blood in the saliva, persistency in the sore throat even with treatment, a lump or pain in the neck and severe ear pain. You will instinctively determine if the white spot on the tonsils is linked to a serious condition or not.

Large & Small Patche Spots on Tonsils

The size of the white spot on the tonsils may provide information concerning:

Severity of the infection

when the spots are small, then it could be that this is the early stage of the condition or infection. However, if the spots are widespread, it could mean that the condition is spreading and that it has been present for some time now.

Identification of the condition

Regardless of the severity of a condition, there are those that characteristically occur as small or large white spots. There are those that occur as streaks. If you were to scope down the throat of a patient with infectious mononucleosis, you might observe streaks of white on the tonsils. Tonsil stones may be small in size but result in serious effects.

Provision of information on outcome

The size of the white spot may be used to determine how the treatment outcome will be. Some infections will require that you give them more time than others to heal. When you have oral thrush localized to the oral cavity and not the esophagus, the prognosis is better unlike the same fungal infection along the esophagus.

People who are immunocompromised such as those with HIV are more prone to the esophageal candidiasis affecting all the tonsils. In this case, the outcome is not comparable to an immunocompetent individual.

How to get rid of Pus & White Spots on Tonsils

Home remedies

Home remedies that can be used to get rid of the white spots and the pus from your tonsils include:

  1. Hot water and salt gargle
  2. Garlic juice
  3. Hot lemon juice or gargle
  4. Garlic, lemon, ginger mix

Treatment and medications

White spots on tonsils can be treated with regard to the disease that has caused it. If it is a fungal infection such as an oral thrush, then fluconazole 150 mg or 200 mg will be administered as a single dose.

If it is a bacterial infection, antibacterials such as amoxicillin and azithromycin are preferred. Analgesics such as paracetamol are indicated for the pain associated with tonsillitis.

How to prevent

Some of the ways through which you can prevent white spots on tonsils from occurring include:

  1. Avoid crowded places
  2. Avoid kissing an infected partner
  3. If you are using a steroid inhaler, it is recommended that you swish your mouth with some water after taking your puffs.
  4. Avoid cold drinks

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