Non-Painful White or Yellow Patches on Tonsils

The tonsils have white (or yellow) patches, but there is no pain?

Hello, Doctor.
I had a case of purulent tonsillitis due to influenza at the beginning of June 2023 (which often happens whenever I get sick).
After that, I was diagnosed with COVID-19 before fully recovering from the flu.
It seems that my immune system weakened due to the prolonged illness, which caused my tonsils to remain inflamed.
After continuous medication and drainage at the clinic, I finally recovered around early August (at least there were no white or yellow patches, and I was not in pain).
However, I recently noticed that my tonsils have started to show faint yellow streaks and spots again, but they are not painful.
I would like to know if it is normal for the tonsils to have yellow (or white) streaks or spots without pain.
I am quite anxious about a potential relapse, especially since I was sick for so long and fear it might lead to difficulty swallowing again.
Thank you for your response, Doctor.

Dai Wei, 20~29 year old female. Ask Date: 2023/08/26

Dr. Ji Zhaoyun reply Otolaryngology

Hello, regarding the conditions for tonsillectomy that you mentioned, they are generally as follows: 1) Enlarged tonsils causing respiratory issues or conditions such as sleep apnea; 2) Presence of malignant tumors; 3) Recurrent tonsillitis (as you mentioned).
Internationally recognized criteria for recurrent tonsillitis include: a) More than 7 episodes of tonsillitis in one year; b) More than 5 episodes per year for two consecutive years; c) More than 3 episodes per year for three consecutive years.
If these criteria are met, tonsillectomy is recommended.
After a tonsillectomy, individuals will no longer experience tonsillitis with future colds.
The immune function of the tonsils (such as T-cell production) is primarily active during childhood, so if an adult has medical needs (as mentioned above), it is appropriate to remove the tonsils.

If you are still uncertain about whether to proceed with a tonsillectomy, it is advisable to maintain oral hygiene by rinsing your mouth after meals, which can help clear some tonsil stones (located in the tonsillar crypts).
Additionally, try to avoid colds, and seek medical attention promptly if you do catch one, as these measures can reduce the likelihood of tonsillitis.
If you are unsure about the yellow streaks and patches on your tonsils and their potential malignancy, it is best to consult an otolaryngologist.
Wishing you good health and safety.

Reply Date: 2023/08/26

More Info

Hello! Thank you for your question regarding the presence of non-painful white or yellow patches on your tonsils. It's understandable to be concerned, especially after experiencing prolonged illness and the complications that can arise from it.

First, let's discuss the tonsils and their role in the immune system. The tonsils are part of the lymphatic system and play a crucial role in defending the body against infections, particularly those that enter through the mouth and nose. They can become inflamed or infected, leading to conditions such as tonsillitis, which often presents with pain, swelling, and the presence of white or yellow patches due to pus.

In your case, it seems that you have a history of recurrent tonsillitis, which can be exacerbated by viral infections like influenza and COVID-19. After such infections, it is not uncommon for the tonsils to take some time to fully recover. The presence of yellow or white patches on the tonsils, especially if they are not accompanied by pain, fever, or difficulty swallowing, can sometimes be a normal part of the healing process. These patches may consist of dead cells, bacteria, or food particles that have accumulated in the tonsillar crypts (the small crevices in the tonsils).

However, it is essential to monitor the situation closely. If the patches persist, change in appearance, or if you start to experience symptoms such as pain, fever, or difficulty swallowing, it would be advisable to consult a healthcare professional. They may perform a physical examination and possibly a throat culture to rule out any bacterial infections, such as streptococcal pharyngitis, which can sometimes present with similar symptoms.

Additionally, if you have a history of recurrent tonsillitis, your healthcare provider may discuss the option of tonsillectomy, especially if the episodes are frequent and significantly impact your quality of life. This surgical procedure involves the removal of the tonsils and can help prevent future infections.

In summary, while the presence of non-painful yellow or white patches on your tonsils can be a normal finding, especially after a recent illness, it is crucial to remain vigilant. If you notice any changes or develop new symptoms, please seek medical advice. Maintaining good hydration, practicing good oral hygiene, and possibly using saltwater gargles can also help soothe your throat and support recovery.

I hope this information provides clarity and reassurance regarding your condition. Please take care of yourself, and don't hesitate to reach out to a healthcare professional if you have further concerns.

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