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My Voice is Hoarse, Why? 10 Hoarse Throat Causes & Treatments

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Last updated June 17, 2022

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Having a hoarse voice is a common symptom, and causes can include inflammatory, environmental, neuromuscular, and malignant conditions. Read more below to learn about hoarse voice causes, at-home treatments, when to see a doctor, and when it's an emergency.

7 most common causes

Obstructive Sleep Apnea
GERD
Hypothyroidism
Acute URI
Pharyngitis
Viral Throat Infection
Illustration of a health care worker swabbing an individual.
Vocal cord overuse

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Hoarse voice symptoms

Most people have experienced being stuck in in bed, with a congested, runny nose, and dry, persistent cough. Often the symptoms only get worse to include a voice so hoarse it is barely recognizable. Sometimes a hoarse voice can be the result of a bad cold, or even a particularly raucous sports game.

Common accompanying symptoms of hoarse voice

Hoarse voice symptoms can also be accompanied by:

However, a hoarse voice can also be a sign of more serious, underlying problems. It is important to follow-up on hoarseness and other associated symptoms in order to get appropriate care.

What causes a hoarse voice?

Hoarseness is the result of inflammation or irritation to your voice box or larynx. Inflammation of the larynx is laryngitis . Inside the larynx are the vocal cords that normally open and close smoothly to help produce the sound of your voice. When you have laryngitis, your vocal cords become so swollen they cannot open and close properly, causing your voice to sound hoarse.

Laryngitis can be caused by a variety of conditions. Depending on the cause, laryngitis can be temporary (acute) or long-lasting (chronic).

Inflammatory hoarse voice causes

A hoarse voice can result due to inflammation from the following.

  • Infections: Viral upper respiratory infections can cause inflammation and irritation of the vocal cords and larynx that leads to hoarseness that usually improves once the infection subsides. Bacterial and fungal infections can also cause acute laryngitis.
  • Allergies: Those seasonal allergies that cause runny nose and itchy eyes can also result in hoarseness.

Environmental hoarse voice causes

A hoarse voice can result due to lifestyle habits or certain exposures.

  • Irritants: Alcohol and smoking can directly irritate the vocal cords and larynx. Overuse of these substances can lead to chronic laryngitis and sometimes cause cancers that further contribute to hoarseness. Acid reflux, also known as GERD, causes direct irritation to the larynx that can become chronic.
  • Overuse: Speaking too much, too loudly and even prolonged singing (watch out for those nights of karaoke) can all cause hoarseness .
  • Iatrogenic (Medical related hoarse voice causes): Medications, such as inhaled corticosteroids for asthma, can cause either acute or chronic laryngitis due to its direct contact with the larynx. Also, in situations requiring intubation (a tube placed in your larynx to assist with breathing) during surgery can cause injury and irritation of the larynx.

Neuromuscular hoarse voice causes

Any medical condition that can cause paralysis or tension of the vocal cords can result in chronic laryngitis. Some of these conditions include nerve injury or multiple sclerosis.

Malignant hoarse voice causes

Some throat cancers can cause hoarseness. Alcohol and smoking increases the risk of throat cancer.

This list does not constitute medical advice and may not accurately represent what you have.

Viral infection of the larynx (voice box)

Laryngitis an inflammation of the larynx, or voice box. This causes the vocal cords to swell and leads to a hoarse, raspy voice.

A viral infection, such as the common cold or influenza, is nearly always the cause of laryngitis. These infections are spread through casual contact, as when someone sneezes and the droplets are inhaled from the air.

Most at risk are people whose immune systems are already weakened by illness, medication, or chemotherapy.

Symptoms include hoarseness; sore, irritated throat; difficulty speaking; coughing; and sometimes fever.

Forcing speech during laryngitis can cause permanent damage to the vocal cords. Hoarseness that never really clears up should be seen by a medical provider, as it can be a symptom of a more serious condition.

Diagnosis is made through throat swab and sometimes blood tests.

Treatment involves rest and drinking plenty of fluids until the virus has run its course, and resting the voice so the swelling can subside on its own. Antibiotics are not effective against a viral illness.

Rarity: Common

Top Symptoms: sore throat, runny nose, fever, dry cough, hoarse voice

Urgency: Self-treatment

Vocal cord overuse

When yelling or speaking loudly, the vocal chords may become overused, causing one's voice to become hoarse. This is called mechanical laryngitis, in other words the inflammation of the voice box.

You do not need medical treatment. Home remedies such as gargling with salt water and staying hydrated will likely be enough to restore a lost voice.

