White spots on tonsils are usually caused by pus, and they tend to appear with bacterial infections like strep throat. White spots can also appear with viral infections, such as mononucleosis or cytomegalovirus. These types of infections typically appear with other symptoms like fever, fatigue and general malaise. Presence of yellow or whitish spots on the tonsils, without other symptoms, may may also just be a sign of tonsil stones.
Ideally, any white spots should be assessed by a doctor, who will assess the underlying cause and start appropriate treatment. Treatment for a bacterial infection, for example, requires antibiotics like amoxicillin, while a viral infection may require anti-inflammatories like ibuprofen.
Pus that appears in the throat should not be removed with your finger or a swab as it will just continue to form until the inflammation improves. Attempting to remove pus may create wounds, as well as worsen the pain and swelling in that area.

Main causes
White spots on the tonsils can appear for many reasons, such as:
- Bacterial infections (like bacterial tonsilitis, strep throat or pneumoccocus)
- Viral infections (like mononucleosis, measles or cytomegalovirus)
- Tonsil stones
The best way to identify the underlying cause of the white spots is to seek an assessment. Determining the cause of white spots will help to guide appropriate treatment.
Treatment for white spots
The cause of the infection will determine the treatment required. A diagnosis must first be made by your family doctor or otolaryngologist.
Pharmacy medication
The doctor may opt to prescribe any of the following medication, or a combination of them:
- Anti-inflammatory drugs, such as ibuprofen, nimesulide and ketoprofen. These help to improve inflammation, redness, difficulty swallowing and fever;
- Corticosteroids, such as prednisone or dexamethasone. These are used when anti-inflammatory drugs do not resolve the problem, or if the throat pain is unbearable
- Antibiotics, such as penicillin, amoxicillin or azithromycin. These are prescribed if a bacterial infection is present.
In some cases, the infection may form an abscess in the tonsils, and when this happens, the doctor may drain the accumulated pus.
Natural treatment options
The home remedies can be used to treat any type of sore throat, however they should be used only as a complement to prescribed treatment. These only help to speed-up recovery and help with symptoms. Some options you can try include:
- Gargling with lukewarm water and salt, or with lemon, water and honey;
- Honey teas with ginger, eucalyptus, mauve, salvia or althea;
- Drinking grapefruit juice. Ideally, grapefruit juice should not be used if you are already taking medication prescribed by your doctor, as it may reduce the effectiveness of the medication.
When undergoing treatment, it is important to rest and drink plenty of fluids, which will help the body recover.