White Spots on Tonsils: Causes and Treatments

White spots on your tonsils are typically a sign of common bacterial or viral infections, such as tonsillitis, strep throat, or mononucleosis. White spots can be caused by tonsil stones, a harmless condition that also leads to bad breath. 

If you have a bacterial or viral infection, the white spots on your tonsils may look like patches of a white fluid, also called tonsil exudate. This fluid is a sign that your tonsils are fighting off an infection.

You may also have a sore throat, swollen tonsils, tender neck, fever, or fatigue.

Sometimes, the white spots may look like small white masses on your tonsils. The only other symptoms may be bad breath and a feeling that something is stuck on your tonsils. 

White spots on your tonsils are usually caused by bacterial or viral infections. However, there are other causes without an underlying infectious cause.

Tonsillitis 

Tonsillitis is inflammation of the tonsils. It’s usually a symptom of a bacterial or viral infection, such as the common cold. Your tonsils may look red, and you may have a sore throat and fever associated with the white spots.

Strep Throat

Strep throat is an infection of the tonsils caused by Streptococcus pyogenes bacteria. If you have strep throat, you may quickly develop a sore throat and fever. Your throat may also feel swollen. Strep throat is spread easily between people and is more common in children. 

Mononucleosis

Mononucleosis is a common viral infection caused by the Epstein-Barr virus (EBV). Mononucleosis is also known as the “kissing disease” or “mono.” It spreads through saliva, typically from sharing drinks, utensils, and kissing. Symptoms of mono may also include:

• Chronic fatigue
• Swollen lymph nodes
• Sore throat
• Fever
• Skin rash
• Reddish pinpoint spots on the roof of your mouth
• Swollen abdomen from an enlarged spleen

Tonsil Stones

Tonsil stones are not caused by infection and generally don’t make you feel sick. These small, hard-looking white spots are caused by debris caught in your tonsils. The main symptom of tonsil stones is bad breath from the bacteria that grow in the debris. You may also feel the tonsil stone as a foreign body in the back of your throat.

White spots on your tonsils are usually a sign of a bacterial or viral infection, so it’s a good idea to get checked out by a healthcare provider to determine and treat the underlying cause.

You can expect the healthcare provider to:

• Look at your tonsils for whitish fluid or harder masses
• Ask about other symptoms you may be experiencing, like a fever or sore throat
• Test your tonsils and throat for the presence of bacteria and viruses

A diagnosis can help prevent the spread of an infection to others. For example, strep throat is highly contagious when untreated, but it’s typically not contagious approximately a day after starting antibiotics. Mononucleosis is also contagious through saliva, and knowing this diagnosis can help you avoid sharing drinks and utensils with others. 

Treating your white spots depends on the cause.

Infection: White spots on your tonsils typically go away as the underlying infection resolves. If it’s a bacterial infection, antibiotics can help clear the infection sooner, which will get rid of your symptoms, including the white spots on your tonsils. 

Tonsil stones: Tonsil stones don’t necessarily need treatment unless they bother you. You can try gently removing any visible tonsil stones with a cotton swab. You can also gargle with a mouth rinse. If you prefer, you can visit your primary care provider or dentist to have the stones removed. 

Because white spots on your tonsils are typically a sign of an underlying infection, preventing them involves avoiding the bacterial and viral infections that cause them. Practicing good hand-washing technique before meals and throughout the day is a great step you can take to prevent infection.

White spots on the tonsils are often a sign of tonsillitis, strep throat, or mononucleosis. Depending on the infection, you may also have a sore throat, fever, swollen tonsils, fatigue, or tender lymph nodes. White spots may also be tonsil stones, which aren’t dangerous but may cause bad breath.