A tonsillectomy results in the formation of thick, yellow-white scabs. These scabs are a normal part of the healing process. They typically fall off between 5 and 10 days after surgery.
The scabs usually fall off in small pieces. There may also be a small amount of bleeding. Most people swallow the scabs, often without realizing.
Recovery from a tonsillectomy can take 10–14 days. Adults commonly take longer than children to recover from the surgery.
The typical stages of recovery are:
Days 1–2 post-surgery
A person may experience a low grade fever and headaches after a tonsillectomy.
People typically feel very tired after surgery.
A person’s throat is likely to be sore and swollen, and they may have difficulty speaking or eating. The scabs will also form quite quickly and often cause bad breath.
Other symptoms include:
- ear pain
- a headache
- low grade fever of up to 101°F
- minor bleeding, such as flecks of blood in the saliva
- nausea and vomiting after the anesthetic
- swelling in the throat
It is important to rest after surgery and to refrain from speaking too much if it causes pain or bleeding.
People should drink lots of water or soothing fluids and eat easy-to-swallow foods, such as broth or applesauce. Avoid milk products, such as ice cream and yogurt, for 24 hours after surgery.
People may also wish to avoid foods and beverages that are hot, acidic, hard, or crunchy for a few days. These items can cause pain and irritation.
Days 3–4 post-surgery
Most people will continue to experience pain.
Some people may even feel worse than they did in the first 2 days following surgery. Post-surgical pain most commonly occurs in the throat and ears, but it can also affect the neck and jaw.
During this period, people should continue to rest, stay hydrated, and consume soft foods. Applying an ice pack to the neck can help reduce pain and swelling.
Days 5–10 post-surgery
Staying hydrated is important after tonsil scabs fall off.
Between days 5 and 10 after surgery, the tonsillectomy scabs will fall off. This may cause a small amount of bleeding, and some people will notice specks of blood in their saliva. Blood may cause people some concern, but it is a normal part of healing.
However, if the blood is excessive and bright red, then people should contact their doctor immediately or bring their child to the emergency room.
Excessive or bright red bleeding indicates that the scabs have fallen off too early, which requires medical attention and evaluation for further surgery.
At this point, most people should be experiencing less pain. It is still important to rest and stay hydrated during this time. As eating and swallowing become more comfortable, people can begin to reintroduce more foods to their diet.
Day 10 or more post-surgery
Most people will begin to feel much better at this point. The pain will continue to fade. Children can go back to school, and adults can return to work once they:
- begin eating their regular diet again
- sleep through the night
- come off pain medication
However, it is still important to avoid strenuous activities and sports until at least 2 weeks after surgery.
Some people may still be experiencing snoring or mouth breathing up to 2 weeks after surgery. These symptoms will resolve once the swelling subsides. Speak to a doctor if these symptoms persist.
Follow-up doctor’s visits
Most people will have a follow-up appointment with their doctor within 3–5 weeks of the surgery to assess their recovery.
People should call their doctor before this if they have any queries or concerns.
Some over-the-counter medicines can help relieve pain after a tonsillectomy.
Almost everyone experiences pain after a tonsillectomy. It is most common in the throat and ears, but it can also affect the neck, head, or jaw. Post-operative pain may get worse around day 3 or 4, but it should then start to improve.
The speed the pain goes away depends on the individual. Some people will experience pain up to 14 days after the procedure. Research suggests that adults also experience more pain and bleeding than children following a tonsillectomy.
Pain management tips include:
Pain relief medications
Taking over-the-counter (OTC) acetaminophen regularly for 3–4 days after surgery may help manage pain.
After this time, people can reduce the amount of medication and take it only when necessary. Always follow the instructions on the label and never take more than the recommended dose in 24 hours.
Some people may find it helpful to alternate doses of acetaminophen and ibuprofen. People should never use both medications at the same time. Discuss this treatment with a doctor or pharmacist first.
If treating children, people should always use medications that are specifically for children.
If OTC medications do not work to control severe pain, a doctor may prescribe narcotic medication.
Home care strategies may also reduce tonsillectomy pain.
People may wish to try:
- placing an ice pack on the neck several times daily
- sucking on ice chips or ice pops to reduce swelling in the throat
- drinking plenty of fluids, such as water or non-citrus juices
- chewing sugar-free gum to reduce spasms after surgery
- getting plenty of bed rest in the first 2 days after surgery
- increasing activities gradually and as necessary
- taking honey to soothe a sore throat
Note that honey is not suitable for children under 1 year due to the risk of infant botulism.
Tonsillectomy scabs form quickly after surgery and remain in place for 5–10 days. They then fall off in small pieces.
If they fall off before this time, they can cause bright red bleeding. It is necessary to seek prompt medical treatment if this occurs.
Tonsillectomy scabs are a normal part of the healing process. Most people will fully recover from a tonsillectomy in around 14 days, although some may take longer.
During this time, pain medications and home care strategies can decrease discomfort. Those who have severe pain, vomiting, high fever, or lots of bleeding should contact their doctor immediately.