What is the treatment for swelling on the tonsils?

Question

Hello doctor,

I am a 20-year-old female, and I had a question about my tonsils. For over a year now, it has been off and swelling only on my right side. It swells for about a week, then goes away for a while, and there are white streaks (they do not look like tonsil stones). Currently, both tonsils have white streaks, but the right one appears gray and ashy and is painful, along with discomfort in my ear.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

Your symptoms suggest a chronic or recurring issue in your right tonsil that needs careful attention. Based on what you described:

Symptoms:

The right tonsil swells repeatedly for a week at a time.
White streaks on both tonsils (not stones).
The right tonsil looks grey or ashy and hurts.
Ear pain on the same side (which can happen due to nerve connection).

This pattern is not typical of a one-time infection. It could be:

Possible causes:

1. Chronic tonsillitis:

Repeated infections over time can cause tonsils to stay inflamed.
White streaks, pus, or biofilm, are a sign of bacterial involvement.
It can cause ear pain due to shared nerves.

2. Tonsillar crypt infection or fungal infection: If antibiotics have not helped in the past and the white patches return, fungal infection (like oral thrush) or tonsil cryptitis could be a cause.

3. Peritonsillar abscess (quinsy): When the infection spreads beside the tonsil, causing severe pain, swelling, or difficulty opening your mouth or swallowing.

4. Asymmetry: One-sided tonsil changes that do not go away completely — especially if the tonsil looks grey or ashy, ulcerated, or firm — should be checked to rule out anything serious, such as a precancerous lesion or lymphoma. These are rare but need to be ruled out.

Please do not ignore this any further, especially because:

It has been over a year. There is a persistent asymmetry. You are now getting white streaks and ear pain.
Visit an ENT (ear-nose-throat) specialist and ask for a throat swab and culture (to check for bacteria or fungus).
Blood work CBC (complete blood count) and ESR (erythrocyte sedimentation rate).
Indirect laryngoscopy or tonsil examination.
If needed, they may suggest a tonsil biopsy or imaging (ultrasound or computed tomography) if anything looks suspicious.

In the meantime (if mild right now):

Gargle with warm saline or Betadine gargle twice a day.
Avoid cold drinks, fried food, and overuse of your voice.
Take Paracetamol or Ibuprofen for pain.
Stay hydrated and rest your throat

I hope this information will help you.

Thanks.