The tonsils are oval-shaped masses of tissue located on both sides at the back of the throat, positioned just behind the tongue. These tissues are part of the body’s lymphatic system and function as an early line of defense, trapping inhaled or ingested pathogens. Visually examining the tonsils can offer important clues about the presence of infection or other common conditions.
The Appearance of Healthy Tonsils
Healthy tonsils typically present as small, symmetrical, and pinkish structures that match the color of the surrounding throat tissue. Their surface may appear smooth or slightly irregular due to naturally occurring folds and crevices known as tonsillar crypts. These crypts increase the tonsil’s surface area to help trap germs.
The size of healthy tonsils varies widely, sometimes appearing recessed or hidden within the throat. Tonsils are naturally larger and more prominent in children than in adults, often shrinking with age. Therefore, a slightly larger size alone does not indicate a problem, provided the color and texture remain normal.
Visual Signs of Acute Infection
When tonsils become infected, a condition known as tonsillitis, the visual appearance changes significantly. The tissue typically displays severe redness and noticeable swelling. This inflammation can cause the tonsils to bulge out, sometimes narrowing the throat space and making swallowing difficult.
A distinguishing feature of many tonsil infections is the presence of exudate, which appears as white, yellow, or grayish patches, streaks, or spots on the swollen tissue surface. These spots are collections of pus, dead cells, and debris, indicating the body is actively fighting an infection. While both viral and bacterial tonsillitis cause redness and swelling, the presence of these white or yellow spots is more commonly associated with bacterial infections, such as strep throat. Viral infections often present with more generalized redness and swelling, possibly accompanied by other cold symptoms like a runny nose or cough.
Other Appearance Changes
Tonsils can exhibit other visual changes, including the formation of tonsil stones (tonsilloliths). These stones appear as small, firm, yellowish-white lumps lodged within the tonsillar crypts. Tonsil stones are calcified accumulations of food particles, bacteria, and hardened mucus, not pus. They can sometimes be seen protruding from the tonsil surface.
Repeated tonsillitis episodes may lead to chronic changes, resulting in permanently enlarged tonsils, a condition called hypertrophy. Frequent infections can cause the tissue to appear scarred or pitted, with deeper crypts prone to trapping debris. A noticeable difference in size between the two tonsils, known as asymmetry, is common, but significant, unexplained enlargement of only one tonsil warrants medical evaluation.
When to Seek Medical Guidance
If a self-check reveals signs of infection, a high fever above 100.4 degrees Fahrenheit, especially combined with red and swollen tonsils, suggests a possible bacterial infection requiring treatment. White patches or spots that persist for more than a few days should be checked by a doctor.
Immediate medical attention is necessary if swelling is severe enough to cause difficulty swallowing or breathing. Other urgent red flags include persistent drooling, which indicates an inability to swallow saliva, or any significant, unexplained enlargement of only one tonsil. Non-healing sores, ulcers, or growths on the tonsils should be evaluated quickly to rule out serious conditions.