White spots on the throat can be concerning, appearing due to various factors from common infections to less frequent conditions. Understanding causes helps identify when medical evaluation is beneficial. This article explores conditions leading to white spots, serving as a general guide and not replacing professional medical advice.
Sexually Transmitted Infections and Throat Symptoms
Certain STIs can cause white spots or lesions in the throat, particularly after oral sexual contact.
Oral herpes, caused by the herpes simplex virus (HSV-1 or HSV-2), results in painful sores or blisters on the lips, gums, tongue, cheeks, and throat. These fluid-filled bumps break open, forming shallow, white or yellowish ulcers with a red border.
Oral gonorrhea, caused by Neisseria gonorrhoeae, typically presents as pharyngitis (throat inflammation) and often remains asymptomatic. When symptoms occur, they can include a sore throat, difficulty swallowing, and sometimes visible redness or pus-like white patches on the tonsils and throat.
Syphilis, caused by Treponema pallidum, can affect the throat in its primary and secondary stages. A chancre, a firm, painless sore, may develop in the throat during the primary stage, sometimes appearing whitish or covered by white exudate. In the secondary stage, generalized mucous patches (flat, moist, white or grayish lesions) can appear on the mucous membranes of the mouth and throat.
Oral candidiasis (oral thrush), caused by the fungus Candida albicans, can also appear. Though not exclusively an STI, it is more prevalent in individuals with weakened immune systems, such as those with untreated HIV infection.
Non-STI Causes of White Spots
White spots on the throat are not exclusively linked to STIs; many other common conditions can also cause them.
Strep throat, a bacterial infection caused by Streptococcus pyogenes, often leads to a sore throat, fever, and white patches or streaks of pus on the tonsils and back of the throat. Tonsillitis, an inflammation of the tonsils (bacterial or viral), can also cause swollen, red tonsils that may have white spots, pus, or a coating.
Oral thrush, a fungal infection, can occur in individuals without compromised immunity, such as infants, denture wearers, or those using certain medications like antibiotics or corticosteroids. This condition manifests as creamy white lesions on the tongue, inner cheeks, tonsils, or throat, which may bleed slightly when scraped.
Various viral infections, including mononucleosis (Epstein-Barr virus) and common cold viruses, can also cause throat inflammation and, in some cases, white spots or exudates on the tonsils.
Canker sores (aphthous ulcers) are small, painful sores with a white or yellowish center and a red border. They can develop on soft tissues inside the mouth, including the throat or tonsils. While typically not widespread, they can be isolated occurrences.
Leukoplakia involves thickened, white patches on mucous membranes in the mouth or throat that cannot be scraped off. Often associated with chronic irritation from tobacco or alcohol, this condition is generally benign, but some forms can show precancerous changes.
Seeking Medical Advice and Diagnosis
White spots on the throat warrant medical evaluation for proper diagnosis and management. Consult a healthcare provider if spots are persistent, or accompanied by pain, fever, difficulty swallowing, or swollen glands. Medical attention is also important after recent unprotected sexual activity, as STIs may require specific testing and treatment.
During a medical visit, the healthcare provider will conduct a physical examination of the throat and mouth, review your medical history, and inquire about symptoms or recent exposures. Diagnostic tests may include a throat swab for bacterial or viral infections (e.g., strep throat, gonorrhea) or blood tests for conditions like mononucleosis or syphilis. Providing a complete and honest medical history, including sexual history, is important for accurate diagnosis. Self-diagnosis is not reliable and can delay proper treatment, potentially leading to complications or infection spread.