Tonsillitis in teenagers

Overview

Tonsillitis is an infection that makes the tonsils — the two small lumps of tissue at the back of your throat — become swollen and sore. It's very common in teenagers and usually gets better on its own within a week.

Yes, tonsillitis is very common in teenagers. Many people get it at least once during their teenage years.

Tonsillitis most often affects children and teenagers, but it can happen at any age.

Symptoms

Common symptoms

• Sore throat that makes it painful to swallow
• Red, swollen tonsils
• White or yellow patches on the tonsils
• Fever (temperature above 38°C / 100.4°F)
• Swollen glands in the neck
• Headache
• Feeling tired and achy

Symptoms in children

• Younger children may have a sore throat but describe it as a tummy ache or being fussy with eating.
• They may also drool more or refuse to drink.

Symptoms in older adults

• Tonsillitis is less common in older adults, but when it occurs, symptoms can include a very sore throat, difficulty swallowing, and fever.

Causes

Main causes

• Viruses — most cases of tonsillitis are caused by common cold viruses, flu viruses, or the Epstein‑Barr virus (which causes glandular fever).
• Bacteria — about 15 to 30% of cases are caused by group A streptococcus bacteria ('strep throat').

Risk factors

• Close contact with someone who has tonsillitis (germs spread through coughing, sneezing, or sharing cups)
• Being a teenager or child — tonsils are more active during these years
• Weakened immune system due to stress, lack of sleep, or other illnesses

When to see a doctor

See a doctor urgently if:

• If you have a fever that lasts more than 3 days or a very high fever
• If your throat pain is so bad you cannot swallow any food or drink
• If you have trouble breathing or feel like something is blocking your throat

Book a routine appointment if:

• If your symptoms last longer than a week without improving
• If you get tonsillitis many times in a short period (for example, 5 or more times a year)
• If you have white patches that do not go away after a week

Diagnosis

A doctor will ask about your symptoms and look at your throat and ears. They may gently press on your neck to check for swollen glands.

Tests that may be done

• A throat swab — the doctor rubs a cotton bud on your tonsils to test for bacteria (rapid strep test or culture).
• Blood tests — sometimes used if glandular fever is suspected.

What to expect at your appointment

The exam is quick and not painful, though the throat swab may make you gag briefly. Results from a rapid test come back in minutes, but a culture can take a day or two.

Treatment

Treatment depends on the cause. Viral tonsillitis does not need antibiotics — it gets better with rest and home care. Bacterial tonsillitis may require antibiotics to prevent complications and reduce spread.

Self-care at home

• Get plenty of rest and sleep
• Drink lots of cool or warm fluids (water, herbal tea, soup) to stay hydrated
• Gargle with warm salt water (half a teaspoon of salt in a glass of warm water) several times a day
• Eat soft foods like yoghurt, mashed potatoes, or ice cream if swallowing is painful
• Use a cool‑mist humidifier or inhale steam from a bowl of hot water to soothe your throat

Medical treatments

If a doctor confirms bacterial tonsillitis, they may prescribe a course of antibiotics, usually for 10 days. It is important to finish the whole course even if you feel better. For pain and fever, over‑the‑counter pain relievers (like paracetamol or ibuprofen) can help, but ask your pharmacist which is right for you.

When is surgery considered?

Surgery to remove the tonsils (tonsillectomy) may be considered if you have very frequent or severe tonsillitis (for example, 7 or more episodes in one year, or 5 or more per year for 2 years). It is only done when other treatments have not worked and the condition significantly affects your life.

Living with this condition

During an episode, take it easy and stay home from school or work until your fever is gone and you feel well enough to return. This usually takes a few days.

Lifestyle tips

• Wash your hands regularly and avoid sharing cups or utensils to stop the infection spreading to others.
• Use your own towel and pillowcase while you are sick.
• If you smoke or vape, try to stop or cut down because smoke can irritate your throat and make tonsillitis worse.

Diet and exercise

Eat soft, easy‑to‑swallow foods when your throat is sore. Avoid very hot, spicy, or acidic foods. You can return to normal exercise once you feel better — usually after a week.

Mental health and emotional wellbeing

Having frequent or painful tonsillitis can be frustrating and may affect your mood or school life. It is normal to feel upset. Talk to your parents, a school nurse, or your doctor if you are struggling.

Prevention

You cannot completely prevent tonsillitis, but you can reduce your risk by practising good hygiene, such as washing your hands often, not sharing drinks or utensils, and avoiding close contact with people who are sick.

Vaccines

There is no vaccine specifically for tonsillitis, but staying up to date with recommended vaccines, such as the flu vaccine, can help prevent some viral infections that lead to tonsillitis.

Screening programmes

There is no routine screening for tonsillitis. See a doctor if you have symptoms.

Complications

If left untreated

• Peritonsillar abscess — a collection of pus behind the tonsil that causes severe pain and makes it hard to open your mouth.
• Sleep apnoea — swollen tonsils can block the airway during sleep, causing pauses in breathing.
• Rheumatic fever — a rare but serious complication of untreated strep throat that can damage the heart.
• Post‑streptococcal glomerulonephritis — a rare kidney inflammation that can occur after a strep infection.

Long-term outlook

Most people with tonsillitis recover fully within a week without any problems. With proper treatment when needed, complications are rare. If you have recurrent severe tonsillitis, surgery can provide long‑term relief and improve quality of life.

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