Laryngitis

Overview

Laryngitis is swelling and irritation of the voice box, called the larynx. The larynx holds your vocal cords, which vibrate to make sound. When it is swollen, your voice may sound hoarse, rough, or very quiet, and you may lose your voice for a short time. Laryngitis is often caused by a cold or flu, but it can also come from straining your voice, smoke, allergies, or acid reflux. Most cases are short-lived and get better with rest and simple care.

Yes. Laryngitis is a very common reason for a hoarse or lost voice. Many people have it at some point, especially during cold and flu season.

Anyone can get laryngitis. It is more common in people who use their voice a lot, such as singers, teachers, call-centre staff, and coaches. It also affects people who smoke, people with allergies or reflux, and children with viral infections. Older adults and people with weakened immune systems may need extra care.

Symptoms

Common symptoms

• A hoarse, rough, or raspy voice
• Voice loss or a very weak voice
• Sore throat or a dry, scratchy feeling in the throat
• A tickly cough that may get worse when talking
• Pain or discomfort when speaking
• A low fever, runny nose, or blocked nose with a cold
• Tender or swollen glands in the neck

Symptoms in children

• A hoarse cry or voice
• A barking cough, which can sound like croup
• Noisy breathing or a high-pitched sound when breathing in
• Fever and poor feeding
• Irritability or unusual sleepiness

Symptoms in older adults

• Symptoms may feel more severe or last a little longer
• A higher risk of dehydration if drinking becomes uncomfortable
• Persistent voice changes should be checked, because older adults can have other causes of hoarseness
• Confusion or weakness with a fever should be taken seriously

Causes

Main causes

• Viral infections, such as the common cold, flu, or COVID-19
• Straining or overusing the voice, such as shouting, singing loudly, or talking for a long time
• Smoke, including cigarette smoke and secondhand smoke
• Dry air, dust, or chemical irritants
• Allergies that irritate the throat and airways
• Acid reflux, where stomach acid comes up into the throat
• Bacterial infections, which are less common

Risk factors

• Smoking or living with someone who smokes
• Working or singing in a job that strains the voice
• Frequent shouting, cheering, or loud talking
• Allergies or hay fever
• Acid reflux or heartburn
• Dry indoor air or winter heating
• A weakened immune system
• Recent cold, flu, or other respiratory infection

When to see a doctor

See a doctor urgently if:

• You have trouble breathing, noisy breathing, or a changing breathing sound
• You cannot swallow fluids or are drooling
• You have severe throat pain or a stiff neck with a high fever
• A child is sleepy, difficult to wake, or not feeding well
• You feel very unwell or symptoms are getting worse quickly

Book a routine appointment if:

• Hoarseness lasts longer than 3 weeks
• Laryngitis keeps coming back
• Symptoms are not improving after about 2 weeks
• You have a new lump in your neck
• You cough up blood
• You have unexplained weight loss
• You are a smoker with a persistent voice change
• A child has repeated or long-lasting hoarseness

Diagnosis

A healthcare provider usually diagnoses laryngitis by asking about your symptoms and examining your throat and neck. They may listen to your voice and check for signs of infection, allergies, or reflux. Most people do not need tests. If hoarseness lasts a long time or there are warning signs, they may refer you to a specialist to look at your vocal cords.

Tests that may be done

• Physical examination of the throat and neck
• Laryngoscopy: a small camera is used to look at the voice box, usually done by an ear, nose, and throat specialist
• A throat swab if a bacterial infection is suspected
• Allergy testing or reflux tests in some cases
• Blood tests or imaging only if other conditions are suspected

What to expect at your appointment

The appointment is usually quick and simple. Your provider will ask how long you have had voice changes and whether you have a cold, fever, or pain. If a camera test is needed, it is usually done in a clinic and may feel a little uncomfortable, but it does not take long. Most people get clear advice and do not need further tests.

