White spots appearing on the throat can be a source of concern. These spots can manifest as small, discolored patches, streaks, or larger areas on the tonsils or the back of the throat. Their presence often signals an underlying condition that requires attention.
Infectious Causes
Infectious agents frequently cause white spots in the throat. Strep throat, caused by Group A Streptococcus bacteria, is a common bacterial infection. It often presents with white patches or streaks of pus on the tonsils, a sudden sore throat, pain when swallowing, and a fever. Swollen lymph nodes in the neck may also occur.
Viral infections, such as adenoviruses, influenza, or coxsackievirus, frequently cause tonsillitis, an inflammation of the tonsils. This can lead to a sore throat, difficulty swallowing, and white spots on the tonsils. While viral tonsillitis often resolves on its own, it can still cause discomfort.
Oral thrush (oral candidiasis) is a fungal infection from an overgrowth of Candida albicans. It causes white, cottage cheese-like patches on the tongue, inner cheeks, and throat. Individuals with weakened immune systems or those taking antibiotics are more susceptible.
Mononucleosis, caused by the Epstein-Barr virus, is a contagious viral infection that can lead to white spots on the tonsils and throat. It often spreads through saliva and can cause fatigue, fever, and swollen lymph nodes.
Non-Infectious and Other Causes
Beyond infections, several other conditions can cause white spots on the throat. Canker sores (aphthous ulcers) can develop in the throat, appearing as small, painful white or yellow lesions with a red border. These are typically not infectious and can be triggered by stress, minor injury, or certain foods.
Leukoplakia causes thick, white patches on the tongue, inner cheeks, or throat that cannot be scraped away. It is often associated with chronic irritation, such as from tobacco use or excessive alcohol consumption. While usually benign, some forms can be precancerous. Monitoring these patches is important due to their potential for malignant transformation.
Tonsil stones (tonsilloliths) are calcified formations in the tonsil crevices, made of trapped food debris, bacteria, and minerals. They appear as small white or yellowish pebbles and can cause bad breath, a sore throat, or a sensation of something stuck in the throat. While generally harmless, they can be a source of irritation.
Diphtheria, a serious bacterial infection, can cause a thick, gray-white coating on the back of the throat and tonsils. Though rare due to vaccination, it is severe and can lead to breathing difficulties, heart problems, and nerve damage.
When to Seek Medical Attention
Seek medical attention if white spots on the throat are accompanied by difficulty breathing or swallowing, as these could indicate severe obstruction or inflammation. A high fever, especially if persistent or rising, also warrants prompt evaluation.
Severe throat pain that interferes with eating or drinking suggests a medical assessment is needed. Seek professional advice if white spots persist for several days without improvement, worsen, or appear widespread. Individuals with a weakened immune system (e.g., from chemotherapy or chronic illnesses) should consult a doctor without delay. Medical evaluation is also recommended if a child or infant develops white spots, due to their increased vulnerability and the potential for rapid progression of some conditions.
Diagnosis and General Treatment Approaches
Diagnosing the cause of white spots on the throat typically begins with a physical examination. A healthcare professional will visually inspect the throat, tonsils, and mouth, noting the spots’ appearance, size, location, and texture. They will also assess for other signs of inflammation or infection, such as redness, swelling, or pus.
Often, a throat swab collects a sample for a rapid strep test, which quickly detects the presence of Group A Streptococcus bacteria, or a laboratory culture to identify bacterial or fungal pathogens. Blood tests may also be ordered to check for viral infections like mononucleosis or assess immune function.
Treatment strategies depend on the underlying cause. For bacterial infections like strep throat, antibiotics are prescribed to eliminate the bacteria. It is important to complete the full course of antibiotics, even if symptoms improve, to prevent recurrence and complications. Viral infections, including most tonsillitis and mononucleosis cases, do not respond to antibiotics; treatment focuses on supportive care like rest, hydration, and pain relief. Antifungal medications treat oral thrush. For non-infectious causes like leukoplakia, monitoring is often recommended, and a biopsy may be performed if a lesion is concerning to rule out precancerous changes. Tonsil stones can sometimes be dislodged with gargling or gentle manual removal; recurrent cases may require an ENT specialist.