My right tonsil is sore, and I have pain while swallowing. What should I do?

Q. My right tonsil is bigger than the other and has a white coating. Why do I have asymmetrical tonsils?

Answered by
Dr. Mehak Agarwal
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 16, 2022 and last reviewed on: Sep 03, 2023

Hi doctor,

I had a right sore tonsil about two months ago; it took about 10 to 12 days to disappear, with only home treatment. I only had pain when swallowing, but not a sore throat. The right tonsil did have a white coat on it, and it started to disappear (it looked a bit like tonsil stones). After that, the symptoms and pain resolved. Two months later, when I just brushed my teeth before bed, I noticed the right tonsil was still bigger than the other and had a white coat. I do not have any symptoms. I have read a lot about tonsil cancer and asymmetrical tonsil on the internet, so it scared me. What should I do? I have had streptococcal pharyngitis maybe four to five times in my lifetime, but it was years ago.



Welcome to

I understand your concern. I have seen the pictures (attachment removed to protect the patient's identity), and you still have some debris collection on your right tonsillar crypt (that could be due to the previous infection). Also, your right tonsil is slightly larger than your left. We see the asymmetrical enlargement of tonsils in carcinoma of tonsils, but many normal people also have asymmetrical growth of the tonsil. I feel that if you do not have any symptoms (including an enlarged neck lymph node), then you need not worry. However, if apprehensive, you can undergo tonsillar biopsy after panendoscopy of the nose, nasopharynx, and oropharynx.

Hi doctor,

Thank you for the reply. Can the tonsil be bigger and white for months? Can this resolve on its own?



Welcome back to

I understand your concern. Yes, if debris is collected. You can start Chlorhexidine mouthwash for now. Use it for ten days and see if the slough reduces. After that, you will have to gargle three times a day. You may also take anti-inflammatory enzymes like Trypsin and Chymotrypsin for five days. It will reduce the swelling (if all tonsils are enlarged due to swelling).

Hi doctor,

Thank you for the reply. Only the right tonsil seems larger, can it become normal and symmetrical? The left one is buried deeper.



Welcome back to

I understand your concern. Right tonsils seem larger and infected. However, you do not need any antibiotics. Instead, you can do gargles and take anti-inflammatory enzymes.

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