Rarity: Uncommon

Top Symptoms: sore throat, hoarse voice

Symptoms that never occur with vocal cord overuse: fever

Urgency: Self-treatment

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Viral throat infection

A sore throat is most often caused by the same viruses that cause influenza and the common cold. The illness spreads when an infected person coughs or sneezes, and then someone else inhales the airborne virus or touches a surface where it has landed.

Those most at risk for viral sore throat are children, smokers, those who work indoors with others, and anyone with a weakened immune system.

Symptoms include throat irritation; pain when swallowing or talking; red, swollen tonsils; fever; body aches; and cold-like symptoms of cough, sneezing, and runny nose.

If symptoms do not clear up within 24 hours – especially in children – a medical provider should be seen. A persistent sore throat can be a symptom of serious illness such as mononucleosis, measles, chickenpox, or croup.

Diagnosis is made through physical examination and throat swab.

Treatment involves rest, fluids, and over-the-counter pain relievers. Do not give aspirin to children. Antibiotics only work against bacteria and cannot help against a viral illness.

The best prevention is frequent and thorough handwashing.

Post-infectious cough

Post-infectious cough is a cough that begins with a cold or other upper respiratory infection, but does not clear up when the infection does. Instead, it lingers for three weeks or more and becomes chronic.

Most susceptible are smokers, because the irritation from the smoke provokes the cough. Other common causes are post-nasal drip, asthma, and some high blood pressure medications.

Symptoms include an irritating sensation in the throat that may provoke severe bouts of coughing. Some coughing is normal and is part of the body's mechanism to clear the air passages and expel any foreign material, but such a cough should only be brief and intermittent.

A post-infectious cough can interfere with quality of life. A medical provider should be seen for help with the condition, both to ease the symptoms and to rule out a more serious cause for the coughing.

Diagnosis is made through patient history, physical examination, and chest x-ray, with the goal of ruling out different conditions one by one until the actual cause is found and can be treated.

Rarity: Uncommon

Top Symptoms: cough, congestion, clear runny nose, mucous dripping in the back of the throat, hoarse voice

Symptoms that always occur with post-infectious cough: cough

Symptoms that never occur with post-infectious cough: fever

Urgency: Phone call or in-person visit

Pharyngitis

A sore throat is most often caused by the same viruses that cause influenza and the common cold. The illness spreads when an infected person coughs or sneezes, and then someone else inhales the airborne virus or touches a surface where it has landed.

Those most at risk for viral sore throat are children, smokers, those who work indoors with others, and anyone with a weakened immune system.

Symptoms include throat irritation; pain when swallowing or talking; red, swollen tonsils; fever; body aches; and cold-like symptoms of cough, sneezing, and runny nose.

If symptoms do not clear up within 24 hours – especially in children – a medical provider should be seen. A persistent sore throat can be a symptom of serious illness such as mononucleosis, measles, chickenpox, or croup.

Diagnosis is made through physical examination and throat swab.

Treatment involves rest, fluids, and over-the-counter pain relievers. Do not give aspirin to children. Antibiotics only work against bacteria and cannot help against a viral illness.

The best prevention is frequent and thorough handwashing.

Obstructive sleep apnea

Sleep apnea means "sleeping without breathing." It means the person briefly stops breathing during sleep and then abruptly wakes up due to lack of oxygen.

In obstructive sleep apnea, the airway becomes relaxed and collapses during sleep. In central sleep apnea, the part of the brain which controls breathing may fail to send out signals during sleep. In both cases, breathing is cut off and the patient is forced to wake up – sometimes hundreds of times per night.

Older, overweight people are most susceptible, as is anyone with enlarged tonsils.

Symptoms include loud snoring; constant rousing during sleep; and constant daytime sleepiness.

Ongoing sleep apnea leads to very poor sleep quality with little REM sleep. This is very stressful and can lead to high blood pressure, stroke, and heart arrhythmias. The daytime drowsiness can lead to car accidents.

Diagnosis is made through physical examination and a sleep study.

Treatment consists of lifestyle changes and usually a CPAP (Continuous Positive Airway Pressure) machine, which allows the patient to experience much better sleep almost immediately.

Lung cancer (non-small cell)

Non-small cell lung cancer, or NSCLC, is a general term that covers most types of lung cancer including adenocarcinoma, large cell carcinoma, and squamous cell carcinoma. "Non-small cell" describes the appearance of the cancer cells, not the affected lung cells.

