HoarsenessVoice strain; Dysphonia; Loss of voice
Hoarseness refers to a 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.
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 sinus 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.
Hoarseness may be caused by:
Acid reflux (
Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents leak backwards from the stomach into the esophagus (the tube from...
An allergy is an immune response or reaction to substances that are usually not harmful.
- Breathing in irritating substances
- Cancer of the throat or larynx
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...
- Colds or upper respiratory infections
- Heavy smoking or drinking, especially together
- Overuse or abuse of the voice (as in shouting or singing), which may cause swelling or growths on the vocal cords
Less common causes include:
Injury or irritation from a breathing tube or
Bronchoscopy is a test to view the airways and diagnose lung disease. It may also be used during the treatment of some lung conditions.
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), or other areas of the throat.
Foreign object in the esophagus or trachea
Foreign object in the esophagus or trac...
If you breathe a foreign object into your nose, mouth, or respiratory tract, it may become stuck and cause breathing problems or choking. It can als...
- Swallowing a harsh chemical liquid
- Changes in the larynx during puberty
Thyroid cancer is a cancer that starts in the thyroid gland. The thyroid gland is located inside the front of your lower neck.
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...
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....
Hoarseness may be short-term ( acute ) or long-term ( chronic ). Rest and time may improve hoarseness. Hoarseness that continues for weeks or months should be checked by a health care provider.
Acute means sudden or severe. Acute symptoms appear, change, or worsen rapidly. It is the opposite of chronic.
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...
Things 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
Call your health care provider if:
- You have trouble breathing or swallowing.
- Hoarseness occurs with drooling, especially 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 is an exam of the voice box (larynx). It can be done using a small mirror held just below the back of your palate, or a rigid or flexib...
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 ...
- Throat examination with a small mirror
X-rays of the neck
X-rays of the neck
A neck x-ray is an imaging test to look at cervical vertebrae. These are the 7 bones of the spine in the neck.
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...
Blood tests such as a complete blood count (
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
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...
Chang JI, Bevans SE, Schwartz SR. Otolaryngology clinic of North America: evidence-based practice: management of hoarseness/dysphonia. Otolaryngol Clin North Am . 2012 Oct;45(5):1109-26. PMID: 22980688 www.ncbi.nlm.nih.gov/pubmed/22980688 .
Chio SS, Zalai GH. Voice disorders. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 5th ed. Philadelphia, PA: Elsevier Mosby; 2010:chap 203.
Review Date: 11/25/2014
Reviewed By: Ashutosh Kacker, MD, BS, Professor of Clinical Otolaryngology, Weill Cornell Medical College, and Attending Otolaryngologist, New York-Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.