Hoarseness is an inflammation of the larynx that results in a change in the voice, making it sound breathy, raspy, scratchy or strained. There may be changes in volume and pitch, as well. Hoarseness falls under the medical category of dysphonia, which refers to voice impairment or any sort of difficulty speaking.
What Causes Hoarseness?
Hoarseness is the result of a problem with the vocal cords. It can be caused by a variety of different conditions including:
- Common cold, upper respiratory tract infection
- Voice overuse (using your voice too much, too loudly, or for a long period of time)
- Acid reflux
- Inflammation of the larynx due to allergies
- Smoking and secondhand smoke
- Head and neck cancer
- Medication side effects
- Age-related changes
- Neurological conditions (examples: Parkinson’s disease, amyotrophic lateral sclerosis)
- Intubation (process of inserting a tube through the mouth and into the airway) and postsurgical injury
When and Who Should I See about My Hoarseness?
You should make an appointment with your regular doctor if your hoarseness does not go away—or at least start to improve—in seven to ten days, especially if you smoke or:
- You do not have symptoms of a cold or flu
- You are coughing up blood
- You’re having difficulty swallowing
- You feel a lump in your neck
- There is complete loss or severe changes in your voice
- You have pain when speaking or swallowing
- Your voice change is goes along with difficulty breathing
- Your hoarseness makes your work hard to do
- You are a vocal performer (singer, teacher, public speaker) and cannot do your job
If your voice is still hoarse four weeks after onset, it is crucial that you ask for a referral to an ENT specialist, or a laryngologist (an ENT voice subspecialist) to rule out a more serious condition and prevent more serious damage to your voice.
How Is Hoarseness Treated?
Many times, hoarseness clears up on its own without any sort of medical intervention. Many patients take a wait-and-see approach, treating symptoms with home remedies that include resting the voice, staying hydrated by drinking plenty of fluids and using a humidifier to add moisture to the air.
Making certain lifestyle changes – eliminating spicy foods, alcohol and caffeine from the diet, giving up cigarettes, avoiding activities that cause vocal cord strain such as shouting, whispering, or using inappropriate pitch or volume – are all helpful ways to reduce or eliminate the symptoms associated with chronic hoarseness.
If it becomes necessary for you to see a doctor about your voice, an otolaryngologist (general ENT specialist) or laryngologist (ENT voice subspecialist) can get to the bottom of the cause.
At your visit, you will be given:
- A complete history
- A complete physical exam of the head and neck region
- Videostroboscopy (a specialized scope used to assess the function of the vocal cords)
- Imaging/X-rays, when warranted
- Blood work/lab testing, when warranted
Treatment depends on the cause and may include medications, Botox injections, surgery and/or voice therapy.