Treatment

Most laryngitis gets better on its own within 1 to 2 weeks. Treatment focuses on resting the voice, keeping the throat moist, and treating any underlying cause such as allergies or reflux. A pharmacist or healthcare provider can advise on safe options for pain or fever. Always check with a qualified healthcare provider before using medicines, especially for children, pregnant people, or people with other health conditions.

Self-care at home

• Rest your voice. Avoid talking, singing, or shouting more than you need to.
• Do not whisper for long periods, because whispering can strain the voice.
• Drink plenty of fluids, especially water, to keep your throat moist.
• Use a humidifier or breathe in moist air from a warm shower.
• Avoid smoke, vaping, and smoky places.
• Limit alcohol and caffeine, which can dry out your throat.
• Gargle with warm salt water if it feels comfortable.
• Suck on ice chips or throat lozenges if they soothe your throat; ask a pharmacist for advice suitable for you.
• Avoid clearing your throat often, as this can irritate the vocal cords.

Medical treatments

A healthcare provider may suggest treatment for an underlying cause, such as allergies or acid reflux. They may also advise medicine for pain or fever that is suitable for you. Most viral laryngitis does not need antibiotics. If a bacterial infection is confirmed, a clinician may discuss whether treatment is needed. If symptoms are severe or last a long time, you may be referred to an ear, nose, and throat specialist or a voice therapist.

When is surgery considered?

Surgery is rarely needed for laryngitis. It may be considered if a specialist finds a growth, structural problem, or other issue on the vocal cords, or if other treatments do not help. A specialist would discuss the risks and benefits with you.

Living with this condition

While your voice recovers, use it gently. Take voice breaks during the day, avoid background noise that makes you shout, and keep water nearby. If your job involves a lot of talking, ask about temporary adjustments or use written notes when you can. Most people can return to normal voice use as symptoms settle.

Lifestyle tips

• Do not smoke, and avoid secondhand smoke
• Keep indoor air moist with a humidifier if the air is dry
• Manage allergies and reflux with advice from your healthcare provider
• Wash your hands often to reduce cold and flu infections
• Avoid shouting, cheering loudly, or talking over loud noise
• Warm up your voice before singing or long periods of speaking

Diet and exercise

Drink enough water throughout the day. Warm fluids can feel soothing. Eat a balanced diet and continue gentle exercise if you feel well. Avoid very spicy foods if they irritate your throat, and limit alcohol and caffeine because they can dry your throat. There is no special diet that cures laryngitis, but healthy habits support recovery.

Mental health and emotional wellbeing

Losing your voice or having ongoing hoarseness can be frustrating and embarrassing. It may affect work, social life, and confidence. These feelings are normal. If you feel anxious, low, or overwhelmed, talk to a healthcare provider. If you ever have thoughts of self-harm, contact your local crisis support service or emergency services immediately.

Prevention

You cannot prevent every case, but you can lower your risk. Wash your hands often, avoid people who are unwell with colds or flu, do not smoke, and avoid smoky or dusty places. Use your voice without straining, keep your throat moist, and manage allergies or reflux. These steps can reduce irritation and infections that lead to laryngitis.

Vaccines

Staying up to date with recommended vaccines, such as flu and COVID-19 vaccines, can reduce some infections that trigger laryngitis. Ask your local health service or pharmacist which vaccines are recommended for you.

Screening programmes

There is no routine screening test for laryngitis. If you have hoarseness that lasts longer than 3 weeks, especially if you smoke, ask your healthcare provider to check it.

Complications

If left untreated

• Long-lasting hoarseness or voice change
• Vocal cord strain, nodules, or polyps from ongoing voice overuse
• Dehydration if swallowing is painful
• Rarely, breathing difficulty if swelling is severe
• Spread of infection to nearby areas, which is rare but needs urgent care

Long-term outlook

The outlook is very good for most people. Simple laryngitis usually clears within 1 to 2 weeks, and the voice returns to normal. If hoarseness lasts longer, it is worth getting checked so any other cause can be found and managed. Most people recover well with rest and simple care.

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