What Causes White Spots in Your Throat?

Medically Reviewed by Poonam Sachdev on July 16, 2024
Written by Amanda Gardner, Lori M. King, PhD
9 min read

You may see white spots or pale yellow patches on the sides or back of your throat while you're brushing or flossing your teeth. This can be a little scary, but the cause of these white spots is usually an infection, whether it's caused by a bacteria, virus, or fungus. Along with the white spots, streaks, or patches at the back of your throat, you may also notice other symptoms, such as:

  • A sore throat
  • Trouble swallowing
  • Fever
  • Fatigue
  • Nose congestion

These other symptoms depend on the cause and may give you and your doctor a clue about what's going on. Read on to find out more about some of the infections or conditions that can cause you to get white spots at the back of your throat.

Tonsillitis is the medical term for swelling and redness in your tonsils. Your tonsils are lumps of soft tissue in the back of your throat. They're a part of your immune system and help trap germs that can make you sick.

The most common cause of tonsillitis is infection with a virus, but bacteria can also cause it. Most cases are caused by the viruses that cause a cold or the flu. Bacterial tonsillitis is usually caused by strep throat.

You can get tonsillitis by coming into close contact with someone who has an infection. For instance, by:

  • Kissing or sharing food, drinks, or utensils
  • Touching a contaminated surface, then touching your nose or mouth
  • Inhaling airborne particles that an infected person sneezed or coughed out

It's more common in kids aged 5-15 years old than in younger kids and adults. So, you may be more likely to get it if you have a school-aged child or work in a day care center or school. You may also be more likely to get it if you live or work in a crowded setting, such as a detention or correctional facility, military training facility, or shelter.

To diagnose you, your doctor will usually ask about all of your symptoms, especially symptoms that can help them rule out other conditions. They'll also likely do an exam of your throat, ears, and nose. To help them figure out if you have bacterial or viral tonsillitis, they may do a throat culture and rapid strep test.

Tonsillitis symptoms

How long your symptoms last depends on the cause. Viral tonsillitis generally has milder symptoms than bacterial tonsillitis and usually goes away without any treatment in about a week. You will most likely need antibiotics for bacterial tonsillitis (strep throat), and it may take about 10 days to feel completely well. In addition to white spots or a white, yellow, or gray coating on your tonsils, you may also have:

  • A sore throat that may feel scratchy
  • Trouble swallowing or pain when you swallow
  • Fever (often above 100.4 F)
  • Swollen lymph nodes in your neck
  • Stomach pain or vomiting (more common in younger kids)

Strep throat is an infection in your throat and tonsils caused by Group A Streptococcusbacteria. You may be exposed to strep bacteria if you have close contact with a person who has strep throat.

Strep throat is one of the most common causes of tonsillitis, so the risk factors are the same. It's most common in kids aged 5-15 years. You may be more likely to get it if you're in regular close contact with school-aged children, or if you live or work in a crowded setting, such as a detention or correctional facility, military training facility, or shelter.

Your doctor can take a throat swab and do a rapid strep test to tell if you have strep throat. If the sample comes back positive, they'll give you antibiotics to kill the bacteria. You may start to feel better in as little as a day, but the antibiotics need about 10 days to finish the job.

Strep throat symptoms

Generally, you'll start getting sick about 2-5 days after you're exposed to strep bacteria. Seeing white patches or steaks of pus on your tonsils is common with strep throat. In addition, you may also have:

  • Red and swollen tonsils
  • Very small red spots (also called petechiae) on the roof of your mouth
  • Swollen lymph nodes in your neck
  • Sore throat (may start very quickly)
  • Pain when you swallow
  • Fever , h eadache , and chills

Symptoms that are more common in children with strep include:

  • Loss of appetite
  • Stomach pain
  • Nausea and vomiting
  • A rash (called scarlet fever), which may show up on your neck and chest first and then spread to other parts of your body

Oral thrush is a yeast infection in your mouth .

It's usually caused by a kind of yeast, a species of fungus called Candida albicans. Everybody has it in their body naturally, but when it overgrows, it can cause symptoms. People who are at the highest risk for this overgrowth include:

  • Infants aged less than 1 month
  • Toddlers
  • Adults aged over 65 years
  • People with weakened immune systems
  • People who regularly take steroids or antibiotics

Most doctors can tell from looking in your mouth if you have thrush. They can confirm it by looking at a sample under the microscope. They may also do an X-ray or endoscopy to see the lining of your esophagus, stomach, and small intestine.

You will generally need an antifungal medicine, such as nystatin. You should start to get better within 1-2 weeks after you start taking medicine. However, the infection may take a bit longer to clear in people who are immunocompromised.

Oral thrush symptoms

The infection usually comes on suddenly. One of the most common signs is creamy white and slightly raised sores on your tongue or inner cheeks. You may also have them on the roof of your mouth, gums, tonsils, or at the back of your throat. These sores may bleed if you scrape them or when you brush your teeth. You may also have:

  • Redness and soreness in the corners of your mouth
  • Temporary loss of your ability to taste
  • A cottony feeling in your mouth

If the yeast spreads to your esophagus, you may also have symptoms such as:

  • Pain or trouble swallowing
  • Fever
  • Feeling like something is stuck in your throat

In people who have weakened immune systems, thrush can also spread to your skin, lungs, and liver. If you have HIV, cancer, or another condition that weakens your immune system, make sure you get treated before it spreads.