The cause of any kind of cancer is not known for certain. Non-small cell lung cancers are associated with smoking and with exposure to radon, asbestos, and some chemicals. Genetics may be a factor.

Symptoms include persistent cough, especially with traces of blood or chest pain; hoarseness; shortness of breath; fatigue; and recurrent bronchitis or pneumonia.

If any of these symptoms are present, the patient should be seen by a medical provider. As with any form of cancer, early diagnosis gives the best chance of successful treatment.

Diagnosis is made through imaging, such as chest x-ray, ultrasound, or MRI; biopsy; and/or lab tests made on lung secretions (sputum.)

Treatment options include surgery, radiation therapy, chemotherapy, and/or immunotherapy. Palliative care is always done to ease symptoms and help keep the patient comfortable.

Rarity: Rare

Top Symptoms: cardinal symptoms of lung cancer like chest pain or changes in breathing, fatigue, cough, shortness of breath, chest pain

Urgency: Primary care doctor

Hypothyroidism

Hypothyroidism, or "underactive thyroid," means that the thyroid gland in the neck does not produce enough of its hormones. This causes a slowing of the body's metabolism.

The condition can occur due to autoimmune disease; any surgery or radiation treatment to the thyroid gland; some medications; pregnancy; or consuming too much or too little iodine. It is often found among older women with a family history of the disease.

Common symptoms include fatigue, constantly feeling cold, weight gain, slow heart rate, and depression. If left untreated, these and other symptoms can worsen until they lead to very low blood pressure and body temperature, and even coma.

Diagnosis is made through a simple blood test.

Hypothyroidism is easily managed with daily oral medication. The patient usually starts feeling better after a couple of weeks and may even lose some extra weight. It's important for the patient to be monitored by a doctor and have routine blood testing so that the medication can be kept at the correct levels.

Rarity: Rare

Top Symptoms: fatigue, depressed mood, difficulty concentrating, weight gain, muscle aches

Urgency: Primary care doctor

Common cold

The common cold is a contagious viral infection that can cause cough, congestion, runny nose, and sore throat. Most adults catch two to three colds per year, and kids can get more than eight colds each year.

Rest and drink plenty of fluids. Colds are contagious and can easily spread to other people, so if possible, avoid close contact with others, such as hugging, kissing, or shaking hands. Colds typically resolve within 7 to 10 days.

Acid reflux disease (GERD)

Gastroesophageal reflux disease is also called GERD, acid reflux disease, and heartburn. It is caused by a weakening in the muscle at the end of esophagus. This allows stomach acid to flow backward, or reflux, up into the esophagus.

Risks factors for GERD include obesity, smoking, diabetes, hiatal hernia, and pregnancy.

Symptoms include a painful burning sensation in the chest and throat, and sometimes difficulty swallowing.

If heartburn occurs more than twice a week, a doctor should be consulted. If symptoms are accompanied by jaw or arm pain, and/or shortness of breath, these may be signs of a heart attack and constitute a medical emergency.

Repeated exposure to stomach acid damages the lining of the esophagus, causing bleeding, pain, and scar tissue.

Diagnosis is made by patient history and sometimes by x-ray, upper endoscopy, or other tests to measure refluxed acid.

Treatment begins with over-the-counter antacids and lifestyle changes. Medication may be used to reduce stomach acid, and surgery may be done to strengthen the sphincter muscle at the lower end of the esophagus.

Hoarse voice quiz

Take a quiz to find out what's causing your hoarse voice.

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Hoarse voice treatments and relief

At-home treatments for hoarse voice symptoms

Most of the time, hoarseness and laryngitis resolve on their own and there are many things you can do at home to help alleviate your hoarse voice symptoms.

  • Rest your voice: Avoid talking and shouting. Try not to whisper or clear your throat, as this actually causes more swelling and strain to your vocal cords.
  • Drink fluids: Fluids moisten your throat and make it easier to clear things like food with less irritation.
  • Avoid caffeine, alcohol and smoking: All of these can dry and irritate your larynx. Moreover, caffeine, alcohol and other caffeinated beverages can dehydrate your body and exacerbate your hoarseness because it strips your throat of its mucous.
  • Avoid spicy foods: If you have GERD, spicy foods can exacerbate your reflux and cause irritation of your larynx and vocal cords.
  • Use a humidifier: This adds moisture to the air and can help open your airway and make breathing easier.
  • Eliminate allergens from your environment: Allergies can not only cause but also exacerbate your hoarseness.
  • Prevent upper respiratory infections: Wash your hands often, shoulder your sneezes and if possible avoid contact with others who have upper respiratory infections.

