Throat zits

Have you ever gotten little white spots in the back of your throat, way back by your tonsils, and wondered what they are? I find that a lot of people are concerned about them, fearful of strep throat and tonsillitis and throat cancer. This is the first installment of an educational series about the human body called "You Are Disgusting." They're not actually called throat zits. (I made that up because I thought it was funny.) They're called tonsilloliths, and they're caused by a collection of rotten food debris in the little naturally-occurring pockets & holes in the back of our throats called "tonsillar crypts." Here's what they look like:

Eww. But they don't indicate infection, they're not generally painful, and they usually go away on their own. They can cause bad breath (halitosis), and sometimes will wiggle loose and taste bad (like a flavor-saver gone totally wrong). But they are not a cause for alarm unless they are accomanied by pain, swelling, fever, or an angry ninja. It's generally recommended to just leave them alone, maybe gargling with warm water occasionally to gently cleanse the area.

But I'm going to be honest with you -- yes, you can pop them. It's not recommended, because by sticking fingers/Q-tips/pencils/etc. back there you run the risk of damaging your throat or starting an infection. (How are you going to explain that one to the ER when you show up with the fish-scaler from your Swiss-army knife jammed into your pharynx?) But with some gentle pressure, sometimes you're able to squeeze all that rotten schmutz out, leaving a satisfying cavity where your throat-zit used to be.

I mention this because I see people not-infrequently who insist they have "strep throat" because "they had this before and they took a Z-pack and it went away." (I've also seen Z-packs cure sprained ankles, concussions, and male-pattern baldness. Either azithromycin is the most amazing antimicrobial in the world, or it should be moved over into the the psychiatry section in the pharmacy.) People love physical findings that support their fears, so it's generally pretty devastating when I use a tongue depressor to quickly dislodge their "infection" and show it to them on a piece of gauze. (I AM THE HUMAN Z-PACK!!! THE PROKARYOTES FLEE IN MY PRESENCE!!!)

However, apparently there is a fairly large portion of medical professionals who are unaware of this common affliction.  I often see people back for a recheck because Keflex/Cipro/Augmentin their doctor gave them isn't strong enough." ("Wow, this looks bad ma'am... we're going to have to resort to Q-TIP-ACILLIN.")  ("I'm allergic to that.  I think I need the Z-one.")  So please... take a deep breath, pop a Zoloft, and put down those needlenose pliers -- you're going to be all right. And by the way, if you smoke you can disregard this entire post.  You probably have throat cancer.