Tonsillar keratosis is not self-healing and requires surgical treatment. The etiology of tonsillar keratosis is usually due to abnormal proliferation and keratinization of tonsil cells caused by recurrent chronic tonsillar inflammation or fungal infections, and lack of oral hygiene. The clinical examination is unilateral tonsillar onset, which is seen as white spots or white patches on the tonsil surface. Patients often experience sore throat, dry throat, itchy throat, foreign body sensation in the throat, and occasionally cough, hoarseness, and bad breath. In terms of treatment, if white spots on the tonsils are found and do not heal over a long period of time, the first step is to take a local pathology section and if the diagnosis of tonsillar keratosis is confirmed then surgery is required to remove the tonsils. The usual surgical method is tonsil peeling or plasma tonsil ablation, which requires a week of hospitalization and post-operative antibiotics to cure.