The appearance of white spots, and in some instances, streaks on the tonsils are indicative of conditions that need treatment. Most individuals tend to get alarmed on witnessing the spots; and apprehend the worst. However, the conditions behind the symptoms can be treated easily and it is possible to get rid of the spots. Here is all that you need to know about white spots on tonsils; sub-sections have cut out the clutter and other information that is not essentially required, offering information that is important to patients.

How do the white spots look on the tonsils?

It is important to be able to discern or identify the white spots; these are typically grain like white spots, that are often accompanied by malodorous breath. The tonsils could also be enlarged in addition to the white spots. The color of the spots may be ivory-white, and appear similar to that of a broken piece of peanut. The surface of the tonsils is not exactly smooth, with recesses that break up the surface.  These white grains often appear like a protrusion and are also known to be painful at times, especially when the individual either swallows food or liquid. The spots may appear either around the tonsils only, or throughout the mouth in some instances.

Reasons for the white spots

The white spots are indicative of an infection; wherein the tonsils are attempting to ward off an infection. White blood cells are released to fight bacteria, and this in turn may attack tissues, forming the white spots.  Additionally, white streaks may be an indication of strep throat, infectious mononucleosis and purulent tonsilitis. Oral candidiasis, a yeast infection could also be the reason for the formation of the white spots or streaks. Tonsil stones could also be a reason for the formation of the spots. Oral herpes, oral cancer and canker sores are also other conditions that could cause formation of white spots.

The tonsils are essentially a part of the lymphatic system; an immune system that is responsible for protecting the body from infections, maintaining the right balance of body fluids, and eliminating cellular waste. It is also responsible for absorbing body fat. The appearance of spots or streaks are indicative of an active infection or the reaction of the system to an infection. To sum up the reasons for the appearance of spots, the causes can be broadly categorized into bacterial infections, fungal infections and viral infections.

What causes strep throat?

This refers to a bacterial infection due to Streptococcus bacteria, and symptoms that are indicative of this include sore throat, fever, swelling in the lymph glands/tonsils, and throbbing headache. This condition is relatively common among children between the ages of 5 and 15 years and may also be witnessed in adults who spend long periods of time with children of this age group. Left untreated, the bacteria that causes this infection could spread, possibly rheumatic fever, could cause kidney ailments and could also trigger ear/sinus infections.

What causes oral thrush?

This refers to a fungal infection that afflicts the throat and the mouth. Symptoms that are indicative of this condition, in addition to the white spots are difficulty when swallowing, sudden loss of taste, and pain while eating or drinking. The throat may feel sore and individuals are likely to experience the feeling of having cotton in the mouth. Visible, discernible changes include cracking or drying off the skin at the corners of the mouth. The fungal infection is more likely to afflict individuals with a weak immune system, such as patients with cancer, or diagnosed as HIV positive. The possibility of this infection is high among individuals who use dentures, and diabetics, apart from asthmatic patients on antibiotics and corticosteroids. Smokers are also at higher risk of the condition.

What causes viral tonsilitis?

This refers to an inflammation of the tonsilitis, arising from a viral infection or other conditions. Indicative symptoms of the condition include inflamed tonsils, that could sometimes be laden with pus. The throat may be sore, and many individuals are known to have a whitish coating on the tonsils. Difficulty while swallowing, or pain while eating/drinking are other possible conditions. Other symptoms that accompany the condition include onset of fever, and malodorous breath. Patients are also known to end up with sleep apnea and are known to sleep with their mouths open. Various viruses are responsible for the condition, for instance, Epstein-Barr virus, herpes simplex virus, cytomegalovirus apart from measles.

What causes infectious mononucleosis?

This refers to a viral infection that has an effect on certain blood vessels/cells. This is an infectious condition and teenagers or young adults are known to be at higher risk of getting infected. Medically known as the Epstein-Barr virus, the condition causes the formation of the spots, in addition to other possible symptoms. For instance, the individual may experience onset of fever, may experience extreme fatigue, and may also end up with a sore throat. Pain in the body and throbbing headache are also possible symptoms that may be experienced by the patient. Lymph nodes may also end up with swelling and this could affect the lymph nodes on the neck or the underarms. In addition to this, the patient may also experience the outbreak of rashes on the skin. Other possible outcomes include swelling in the liver or the spleen.

