What causes laryngitis, and how is it treated?

Man holding a cup of tea and touching his sore throat

What is laryngitis?               

Laryngitis is the inflammation of the larynx, often caused by a viral infection or vocal overuse. Many people say they have laryngitis, but what they’re experiencing is vocal hoarseness, which can be caused by a number of things.

Hoarseness is when you have a scratchy, sore or raspy voice and may have difficulty speaking. Short-term hoarseness lasts less than two weeks. Hoarseness that lasts longer than a month is considered chronic.

“Acute hoarseness is most often caused by viral laryngitis,” says laryngologist Christopher Bingcang, MD. “This is when a cold or upper respiratory infection causes you to lose your voice.

Hoarseness is also be caused by vocal overuse or abuse, such as shouting or screaming at a football game or concert. This is called traumatic laryngitis, which can result in a vocal cord hemorrhage or tear. It is typically a short-term condition. Most will recover in a few days by resting their voice.

Chronic hoarseness can result from long-term overuse by those who use their voice as part of their job. This includes singers, actors, physicians, nurses and preachers. If you have chronic hoarseness (lasting two weeks or more), it is important to see an ear, nose and throat doctor to determine the cause.

Other causes of chronic hoarseness include reflux laryngitis and vocal cord paralysis. Vocal cord paralysis can develop randomly or as a complication of neck or chest surgery. Reflux laryngitis is caused by gastroesophageal reflux disease. GERD creates inflammation of the vocal cords so the patient's vocal cords don’t vibrate well. Treatment for reflux to suppress stomach acid will stop the hoarseness.

How is laryngitis diagnosed?

See an ear, nose and throat specialist if your hoarseness lasts longer than two weeks. An ENT can perform a laryngoscopy to look for vocal cord tumors and other benign growths. It is important to rule out vocal tumors before treating a patient for laryngitis or other causes of hoarseness.

“A laryngoscopy can be done quickly in the clinic,” says Dr. Bingcang. “We use a little anesthetic in the nose before inserting the scope to look at the vocal cords. It is the only way to detect vocal cord tumors and other noncancerous growths that might cause hoarseness. Most patients easily tolerate the procedure without problems.”

How do I treat laryngitis?

Chronic hoarseness caused by traumatic laryngitis (vocal abuse or overuse) can be treated with voice therapy. “When treating hoarseness, you never want to push through with your voice if you feel like it takes a lot of effort,” says speech/language pathologist Amber Koch, MS, CCC-SLP. “If you feel like you must strain to use your voice, that’s your body’s way of telling you to rest your voice.”

Decreasing throat clearing is important to recovering from hoarseness. When you clear your throat, your vocal cords slam together. That puts you in a vicious cycle of irritation because your vocal cords swell. Then you produce protective mucus that you want to clear. When you clear your throat, your vocal cords swell, and your voice changes more.

“When you're really struggling to speak, you should limit voice use to no more than 15 minutes per hour,” says Koch. “Use a low loudness so you're not pushing and straining through. You don't want to physically push from your voice box to get your voice out.”

One of the most important treatments for any voice concern is hydration. Drinking water allows your body to produce enough of the slippery, thin mucus that helps to decrease friction. Friction happens when your vocal cords are swollen. Your voice might be hoarse because swollen vocal cords rub on an uneven plane. A pure tone is created when your vocal cords have smooth edges that move easily.

In addition to drinking water, make sure your environment has enough humidity. Even in a humid time of year, you might still need to supplement with extra-long showers or run a humidifier at bedtime. The only reason not to use a room humidifier is if you have a dust mite allergy because humidity can worsen that.

You shouldn’t use menthol-based cough drops to treat hoarseness because menthol will dry you out more. Use a pectin-based lozenge instead. There are also pectin-based lollipops that are helpful for children with hoarseness.

Diagnosing and treating laryngitis and other causes of hoarseness

If you experience hoarseness that has lasted more than two weeks, it is good to have a laryngoscopy to determine the cause. Call 800.922.0000 to schedule your appointment with one of our ear, nose and throat specialists.