Hoarseness
Voice strain; Dysphonia; Loss of voiceHoarseness refers to difficulty making sounds when trying to speak. Vocal sounds may be weak, breathy, scratchy, or husky, and the pitch or quality of the voice may change.
Considerations
Hoarseness is most often caused by a problem with the vocal cords. The vocal cords are part of your voice box (larynx) located in the throat. When the vocal cords become inflamed or infected, they swell. This can cause hoarseness.
The most common cause of hoarseness is a cold or throat infection, which most often goes away on its own within 2 weeks.
A rare but serious cause of hoarseness that does not go away in a few weeks is cancer of the voice box.
Voice box
The larynx, or voice box, is located in the neck and performs several important functions in the body. The larynx is involved in swallowing, breathing, and voice production. Sound is produced when the air which passes through the vocal cords causes them to vibrate and create sound waves in the pharynx, nose and mouth. The pitch of sound is determined by the amount of tension on the vocal folds.
Causes
Hoarseness may be caused by:
- Acid reflux (gastroesophageal reflux)
Gastroesophageal reflux
Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents leak backward from the stomach into the esophagus (food pipe). F...
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Allergies
Allergies
An allergy is an immune response or reaction to substances that are usually not harmful.
Read Article Now Book Mark Article - Breathing in irritating substances
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Cancer of the throat or larynx
Cancer of the throat or larynx
Throat cancer is cancer of the vocal cords, larynx (voice box), pharynx, or other areas of the throat.
Read Article Now Book Mark Article - Chronic coughing
Coughing
Coughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder. Some coughs are d...
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Colds or upper respiratory infections
Colds
The common cold most often causes a runny nose, nasal congestion, and sneezing. You may also have a sore throat, cough, headache, or other symptoms....
Read Article Now Book Mark Article - Heavy smoking or drinking, particularly together
- Overuse or abuse of the voice (as in shouting or singing), which, over time, may cause swelling or growths on the vocal cords called vocal nodules
Less common causes include:
- Injury or irritation from a breathing tube or bronchoscopy
Bronchoscopy
Bronchoscopy is a test to view the airways and diagnose lung disease. It may also be used during the treatment of some lung conditions.
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Damage to the nerves and muscles around the voice box (from trauma or surgery)
Damage to the nerves and muscles around...
Throat cancer is cancer of the vocal cords, larynx (voice box), pharynx, or other areas of the throat.
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Foreign object in the esophagus or trachea
Foreign object in the esophagus or trac...
If you swallow a foreign object, it can get stuck in the gastrointestinal (GI) tract from the esophagus (swallowing tube) to the colon (large intesti...
Read Article Now Book Mark Article - Swallowing a harsh chemical liquid
- Changes in the larynx during puberty
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Thyroid or lung cancer
Thyroid
Thyroid cancer is a cancer that starts in the thyroid gland. The thyroid gland is located in the front of your lower neck.
Read Article Now Book Mark ArticleLung cancer
Lung cancer is cancer that starts in the lungs. The lungs are located in the chest. When you breathe, air goes through your nose, down your windpipe...
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Underactive thyroid gland
Underactive thyroid gland
Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone. This condition is often called underactive thyroid....
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Home Care
Hoarseness may be short-term (acute) or long-term (chronic). Vocal rest and time may improve hoarseness. Hoarseness that continues for more than 4 weeks should be checked by a health care provider.
Acute
Acute means sudden. Acute symptoms appear, change, or worsen rapidly. It is the opposite of chronic.
Read Article Now Book Mark ArticleChronic
Chronic refers to something that continues over an extended period of time. A chronic condition is usually long-lasting and does not easily or quick...
Read Article Now Book Mark ArticleThings you can do at home to help relieve the problem include:
- Talk only when you need to until hoarseness goes away.
- Drink plenty of fluids to help keep your airways moist. (Gargling does not help.)
- Use a vaporizer to add moisture to the air you breathe.
- Avoid actions that strain the vocal cords such as whispering, shouting, crying, and singing.
- Take medicines to reduce stomach acid if hoarseness is due to gastroesophageal reflux disease (GERD).
- Do not use decongestants which can dry out the vocal cords.
- If you smoke, cut down, or stop at least until hoarseness goes away.
When to Contact a Medical Professional
Contact your provider if:
- You have trouble breathing or swallowing.
- Hoarseness occurs with drooling, particularly in a small child.
- Hoarseness occurs in a child less than 3 months old.
- Hoarseness has lasted for more than 1 week in a child, or 2 to 3 weeks in an adult.
What to Expect at Your Office Visit
The provider will examine your throat, neck, and mouth and ask you some questions about your symptoms and medical history. These may include:
- To what extent have you lost your voice (all or partially)?
- What kind of vocal problems are you having (making scratchy, breathy, or husky vocal sounds)?
- When did hoarseness start?
- Does hoarseness come and go or get worse over time?
- Have you been shouting, singing, or overusing your voice, or crying a lot (if a child)?
- Have you been exposed to harsh fumes or liquids?
- Do you have allergies or a post nasal drip?
- Have you ever had throat surgery?
- Do you smoke or use alcohol?
- Do you have other symptoms such as fever, cough, sore throat, difficulty swallowing, weight loss, or fatigue?
You may have one or more of the following tests:
- Laryngoscopy
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Throat culture
Throat culture
A throat swab culture is a laboratory test that is done to identify germs that may cause infection in the throat. It is most often used to diagnose ...
Read Article Now Book Mark Article - Throat examination with a small mirror
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X-rays of the neck or CT scan
X-rays of the neck
A neck x-ray is an imaging test to look at the cervical vertebrae. These are the 7 bones of the spine in the neck.
Read Article Now Book Mark ArticleCT scan
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
Read Article Now Book Mark Article - Blood tests such as a complete blood count (CBC) or blood differential
CBC
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
Read Article Now Book Mark ArticleBlood differential
The blood differential test measures the percentage of each type of white blood cell (WBC) that you have in your blood. It also reveals if there are...
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References
Akst L. Hoarseness and laryngitis. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn's Current Therapy 2023. Philadelphia, PA: Elsevier; 2023:28-33.
Flint PW. Throat disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 401.
Stachler RJ, Francis DO, Schwartz SR, et al. Clinical Practice Guideline: Hoarseness (Dysphonia) (Update). Otolaryngol Head Neck Surg. 2018;158(1_suppl):S1-S42. PMID: 29494321 pubmed.ncbi.nlm.nih.gov/29494321/.
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Throat anatomy - illustration
Structures of the throat include the esophagus, trachea, epiglottis and tonsils.
Throat anatomy
illustration
-
Voice box - illustration
The larynx, or voice box, is located in the neck and performs several important functions in the body. The larynx is involved in swallowing, breathing, and voice production. Sound is produced when the air which passes through the vocal cords causes them to vibrate and create sound waves in the pharynx, nose and mouth. The pitch of sound is determined by the amount of tension on the vocal folds.
Voice box
illustration
-
Throat anatomy - illustration
Structures of the throat include the esophagus, trachea, epiglottis and tonsils.
Throat anatomy
illustration
-
Voice box - illustration
The larynx, or voice box, is located in the neck and performs several important functions in the body. The larynx is involved in swallowing, breathing, and voice production. Sound is produced when the air which passes through the vocal cords causes them to vibrate and create sound waves in the pharynx, nose and mouth. The pitch of sound is determined by the amount of tension on the vocal folds.
Voice box
illustration
Review Date: 11/29/2022
Reviewed By: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.