What is Hoarseness? Causes & Treatments

Hoarseness refers to when your voice sounds raspy, breathy, or strained. The medical term is dysphonia. When you have a hoarse voice, the volume and pitch of your voice change, and you do not sound like your usual self.

The causes of hoarseness can be harmless, such as speaking loudly, talking for too long, or from an upper respiratory infection. But hoarseness can also be the symptom of a more serious underlying medical condition. The treatment for hoarseness can range from voice rest and voice therapy to surgery, depending on the cause.

Please continue reading to learn more about the possible causes of hoarseness and when to have hoarseness diagnosed and treated by a healthcare provider.

What is hoarseness a symptom of?

Hoarseness is a symptom of a problem with the larynx (voice box) or vocal folds (vocal cords). The larynx is located just above the trachea (windpipe) and contains two bands of muscles called the vocal folds. When you speak, air makes the vocal cords vibrate, which creates sound waves. Any condition that affects these structures can affect your voice quality. For example, it can make you sound breathy or raspy.

Risk factors for hoarseness include smoking and professions that require using your voice, such as singers, teachers, receptionists, attorneys, telemarketers, and salespersons.

What are the possible underlying causes of a hoarse voice?

Some causes of voice irregularities, such as a hoarse voice, are minor and self-limited. However, hoarseness can also be a sign of a more serious medical condition. Possible causes of hoarseness include:

Talking for too long without adequate voice rest
Shouting, cheering, or singing loudly
A raspy voice due to age-related limpening of the vocal folds
A viral infection such as a cold or flu
Acute laryngitis (inflammation of the vocal folds due to allergies, infection, sore throat, or post-nasal drip)
Gastroesophageal reflux disease or GERD, in which excess stomach acid travels back into the throat, sometimes up to the vocal folds
Vocal fold hemorrhage (bleed) when a blood vessel in the vocal fold ruptures.
Non-cancerous growths such as vocal nodules, polyps, and cysts
Vocal fold paralysis, a condition in which the muscles of the vocal folds don’t work properly. The cause of vocal cord paralysis is unknown, but it can occur in people with a medical history of infections, injuries, stroke, lung cancer, thyroid cancer, multiple sclerosis, and Parkinson’s disease
Neurological diseases such as Parkinson’s disease or stroke that affect the part of the brain that controls the muscles of the larynx
Laryngeal cancer or throat cancer
Laryngeal papillomatosis or recurrent respiratory papillomatosis, a condition in which there are noncancerous tumors in the voice box and air passages
Spasmodic dysphonia, or laryngeal dystonia, a lifelong neurological voice disorder in which the laryngeal muscles go through spasms
Muscle tension dysphonia, a condition in which tension in the muscles in and around the voice box causes voice strain
Radiation therapy to the neck
A complication of a thyroidectomy, due to laryngeal nerve injury.

When should I worry about hoarseness?

You should see your healthcare provider without delay if you have persistent hoarseness that lasts for more than three weeks or hoarseness that is accompanied by other symptoms such as difficulty breathing or difficulty swallowing.

What is the treatment for hoarseness?

It’s important to see a healthcare provider to find out the underlying cause of your hoarseness if it has been going on for more than three weeks. Some voice disorders, such as muscle tension dysphonia, require speech therapy and voice work with a specialist called a speech language pathologist. In other cases, hoarseness goes away on its own, for example, after a viral illness. You may need to see a throat specialist, and they may recommend surgery if the cause of your hoarse voice is something like a vocal polyp, laryngeal papillomatosis, vocal fold paralysis, or laryngeal cancer.

How do you get rid of hoarseness?

The following tips can help in improving voice quality if you have hoarseness. They may also help to prevent hoarseness.

Don’t overuse your voice. Too much friction in the vocal cords can lead to a raspy voice.
Drink plenty of water and stay well-hydrated.
Let an upper respiratory viral illness run its course. Take over-the-counter medications for relief of symptoms such as throat pain and post-nasal drip.
Get treatment to reduce stomach acid if you have acid reflux. Avoid spicy foods that cause reflux symptoms.
If you smoke, take steps to quit. Avoid secondhand smoke exposure.
Get appropriate treatment for thyroid problems, neurological diseases, and other communication disorders that can affect voice quality.