Laryngitis: Why You Lose Your Voice and What Helps
If your voice becomes hoarse, weak, or disappears altogether, laryngitis is a common reason.
“Laryngitis simply means inflammation of the larynx, which is also known as the voice box,” says Michael Lerner, MD, a Yale Medicine laryngologist, a physician who specializes in disorders of the voice. “The larynx contains the vocal cords, which are very delicate. When they become inflamed, they swell and stiffen, making it hard to produce a normal-sounding voice.”
In most cases, laryngitis—inflammation of the larynx—is temporary and improves with rest and basic self-care. But when symptoms last longer than a few weeks or are accompanied by pain or breathing difficulty, medical evaluation is important.
What causes laryngitis?
The most common cause of laryngitis is an upper respiratory infection, such as the common cold, flu, or COVID-19. These infections—usually viral—can inflame the larynx and surrounding tissues.
Other common causes include:
- Voice strain, such as prolonged talking, yelling, cheering, or singing
- Allergies or environmental irritants, including smoke and air pollution
- Laryngopharyngeal reflux disease (LPRD), when stomach acid irritates the throat
Less commonly, bacterial or fungal infections can cause laryngitis. Fungal laryngitis is more likely to arise in people who use steroid inhalers. Smoking and alcohol use can also irritate the larynx and worsen symptoms.
While throat cancer is not a typical cause of laryngitis, persistent hoarseness or throat pain should always be evaluated carefully. “We screen for cancer when symptoms don’t resolve or when other concerning signs are present,” Dr. Lerner says.
Can talking too much cause laryngitis?
Yes, overusing your voice can lead to a type of injury called phonotrauma. People whose jobs or daily lives require frequent or prolonged voice use, such as teachers, parents, coaches, actors, and singers, can develop a voice change after prolonged voice use—especially when trying to be heard over competing background noise.
“When you speak or sing, your vocal cords repeatedly slam against each other and vibrate—typically at a magnitude of hundreds of times per second,” Dr. Lerner explains. “These repetitive collisions can cause swelling, much like overuse injuries in joints or muscles.”
What is the larynx, and how does it work?
The larynx is a relatively small, cartilage-framed biologic valve located at the front of the neck and on top of the trachea or windpipe. Inside are the vocal cords (also called vocal folds), which are two narrow bands of tissue that stretch across the airway. In most adults, the vocal folds are only about 1 to 2 centimeters long or roughly the length of a fingernail.
As air is exhaled from the lungs and passes up through closed vocal folds, they begin to rapidly and repeatedly collide, generating sound pressure waves. The larynx also plays a critical role in swallowing by closing to prevent food or liquid from entering the lungs.
Just above the larynx is the pharynx, a muscular passage that connects the nose and mouth to both the windpipe and the esophagus.
How is laryngitis diagnosed?
In many cases, laryngitis can be diagnosed based on your symptoms and a physical exam. If symptoms are persistent or unclear, your doctor may refer you to an ear, nose, and throat (ENT) specialist or laryngologist.
Specialized exams may include:
- Laryngoscopy, which uses either a thin, flexible camera passed through the nose or a rigid telescope through the mouth to view the vocal folds
- Laryngeal stroboscopy, which provides more nuanced analysis of hoarseness by using light synchronized to an individual’s voice to assess how the vocal folds vibrate in slow motion
These tests help identify inflammation, stiffness, scarring, or growths that may not be visible during a routine exam.
How is laryngitis treated?
Treatment depends on the cause, but most cases improve with conservative care, including:
- Resting your voice as much as possible
- Drinking plenty of fluids
- Using a humidifier
- Avoiding throat irritants, such as smoke
Antibiotics are only used when a bacterial infection is confirmed. If reflux is contributing to symptoms, lifestyle changes and anti-reflux medications may help.
Menthol-containing lozenges can be irritating for some people and are often best avoided.
When should you see a doctor?
Most cases of voice change or laryngitis improve within two to four weeks. You should seek medical care if:
- Hoarseness lasts longer than four weeks
- You have throat pain, difficulty swallowing, or trouble breathing
- You lose your voice repeatedly or without a clear cause
“These are signals that we should take a closer look,” Dr. Lerner says.
How can you prevent laryngitis?
Basic prevention steps include frequent handwashing to reduce viral infections and avoiding smoking and secondhand smoke. If you use your voice heavily, limit prolonged speaking when possible and avoid shouting. When you do speak, use a comfortable volume—loud enough for someone who is an arm’s length away to hear.
If you have acid reflux, things to avoid or limit include late-night meals, lying down immediately after eating, and acidic foods.
