Ulcers in the Throat

What Are Throat Ulcers?

Throat ulcers are open sores that develop on the soft tissue at the back of your mouth and upper throat area. In medical terms, these are often called pharyngeal ulcers when they occur in the throat, or oesophageal ulcers if they form lower down in the food pipe. While most people associate ulcers with the tongue or inside of the cheeks, they can also form deeper in the throat, including on or around the tonsils.

These sores are often painful and can make eating and drinking difficult. Throat ulcers are frequently a sign of an underlying condition rather than a standalone problem, which means getting them checked by a healthcare professional is usually sensible.

Both mouth ulcers and throat ulcers may need specific treatment depending on what is causing them. Some clear up on their own, while others require medical attention, particularly if linked to an underlying health condition. Understanding the possible causes and knowing when to seek help means you can get appropriate treatment sooner.

Common Causes of Throat Ulcers

Throat ulcers can develop for various reasons. Some causes are relatively minor and easy to treat, while others may need more attention from your GP or a specialist.

• Viral infections: The herpes simplex virus, which also causes cold sores, can sometimes lead to ulcers forming in the throat. The varicella-zoster virus, responsible for chickenpox and shingles, may occasionally affect the throat lining and produce sores. Vaccination against shingles can help prevent this in eligible adults.
• Oral thrush: This is a fungal infection caused by an overgrowth of Candida yeast. It commonly appears as white patches in the mouth and throat and can develop into painful ulcerated areas if left untreated. People with weakened immune systems or those taking certain medications like antibiotics or inhaled corticosteroids are more prone to thrush.
• Bacterial infections: Severe or untreated bacterial tonsillitis can sometimes cause tissue breakdown in the tonsil area, resulting in ulceration. Streptococcal infections are one example that may lead to this kind of damage if not treated promptly.
• Sexually transmitted infections: Certain STIs, including syphilis and herpes, can cause sores to develop in the throat. This is more likely following oral sexual contact with an infected person.
• Acid reflux: When stomach acid repeatedly flows back into the throat, it can irritate and damage the delicate tissue there. Over time, this may result in ulceration, particularly in people with chronic gastro-oesophageal reflux disease. Prevention strategies include avoiding eating within three hours of bedtime, raising the head of your bed, and reducing intake of acidic, fatty or spicy foods.
• Injury or irritation: Physical trauma to the throat from swallowing something sharp, medical procedures, or very hot food and drink can cause ulcers to form as the tissue heals. Taking smaller bites, chewing food thoroughly, and allowing hot drinks to cool can reduce this risk.
• Medication side effects: Some medications, particularly certain types of chemotherapy drugs or medications that suppress the immune system, can make the throat lining more vulnerable to ulceration.

In rarer cases, persistent or unusual throat ulcers may be linked to more serious conditions. If you have ulcers that do not heal within a few weeks, or if they keep coming back, your GP will likely want to investigate further.

Recognising the Symptoms

The symptoms of throat ulcers can vary depending on the cause and severity, but there are some common signs to look out for.

Pain when swallowing is one of the most typical symptoms. This might range from mild discomfort to severe pain that makes it difficult to eat, drink or even swallow saliva. Some people describe a burning or raw sensation at the back of the throat.

You may be able to see the ulcers yourself if you look in a mirror with good lighting. Open your mouth wide and try to flatten your tongue down to get a clearer view of the throat area. Throat ulcers often appear as white, yellow or red patches on the tonsils or surrounding tissue. Swelling and inflammation typically accompany these sores.

It is worth noting that similar symptoms can occur with other conditions such as pharyngitis or tonsillitis. These conditions can present with throat pain and visible changes to the throat tissue but require different management, so accurate diagnosis matters.

Other symptoms that may accompany throat ulcers include:

• A sore throat that persists for more than a few days
• Difficulty swallowing food or liquids
• A feeling that something is stuck in your throat
• Bad breath
• Swollen lymph nodes in the neck
• Fever or feeling generally unwell
• Earache, which can sometimes be referred pain from the throat
• Changes to your voice or hoarseness

If you notice pus or discharge coming from the ulcerated area, this warrants medical assessment to determine whether antibiotics are needed. Similarly, if you develop a high fever alongside throat ulcers, this warrants prompt medical attention.

When speaking to your GP, try to describe when the symptoms started, whether the pain is on one side or both, and any other symptoms you have noticed such as weight changes or lumps in your neck. This information helps with diagnosis.

Your situation may be slightly different. ask a question below ↓ and our editorial team will reply with our advice.

When to See a Doctor

While some throat ulcers will heal on their own with basic home care, there are situations where you should contact your GP or seek medical advice.

You should make an appointment with your GP if your throat ulcers have not started to improve within two weeks, if they keep returning, or if you are finding it very difficult to eat or drink because of the pain.

Certain symptoms should prompt you to seek medical advice more urgently. These include unexplained weight loss, persistent hoarseness lasting more than three weeks, pain that is noticeably worse on one side of the throat, lumps in your neck, or fevers that do not settle. These can be warning signs of conditions including throat cancer or chronic infections that need investigation.

Seek urgent medical attention if you are struggling to breathe, if you cannot swallow at all, or if you are drooling because swallowing has become too painful. These symptoms could indicate a serious problem that needs immediate treatment.

Your GP will examine your throat and ask about your symptoms and medical history. Depending on what they find, they may take a swab from the affected area to test for bacterial or viral infections. In some cases, they might refer you to an ear, nose and throat specialist for further investigation, particularly if the cause is unclear or the ulcers are not responding to treatment.

If there is any concern about the appearance of the ulcers, your GP may arrange for a biopsy. This can help rule out conditions such as oral cancer or chronic infections. While this can sound worrying, most throat ulcers are caused by infections, reflux or minor injuries.

Treatment and Home Care

Treatment for throat ulcers depends on the underlying cause. Once your GP has identified what is causing the problem, they can recommend the most appropriate approach.

For viral infections, treatment usually focuses on managing symptoms while the infection runs its course. This might include pain relief, staying hydrated, and getting plenty of rest. Antiviral medications may be prescribed in some cases, particularly for herpes-related ulcers.

Bacterial infections may require antibiotics, though not all will. UK guidelines encourage careful use of antibiotics to prevent resistance, so your GP will assess whether they are necessary based on the severity of your infection and your individual circumstances. If you are prescribed antibiotics, it is sensible to complete the full course even if you start feeling better before they are finished.

Oral thrush is usually treated with antifungal medications, which may come as lozenges, mouth rinses or tablets depending on the severity. Your pharmacist can advise on over-the-counter options for mild cases, but more stubborn infections may need prescription-strength treatment.

For ulcers caused by acid reflux, your GP may recommend lifestyle changes alongside medication to reduce stomach acid production. Raising the head of your bed, avoiding eating late at night, and cutting down on acidic or spicy foods can all help.

While you are recovering, there are several things you can do at home to ease discomfort:

• Drink plenty of fluids, particularly cool or lukewarm drinks
• Avoid very hot, spicy, acidic or rough-textured foods that may irritate the ulcers
• Soft foods like soup, yoghurt and mashed vegetables are often easier to swallow
• Over-the-counter pain relief such as paracetamol or ibuprofen can help with pain and fever
• Gargling with warm salt water may provide some relief, though this can be uncomfortable if the ulcers are very sore
• Avoid smoking and alcohol, both of which can slow healing and irritate damaged tissue

If you have concerns about throat ulcers or any other throat problems, the NHS website provides reliable information and guidance on when and how to access care. Your local pharmacy can also offer advice on managing symptoms and may be able to recommend suitable over-the-counter remedies.