6th August, 20194 min read

White spots on tonsils: Causes and treatments

Last reviewed: 06/08/2019
Medically reviewed

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Tonsils are the two fleshy bumps at the back of your mouth - there’s one on the left and one on the right. They are responsible for trapping and killing germs, and helping prevent throat and lung infections.

But sometimes the tonsils themselves can become infected, and this may cause white spots to appear at the back of your throat.

There are many reasons for getting white spots on your tonsils. This article explains five possible causes.

White spots on tonsils caused by strep throat

Strep throat is a contagious bacterial infection. As well as white patches on your tonsils, symptoms may include:

  • a fever
  • a red and sore throat
  • a headache
  • chills
  • difficulty swallowing
  • swollen lymph nodes or glands in your neck
  • loss of appetite

You will usually need antibiotics to treat strep throat, but once treatment begins symptoms usually resolve in about a week.

When to worry

Speak to a doctor if you experience:

  • symptoms of strep throat
  • difficulty breathing
  • a sore throat that lasts longer than two days
  • a sore throat with a fine, sand-paper like pink rash on the skin
  • difficulty swallowing

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White spots on tonsils caused by tonsillitis

If you have white spots on your tonsils it could be a sign of tonsillitis. Tonsillitis is usually a viral infection, and symptoms tend to go away after a week.

Other symptoms of tonsillitis include:

  • a cough
  • a fever
  • a headache
  • nausea
  • fatigue
  • swollen neck glands
  • red and swollen tonsils

When to worry

Visit your doctor if your symptoms don’t improve after three to four days, or if they are severe.

You should seek immediate medical attention if you have:

  • difficulty breathing, swallowing saliva, or opening your mouth
  • severe pain
  • a constant high temperature
  • severe symptoms, in particular having pain on just one side of your throat

White spots on tonsils caused by oral thrush

Oral thrush is a fungal infection which can occur in the mouth, and it causes white spots on the tonsils. The white spots can develop on other parts of your mouth too, and sometimes they join together to form larger spots, called ‘plaques’.

Oral thrush is not usually serious or contagious, and in most cases it will resolve without treatment.

As well as white spots, oral thrush can cause:

  • sore, red patches around your mouth
  • pain when eating or drinking
  • red and sore mouth
  • temporary changes to your taste buds

You can treat oral thrush with a mouth gel from a pharmacy, and treatment usually takes seven days.

When to worry

You should see your doctor if:

  • your symptoms don’t improve after one week of treatment
  • you are struggling to breath
  • it hurts to swallow

White spots on tonsils caused by infectious mononucleosis (glandular fever)

Infectious mononucleosis or glandular fever is caused by the Epstein-Barr virus, and one of the symptoms is severe tonsillitis, which causes white spots on your tonsils.

It’s a self-limiting disease, and most people recover in about two weeks, but you may feel tired for a few weeks after your symptoms have subsided.

As well as white spots on tonsils it can cause:

  • a sore throat
  • swelling around the eyes
  • intense tiredness
  • mild pain in the upper left abdomen (due to a swollen spleen)
  • flu-like symptoms, such as a fever, muscle aches, and headaches
  • swollen glands

When to worry

Go to a doctor if you have any symptoms of glandular fever.

Get immediate medical help if you:

  • are having trouble swallowing
  • are struggling to breathe
  • have severe stomach pain

White spots on tonsils caused by tonsil stones

Tonsil stones are a build up of debris at the back of your throat. Usually they are nothing to be concerned about, but they can cause unpleasant symptoms, such as:


There are a number of reasons you could have white spots on your tonsils. Most likely the cause isn’t serious, but see a doctor if you have any of the worrying symptoms mentioned above.

You can also try our Self-Assessment Tool to get more information about what could be causing the white spots on your tonsils.

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