For some individuals, a quick glance in the mirror might reveal small white spots, resembling grains of rice, lodged in the crypts of the tonsils. These spots may emit an unpleasant odor and are sometimes accompanied by swollen tonsils. What do these symptoms indicate?
1. What Causes White Spots on the Tonsils?
The surface of the tonsils is not entirely smooth but contains an average of 10–20 crypts that extend deep into the tissue. Crypts of the tonsils are small pockets or folds in the tonsils. These crypts may harbor particles made of live or degenerated lymphocytes, exfoliated epithelial cells, and microorganisms.
When tonsillitis develops, numerous white spots may appear on the tonsils. These spots, typically white or off-white in color, resemble small fragments of peanuts and often emit a foul odor. They may protrude from the crypts, causing discomfort while swallowing or even a sensation of having a foreign object in the throat. Pain may radiate to the ears. Tonsillitis is also a common cause of bad breath.
The white spots on the tonsils often form as the body fights off infections. These spots typically consist of pus, produced as white blood cells combat bacteria or viruses invading the throat tissues. The presence of these white spots could indicate various conditions, including tonsillitis with pus, strep throat, infectious mononucleosis, or other infections.
These spots may appear solely on or around the tonsils, or they could spread across the mouth, including the back of the throat. Symptoms that commonly accompany white spots on the tonsils include sneezing, sore throat, coughing, fever, painful swallowing, nasal congestion, headaches, body aches, swollen lymph nodes, and, in some cases, breathing difficulties due to enlarged tonsils partially blocking the airway.
2. What Conditions Are Associated with White Spots on the Tonsils?
Tonsillitis
When the tonsils become infected by bacteria or viruses, they respond by secreting white pus, forming multiple white streaks or spots. Early symptoms of tonsillitis may include headaches, fever, or neck stiffness.
Tonsilloliths
Tonsilloliths or tonsils stones, form when debris such as dead cells, mucus, food particles, and bacteria accumulates in the tonsillar crypts. Over time, this debris calcifies, creating an ideal environment for bacterial growth and increasing the risk of infection. Tonsil stones can harden and grow, leading to discomfort and difficulty in treatment.
Oral Thrush
White patches on the tonsils may also be caused by a fungal infection. While fungi exist harmlessly in our bodies, certain conditions, such as a weakened immune system or a diet high in sugar, can allow them to proliferate, causing health issues. Thrush-related white patches can extend to the tongue, cheeks, and throat. Although they do not cause swelling, they may alter the sense of taste.
Sore Throat
Strep throat, caused by Streptococcus bacteria, is a common cause of sore throats. This condition produces white streaks on the tonsils and throat, accompanied by pain when swallowing, scratchy throat sensations, swollen lymph nodes, and fever as the immune system combats the infection.
Infectious Mononucleosis
Also known as "mono," this rare condition results from Epstein-Barr virus infection. Symptoms may mimic tonsillitis with pus, including fatigue, fever, and headaches. In adolescents, mono often causes white patches around the tonsils and lymph node swelling. Some patients may also develop a red rash across their body.
3. How Are White Spots on the Tonsils Treated?
Treatment for white spots on the tonsils often involves regular gargling with saline solution to maintain oral hygiene. During acute infections, appropriate antibiotics may be prescribed.
For tonsil stones, gentle removal using a cotton swab or finger can help. However, if symptoms persist or recur frequently, surgical removal of the tonsils may be necessary to alleviate discomfort and prevent further complications.
At Vinmec International General Hospital, the Department of Otolaryngology specializes in diagnosing and treating common ENT conditions such as tonsillitis, sore throat, tinnitus, non-allergic rhinitis, sinusitis, throat cancer, and congenital ENT abnormalities using advanced surgical techniques.
To arrange an appointment, please call HOTLINE or make your reservation directly HERE. You may also download the MyVinmec app to schedule appointments faster and manage your reservations more conveniently.