When to see a doctor for hoarse voice symptoms

See your doctor if these home remedies do not improve the duration or severity of your hoarseness. Your doctor will be able to determine the cause and provide the proper treatment.

When hoarse voice symptoms are an emergency

However, seek medical attention immediately for hoarse voice symptoms if you also have:

  • Trouble breathing
  • Blood when you cough
  • Persistent fever
  • Increasing pain
  • Trouble swallowing

FAQs about hoarse voice

Can thyroid problems cause hoarseness?

Yes, hypothyroidism can cause a deepening of the voice. This deepening is often noticed and more common in middle-aged women. A thyroid nodule or thyroid cancer can interrupt the nerve that supplies one of an individual's two vocal cords, causing paralysis and hoarseness. Finally, surgery on the neck can cause paralysis and hoarseness.

What does is sound like when your voice is hoarse?

Hoarseness refers to a change in the characteristics of an individual's voice. It can apply to a variety of changes in the voice, including weakness or inability to produce significant volume, fatigability or losing one's voice quickly, a shaky or altered pitch, a warbling or tremulous tone, or a strained voice quality.

Why is my voice hoarse but my throat doesn't hurt?

A hoarse voice without a sore throat can occur when a non-inflammatory condition has caused loss of vocal cord function. This can be caused by overuse like yelling or speaking in an abnormal tone for long periods of time. A vocal cord polyp or nodule which can develop from overuse (e.g. speakers, singers), and can also cause hoarseness. Additionally, surgery, cancer, or neurological disorders like Parkinson's disease can also cause hoarseness without pain albeit much less frequently than the above causes.

Can allergies cause my voice to be hoarse?

Yes. Allergies can cause voice hoarseness. Over time, mucus from an allergic reaction to pollen and dust in the air can cause a buildup of mucus [14]. This mucus may cause a runny nose or post nasal drip in which it drips onto the back of the throat, causing irritation and inflammation. Over time, this can cause a sore throat and a hoarse voice.

Why is my voice constantly hoarse?

Chronic hoarse voice may be caused by chronic laryngitis — defined as a hoarse voice and sore throat that lasts longer than three weeks. Chronic laryngitis can be caused by inhalation of chemical fumes (e.g. industrial fumes, cigarette smoke), gastroesophageal reflux or (GERD) causing some stomach acid to affect the vocal cords, chronic alcohol use, or post nasal drip from allergies.

Questions your doctor may ask about hoarse voice

  • Do you currently smoke?
  • Do you have a sore throat?
  • Do you have a cough?
  • Any fever today or during the last week?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

  1. Hoarseness. National Institute on Deafness and Other Communication Disorders (NIDCD). Updated March 6, 2017. NIDCD Link
  2. Ho T. Hoarseness. U.S. National Library of Medicine: MedlinePlus. Published October 30, 2016. MedlinePlus Link
  3. Tesini BL. Infections. Merck Manual Professional Version. Updated June 2018. Merck Manual Professional Version Link
  4. Voice Disorders. U.S. National Library of Medicine: MedlinePlus. Updated May 17, 2018. MedlinePlus Link
  5. Laryngitis. NCBI. NCBI Link
  6. Vorvick LJ. Laryngitis. U.S. National Library of Medicine: MedlinePlus. Published December 10, 2016. MedlinePlus Link
  7. Sasaki CT. Laryngitis. Merck Manual Consumer Version. Updated May 2018. Merck Manual Consumer Version
  8. Reiter R, Hoffmann TK, Pickhard A, Brosch S. Hoarseness - Causes and Treatments. Deutsches Arzteblatt International. 2015;112(19):329-337. NCBI Link
  9. Otolaryngology - Head and Neck Surgery. Johns Hopkins Medicine. Johns Hopkins Medicine
  10. Schiff BA. Laryngeal Cancer. Merck Manual Professional Version. Published April 2018. Merck Manual Professional Version
  11. Gastroesophageal Reflux Disease (GERD)/Heartburn. Johns Hopkins Medicine. Johns Hopkins Medicine
  12. Wisse B. Hypothyroidism. U.S. National Library of Medicine: MedlinePlus. Published June 14, 2018. MedlinePlus Link
  13. The American Cancer Society Medical and Editorial Content Team. What is Thyroid Cancer? American Cancer Society. Updated April 15, 2016. American Cancer Society
  14. Shmerling RH. Treatments for Post-Nasal Drip. Harvard Medical School: Harvard Health Publishing. Published April 2018. Harvard Health Publishing