White spots at back of throat
See a doctor about this one
See a doctor about this one. It is a symptom that needs a cause found, and no remedy on this site is a substitute for that.
You looked in the mirror and saw white or yellow spots at the back of your throat. They may sit on your tonsils, the two soft lumps on each side. They can look like dots, patches, streaks, or a thin film.
Most of the time the spots come with a sore throat. Many people also have a fever, bad breath, or swollen glands in the neck.
White spots are a sign, not a diagnosis. The cause can be a germ, a virus, a yeast, or just trapped gunk. What you do next depends on which one it is.
When to see someone
Go to the ER right away if you cannot breathe well. Go if you drool because you cannot swallow your own spit. Go if your voice sounds muffled, like you have food in your mouth.
Also go the same day if one side hurts much more than the other. A stiff jaw that will not open wide is another warning sign. These can mean a pocket of pus behind a tonsil.
Call your doctor today if you have a fever and sore neck glands but no cough. That mix often points to strep. Strep needs a swab test, so home care alone is not enough.
Book a visit if the white spots last more than a week. Do the same if you have been very tired for weeks. Also call if the spots wipe off and leave a raw red patch under them.
Call your doctor if you get a rash, or if your neck is stiff. Call if you have a weak immune system, take steroids, or are in cancer care. Children who will not drink and have few wet diapers need to be seen.
Why it happens
Your tonsils are part of your immune system. They trap germs that come in through your mouth and nose. When they fight, white blood cells pile up and form pus, which looks like white spots.
Tonsils also have small pits and folds called crypts. Food bits, spit, and dead cells can pack into these pits and harden. That gives you a chalky white lump, not an infection.
A yeast called candida can also grow on the mouth and throat lining. It forms a creamy white coating instead of round spots.
What else it could be
Strep throat comes on fast and hurts a lot. You often get a fever and tender neck glands, and you usually do not cough. Strep needs a throat swab, and it is treated with antibiotics.
A virus is the most common cause overall. Viral sore throats usually come with a cough, a runny nose, a hoarse voice, or red eyes. The spots may look more like streaks or a light film.
Mono (the kissing disease) often hits teens and young adults. The tonsils get very large and covered with a thick gray-white coating. The big clue is deep tiredness that lasts for weeks, plus swollen glands in the neck and armpits.
Tonsil stones are hard white or yellow lumps you can sometimes pop out. They cause bad breath and a feeling that something is stuck. There is little or no fever, and often little pain.
Oral thrush is a yeast. It looks like white curds that you can wipe off, leaving a red or sore spot under it. It is more common in babies, in people who use steroid inhalers, and in people with a weak immune system or diabetes.
A canker sore or a small ulcer can also look white. It is usually one spot, it burns, and there is no fever. Smoke, acid reflux, and very dry air can leave the throat raw and patchy too.
How to read the grades below
The options below come from our page on Sore Throat. Each one carries two labels.
The first label is the evidence grade. A means strong trials in people, B means smaller or mixed studies, and C means early or limited findings. D means lab work only, and “insufficient” means the research cannot settle it yet.
The second label is the traditional tier. T3 means long use in more than one tradition, T2 means long use in one, and T1 means known use. T0 means no such record.
These grades come from research on Sore Throat, the parent Health Topic, not on white spots at back of throat.
A grade tells you how strong the research is, not how well something will work for you. Talk to a doctor or pharmacist before you start anything, above all if you take other medicines.
What to try first
Home care can ease the pain while your body works. It does not treat strep or thrush, and it will not make the white spots go away on its own. If a swab test is needed, get the test.
A saltwater rinse (evidence grade A, traditional tier T3) is the cheapest first step. Stir half a teaspoon of salt into a cup of warm water, gargle, and spit. It can loosen gunk on the tonsils and soothe soreness.
Honey (evidence grade A, traditional tier T3) coats the throat and can calm pain and cough. A spoonful plain, or stirred into warm water, works. Never give honey to a baby under one year old.
Zinc (evidence grade A, traditional tier T0) has trial support for shortening common cold symptoms when started early. Lozenges can leave a metal taste or upset your stomach. Andrographis paniculata extract (evidence grade A, traditional tier T3) also has trial support for cold and sore throat symptoms.
Licorice root (Glycyrrhiza glabra) (evidence grade B, traditional tier T3) has been used as a gargle and a tea for raw throats. It can raise blood pressure and lower potassium if you use a lot for a long time. Skip it if you are pregnant or have high blood pressure or heart or kidney problems.
Marshmallow Root (Althaea officinalis) (evidence grade insufficient, traditional tier T0) is a slippery herb used in tea to coat a sore throat. Turmeric (evidence grade insufficient, traditional tier T3) is used in warm milk or a gargle in many home traditions. Both are traditional use, not proven by trials, for this problem.
Acupuncture (evidence grade insufficient, traditional tier T3) is a traditional practice some people use for throat pain. There is not enough trial evidence here to say how well it works.
Also drink fluids, rest your voice, and use a cool mist humidifier. For tonsil stones, gargling and gentle rinsing may loosen them. Do not dig at your tonsils with a sharp object.
How long it takes
A viral sore throat usually peaks in 2 to 3 days and fades within a week. The white spots often fade along with it.
Strep treated with antibiotics usually feels better in 1 to 2 days. The spots may take several more days to clear. Finish all the pills even when you feel fine.
Thrush needs antifungal medicine and often clears in 1 to 2 weeks. Mono takes longer, and the tiredness can drag on for weeks. Tonsil stones may come and go for years if your tonsils have deep pits.