Mononucleosis is a contagious disease, most often caused by Epstein-Barr virus (EBV), but it can be caused by other viruses, such as cytomegalovirus (CMV).

Viruses spread through bodily fluids, such as spit, blood, and semen. You can help protect yourself by not sharing drinks or food, having intimate contact, or sharing personal items (such as toothbrushes) with people who have mononucleosis.

Your doctor can usually diagnose you by asking about your symptoms and doing a physical exam. They may do some blood tests, as well.

Since mononucleosis is caused by a virus, you don't need antibiotics. You can help ease your symptoms in the following ways:

  • Take over-the-counter medications for pain and fever, such as ibuprofen, naproxen, or acetaminophen
  • Drink fluids to stay hydrated
  • Get plenty of rest

Mononucleosis symptoms

You will usually start getting symptoms about 4-6 weeks after you're infected with the virus. In addition to white spots on your tonsils, you may also have:

  • Sore throat
  • Extreme fatigue
  • Fever
  • Swollen lymph nodes in your neck and armpits
  • Headaches and body aches
  • Swollen spleen or liver or both (rare)
  • Rash

Symptoms generally last about 2-4 weeks, although some people will have fatigue for several weeks. Some people may have symptoms for up to 6 months.

Human papillomavirus (HPV)

HPV is the most common sexually transmitted infection (STI) in the U.S. It can infect your mouth, throat, and genitals. Most people with HPV infection don't have any symptoms, so they may not know they're infected. However, some people have symptoms such as sores or warts on their lips or inside their mouth or throat, including white spots on their tonsils. At least one form of the virus, HPV-16, can cause cancer over time. If you have white spots on your tonsils, it's important to go see your doctor.

Chlamydia

Chlamydia is a common STI caused by a bacterial infection. The bacteria that causes it can spread through vaginal fluid and semen. It can infect your mouth, throat, anus, and genitals. You may get white spots on your tonsils from chlamydia. It's treatable, but you will need to go to the doctor to get antibiotics. Don't delay because the infection won't go away on its own, and the bacteria can cause long-term damage to your health.

Tonsil stones (also called tonsilloliths)

Tonsil stones are small lumps that form in the nooks and crannies of your tonsils. You get them when food debris and germs get stuck around your tonsils and then become hardened with calcium. They usually look like small white or yellow pebbles in and around your tonsils. Other than the white or yellow spots, you may also have:

  • Bad breath
  • Bad taste in your mouth
  • Sore throat
  • Cough
  • Earache
  • Trouble swallowing
  • Feeling like you have something stuck in your throat

You may be more likely to get tonsil stones if you get tonsillitis often. Teenagers, people with large pits in their tonsils, and people who stay dehydrated may also get tonsil stones more frequently.

They often go away on their own and don't usually need treatment. If they bother you, you can try gargling with salt water, coughing to dislodge them, using a water flosser to gently flush them out, or pushing them out gently with a cotton swab. If you can't remove them yourself, talk to your doctor or dentist about having them removed at an office visit.

Leukoplakia (pronounced loo-koh-PLAY-key-uh)

Leukoplakia is a condition that causes white or reddened patches in your mouth and throat. It's caused by something that's irritating the lining of your mouth, such as ill-fitting dentures, using chewing tobacco, or drinking a large amount of alcohol. Most often, you will get patches of white on your gums, tongue, and the inside of your cheeks. However, you may also get patches on the roof of your mouth and in your throat.

About 15% of people who have leukoplakia develop oral cancer, so if you notice white patches in your mouth, go see your doctor for a biopsy. Your doctor can also remove the patches with a laser, a heated needle, light-activated drugs (photodynamic therapy), or by freezing (cryotherapy).

Lichen planus (pronounced like-en play-nes)

This is an inflammatory condition that mostly causes a rash on the skin around your wrists and elbows, the back of your hands, and the fronts of your lower legs. However, about half of people with lichen planus also get it in their mouth. This usually starts as small white dots on the skin inside of your cheeks or your tongue, but you may also notice lacy-looking white patches in your throat. Your doctor may treat you with antihistamines, immunosuppressive drugs, or retinoids. Or, they may remove the patches using ultraviolet light.

Seeing white or pale yellow spots on the sides or back of your throat can be a little scary. But they're usually caused by an infection, such as strep throat, oral thrush, or mononucleosis. If you notice white spots on your throat, go get checked out by your doctor. They can usually figure out the cause by asking about any other symptoms you may have and doing a physical exam. In most cases, your doctor can send you on your way with a prescription that will get you on the mend in a week or so.

Are white spots in the throat cancerous?

It's very unlikely that white spots in your throat are caused by cancer. Most often, they're caused by a viral, bacterial, or fungal infection. If you notice white spots in your throat, it's time to go get checked out by your doctor. Some causes, such as strep throat, can cause complications if you wait too long to get treated.