About Laryngitis

Laryngitis is an inflammation of your voice box (larynx) due to overuse, irritation or infection. Inside the larynx are your vocal cords — two folds of mucous membrane covering muscle and cartilage.

Normally your vocal cords open and close smoothly, forming sounds through their movement and vibration. But in laryngitis, your vocal cords become inflamed or irritated. This swelling causes distortion of the sounds produced by air passing over them. As a result, your voice sounds hoarse. In some cases of laryngitis, your voice can become so faint as to be undetectable.

Laryngitis may be short-lived (acute) or long lasting (chronic). Most cases of laryngitis are triggered by temporary viral infection or vocal strain and are not serious. But persistent hoarseness can sometimes signal a more serious underlying medical condition.

Symptoms of laryngitis

Signs and symptoms of laryngitis can include:

  • Hoarseness
  • Weak voice or voice loss
  • Tickling sensation and rawness of your throat
  • Sore throat
  • Dry throat
  • Dry cough
  • Difficulty breathing (in children)

Causes

Most cases of laryngitis last less than a few weeks and are caused by something minor, such as a cold. Less often, laryngitis is caused by something more serious or long lasting.

Acute laryngitis
Most cases of laryngitis are temporary and improve after the underlying cause gets better. Causes of acute laryngitis include:

  • Viral infections such as those that cause a cold
  • Vocal strain, caused by yelling or overusing your voice
  • Viruses such as measles or mumps
  • Bacterial infections such as diphtheria — this is rare

Chronic laryngitis
Laryngitis that lasts more than three weeks is known as chronic laryngitis. This type of laryngitis is generally caused by irritants over time. It can cause vocal cord strain, injuries or growths on the vocal cord (polyps or nodules). These injuries can be caused by:

  • Inhaled irritants, such as chemical fumes, allergens or smoking
  • Acid reflux, also called gastroesophageal reflux disease (GERD)
  • Chronic sinusitis
  • Excessive alcohol use
  • Habitual overuse of your voice (such as with singers or cheerleaders)
  • Smoking

Less common causes of chronic laryngitis include:

  • Bacterial or fungal infections
  • Infections with certain parasites
  • Cancer
  • Vocal cord paralysis, which can result from injury, stroke or a lung tumor, or other health conditions

Risk factors for laryngitis include:

  • Having a respiratory infection, such as a cold, bronchitis or sinusitis
  • Exposure to irritating substances, such as cigarette smoke, excessive alcohol, stomach acid or workplace chemicals
  • Overusing your voice, by speaking too much, speaking too loudly, shouting or singing

Diagnosis

The most common sign of laryngitis is hoarseness. Changes in your voice can vary with the degree of infection or irritation, ranging from mild hoarseness to almost total loss of your voice. Your doctor may ask whether you smoke or if you have any health conditions — such as a cold or allergies — that may be causing vocal irritation. Your doctor may also ask you whether any overuse of your vocal cords — such as singing or shouting — may have irritated your vocal cords.

If you have chronic hoarseness, your doctor may want to listen to your voice and to examine your vocal cords and may refer you to an ear, nose and throat specialist. These techniques are sometimes used to help diagnose laryngitis:

  • Laryngoscopy. Your doctor can visually examine your vocal cords in a procedure called laryngoscopy, by using a light and a tiny mirror to look into the back of your throat. Or your doctor may use fiber-optic laryngoscopy. This involves inserting a thin, flexible tube (endoscope) with a tiny camera and light through your nose or mouth and into the back of your throat. Then your doctor can watch the motion of your vocal cords as you speak.
  • Biopsy. If your doctor sees a suspicious area, your doctor may do a biopsy — taking a sample of tissue for examination under a microscope.

Treatment

Treatment for laryngitis depends on the underlying cause. Acute laryngitis caused by a virus often gets better on its own within a week or so.

Home treatment can help with symptoms:

  • Breathe moist air: Inhale steam from a bowl of hot water or a hot shower.
  • Rest your voice as much as possible.
  • Drink plenty of fluids to prevent dehydration (avoid alcohol and caffeine).
  • Treat the underlying cause of laryngitis, such as heartburn, smoking or alcoholism.
  • Suck lozenges, gargle salt water or chew a piece of gum — this won’t help your vocal cords, but can ease throat irritation.

Medications used in some cases include:

  • Antibiotics. In almost all cases of laryngitis, an antibiotic won’t do any good because the cause is viral. But, if you have a bacterial infection (a very rare cause of laryngitis), your doctor may recommend an antibiotic.
  • Corticosteroids. In some cases, corticosteroids can help reduce vocal cord inflammation. However, this treatment is only used when there’s an urgent need to treat laryngitis — for example, when you need to use your voice to sing or give a speech or oral presentation, or in some cases when a toddler has laryngitis associated with croup.
  • Acid reflux medications, if gastroesophageal reflux disease (GERD) is the cause of your laryngitis.

To prevent dryness or irritation to your vocal cords:

  • Don’t smoke, and avoid secondhand smoke. Smoke dries your throat and irritates your vocal cords.
  • Drink plenty of water. Fluids help keep the mucus in your throat thin and easy to clear.
  • Avoid clearing your throat. This does more harm than good, because it causes an abnormal vibration of your vocal cords and can increase swelling. Clearing your throat also causes your throat to secrete more mucus and feel more irritated, making you want to clear your throat again.
  • Avoid upper respiratory infections. Make sure to get your annual flu shot if your doctor recommends it. Wash your hands often and avoid contact with people who have upper respiratory infections such as colds.

The following self-care steps may relieve the symptoms of laryngitis and reduce strain on your voice:

  • Use a humidifier. Keep the air throughout your home moist.
  • Inhale steam. Breathe in steam from a bowl of hot water or a hot shower.
  • Avoid talking or singing too loudly or for too long. If you need to speak before large groups, try to use a microphone or megaphone.
  • Give your voice a break. Rest your voice when possible.
  • Avoid decongestants. These medications can dry out the throat.
  • Avoid whispering. This puts even more strain on your voice than normal speech does.
  • Moisten your throat. Try sucking on lozenges, gargling with salt water or chewing a piece of gum.