What causes tonsil stones?

This refers to a condition medically known as tonsilloliths, that results in the formation of stones on the tonsils. The stones are white in color and are hard in consistency, and symptoms that accompany the condition is malodorous breath, pain in the ears, and difficulty while swallowing food or liquid. The individual may also have the strange sensation of having objects/substances stuck in the throat. Of importance is the fact that, at times the stones may not be noticeable, though effectively, the stones may be large in size. The formation of the stones occurs as a result of bacteria and debris accumulating in the crevices. This could also occur when mucus and food accumulate, and when this accumulation gets hard or calcifies, the white spots on the tonsils are visible.

What causes leukoplakia?

This refers to the formation of whitish or gray coloration in the throat or the mouth, that cannot be scraped off like usual deposits in the mouth.  Individuals who smoke are known to be at higher risk of the condition. Similarly, individuals with the habit of chewing tobacco are also at higher risk of ending up with the condition. This could also affect individuals who chew betel nut either as a habit, or after eating. Patients with dentures that are not of the right size, are also likely to be affected with leukoplakia. On an important note, the condition could also indicate early stages of cancer. Individuals who are risk of cancer, with any tell-tale symptoms are to seek detailed diagnosis, including biopsy.

Other symptoms in addition to white spots

Apart from the formation of white spots, there is the possibility of other symptoms. For instance, individuals with the condition may experience a sore throat, and bouts of sneezing, while some are known to experience fever and pain at the time of swallowing. Other possible symptoms include a stuffy nose, throbbing headache, pain in the body and swelling in the glands. One of the indirect outcomes of swollen tonsils is difficulty in breathing as the airway may be blocked, causing difficulty. The spots, in certain instances may also be pus bearing, and this could cause stronger bad odor.

Symptoms that necessitate further diagnosis and treatment

Most individuals tend to fear any changes and are known to panic without sufficient cause. The onset of symptoms is not to be considered as alarming, and individuals experiencing any symptoms are to seek further diagnosis and possible treatment only when the symptoms cross a threshold. For instance, if the symptoms persist, or if the intensity continues to increase, it could be a cause for concern. Similarly, if the symptoms clearly point to strep throat, it may require treatment. When such infections or symptoms are recurring in nature, it may also require diagnosis to rule out other conditions. Difficulty in breathing warrants urgent attention to avoid possible complications.  High fever or sore throat with hoarse voice that lasts beyond a fortnight is also to be medically assessed. Individuals who observe traces of blood either in the saliva or phlegm while spitting are to seek further diagnosis. Similarly, pain in the ear that is severe and persistent, needs to be checked and treated. As outlined above, certain symptoms may be indicative of oral cancer, and this needs to be checked thoroughly.

Treatment options for white spots on tonsils

Treatment options for white spots depend on the diagnosis that determine the underlying reason for the spots. This is not a symptomatic form of treatment, but is focused on fixing the cause for the symptoms. For instance, individuals diagnosed with strep throat are administered antibiotics. However, it is important to note that in the event of patients testing positive, without any strong or perceivable symptoms, antibiotics are not administered. Category of antibiotics administered include penicillin and amoxicillin. Patients diagnosed with oral thrush are administered antifungal medications, with severe cases being recommended fluconazole.

When tonsilitis is the reason for the white spots, the treatment is symptomatic to manage tonsilitis. Similarly, when the condition is diagnosed as infectious mononucleosis, the treatment is symptomatic with pain killers and fever medication. Patients diagnosed with tonsil stones undergo simple surgery to remove the stones, with some having to undergo removal of entire tonsilitis. Treatment for leukoplakia includes possible surgery, and will also depend on the results of biopsy.

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