White Spots on Tonsils: Causes, Symptoms & Treatment

White spots on the tonsils are often a sign of a throat infection and may appear with symptoms such as fever, redness, swelling, and pain when swallowing. These spots are usually caused by viral or bacterial infections that lead to pus forming in the throat.

White spots on the tonsils can appear in conditions like mononucleosis or bacterial tonsillitis. They may also be accompanied by bad breath or swollen lymph nodes in the neck. In some cases, the white or yellow lumps are tonsil stones, which are not always caused by infection.

Treatment for white spots on the tonsils depends on the cause and may include rest, increased hydration, pain-relieving medicines, antibiotics for bacterial infections, or other treatments recommended by a healthcare provider. Prompt evaluation helps confirm the diagnosis and reduce the risk of complications like tonsil abscesses.

Main symptoms

The main symptoms of pus in the throat are:

• White spots or patches in the throat or on the tonsils.

• A red, swollen throat.

• Sore throat or pain when swallowing.

• Fever above 100.4°F (38°C).

• Bad breath.

• Swollen lymph nodes in the neck.

In addition, children and babies may have excess saliva, drool more than usual, become irritable, or refuse to eat or breastfeed.

According to the CDC, strep throat commonly causes fever, pain when swallowing, swollen lymph nodes in the neck, and white patches or streaks of pus on the tonsils.

Small yellow or whitish lumps in the throat, when no other symptoms are present, may simply indicate tonsil stones.

It’s important to see an otolaryngologist (ENT) if you notice pus in your throat, so the cause can be found and the right treatment started promptly.

Is pus in the throat dangerous?

Pus in the throat can be dangerous if it is not treated properly by a healthcare provider.

This happens because an abscess can develop in the tonsils, potentially causing complications such as additional abscesses in the pharyngeal area or even a more widespread infection.

Confirming a diagnosis

An ENT specialist, primary care provider, or pediatrician diagnoses pus in the throat by assessing symptoms and examining the throat.

In most cases, no additional testing is not needed. However, in some cases, the provider may request an analysis of the pus in the throat to identify the microorganism and recommend the most appropriate treatment.

How long does it last?

A sore throat with pus can last one to two weeks, depending on the underlying cause.

Starting treatment early under medical supervision helps the infection clear faster and reduces throat inflammation. Therefore, it’s important to see a healthcare provider as soon as pus appears in the throat to begin proper treatment.

Main causes

The main causes of white spots on the tonsils are:

1. Viral infections

Some viral infections can cause pus in the throat, such as:

• Viruses that cause the common cold, such as rhinovirus and adenovirus.

• Flu viruses, such as influenza A or B.

• Respiratory syncytial virus (RSV).

• Epstein-Barr virus, which causes mononucleosis (mono).

Less commonly, HIV infection and the measles virus may also cause white spots on the tonsils.

2. Bacterial infections

According to the CDC, group A Streptococcus, also called Streptococcus pyogenes, causes strep throat and can infect the throat and tonsils. Streptococcus pyogenes (strep A) is naturally present in the throat and may multiply when the immune system is weakened or be passed from one person to another.

This bacterial infection mainly affects the pharynx or tonsils, causing bacterial tonsillitis and pus plaques in the throat.

Treatment options

Treatment for a sort throat with pus should be guided by an ENT, primary care provider, or pediatrician and depends on the cause.

The main treatments include:

1. Rest

Rest is important because it helps the immune system fight the infection more quickly.

2. Hydration

Increasing fluid intake is important to help prevent dehydration, especially when fever is present.

For this reason, it is recommended to drink more water or offer breast milk on demand to babies and breastfeeding children.

Warm teas or soups may also help keep the body hydrated.

3. Salt water gargles

A salt water gargle is a good option for an sore throat with pus because it can help relieve pain and inflammation and may help remove bacteria.

This gargle has anti-inflammatory, antiseptic, and antibacterial effects and can be done several times a day. However, gargling with warm salt water does not replace medicines prescribed by a healthcare provider.

4. Medications

The primary medications a healthcare provider may prescribe for a throat infection with pus include:

• Pain relievers, such as acetaminophen.

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.

• Throat lozenges, such as benzocaine lozenges.

• Corticosteroids, such as prednisone or dexamethasone.

• Antibiotics, such as amoxicillin or azithromycin, in cases of bacterial infection.

Medications should be taken only under medical supervision, according to the symptoms and the underlying cause of the inflammation.

5. Drainage

In some cases, the infection can lead to an abscess forming in the tonsils. If this occurs, the healthcare provider may need to drain the accumulated pus.

6. Home treatments

Lemon tea, garlic tea, or ginger tea may help reduce throat inflammation and relieve symptoms due to their antioxidant, anti-inflammatory, and antibacterial effects.

These home remedies may be used along with medicines prescribed by a healthcare provider, but they should not replace medical treatment.

How to remove pus from an inflamed throat

The pus plaque that appears in the throat should not be removed with a finger or cotton swab, because it will continue to form until the inflammation improves. Trying to remove it can also create new injuries, worsen pain, and make the infection worse.

The best way to get rid of pus in an inflamed throat is to follow the treatment recommended by a healthcare provider so the cause of the infection is treated and symptoms improve.