Changes in your voice that do not sound normal are known as hoarseness. Some voice changes are caused by other temporary illnesses, like allergies or a cold. In other cases, hoarseness can be a symptom of a more serious problem.
Hoarseness is typically caused by something that affects how the vocal cords or folds work. When we breathe, the vocal folds separate to allow air to pass through. When we vocalize, the vocal folds come together. Air passing between the folds causes them to vibrate, which produces the sounds of speaking or singing. Swelling or lumps on the vocal folds can change the way our voice sounds, causing hoarseness.
Hoarseness can mean a variety of changes in the sound of our voice. It may sound breathy, raspy, strained, or the pitch may change either up or down. Hoarseness can last for a few days, weeks, or even months, and can be caused by a number of different conditions.
• Laryngitis – The vocal cords may swell as a result of a common cold, upper respiratory infection, or voice strain. You can seriously damage your vocal folds if you abuse your voice while you have laryngitis;
• Voice Misuse - You can over-exert your voice in many different ways including talking loudly, excessive use of the voice which can include singing or speaking, talking on the telephone with the handset cradled against your shoulder, speaking in an unnaturally high or low pitch, or not using a microphone when speaking to a large group in public;
• Vocal Cord Lesions – Nodules, cysts, or polyps can grow on your vocal folds if you use your voice too much or too loudly;
• Vocal Hemorrhage – If you suddenly lose your voice after yelling or other strenuous voice use, you may have a hemorrhage in one of the blood vessels on the vocal fold. When this happens, the tissue of the vocal fold can fill up with blood. This is a vocal emergency that requires complete voice rest and immediate treatment by an Otolaryngologist (Ear, Nose, and Throat doctor);
• Stomach Acid – When acid from the stomach travels up the esophagus from the stomach, it can irritate the vocal folds. This condition, known as gastroesophageal reflux or GERD, is usually accompanied by heartburn. If the acid reflux from the stomach rises all the way into the back of the throat, the condition is known as laryngopharyngeal reflux or LPRD;
• Smoking – In addition to the irritation to the vocal folds from smoking, smoking is the major cause of throat cancer. So smokers who become hoarse should see an otolaryngologist for evaluation;
• Neurological Disorders – Conditions such as Parkinson’s or a stroke can cause hoarseness, as can a paralyzed vocal fold; and
• Prolonged Crying in children – Your child may become hoarse following an extended bout of crying.
Do’s and Don’ts for Hoarseness
Regardless of how long hoarseness lasts, the treatments are typically the same. Rest and time are the only cures for hoarseness that is not caused by another condition or associated with other symptoms. Here are a few Do’s and Don’ts when you are hoarse:
• Don’t talk – The best cure for hoarseness is to rest the voice. Crying, shouting, and excessive talking or singing will make your symptoms worse;
• Don’t whisper – It may seem as though whispering is easy on your voice, but the opposite is actually true. Whispering can actually strain the vocal folds more than speaking aloud;
• Don’t gargle – While it won’t hurt your vocal folds, it won’t help them either;
• Don’t take decongestants – These drugs can dry the vocal folds, which will make them stay irritated longer;
• Don’t smoke;
• Do hydrate – Adding humidity to the air with a vaporizer can ease your symptoms. Also, make sure to drink enough water to stay well-hydrated; and
• Do treat other conditions – If you have other conditions or symptoms in addition to hoarseness, such as alcoholism, allergies, bronchitis, or laryngitis, follow your doctor’s instructions to treat those conditions.
When to See a Doctor
You should see your doctor if you have been hoarse more than two weeks or if you have difficulty breathing or swallowing. Take your child to the doctor if he has been hoarse for more than a week, if he is also drooling more than usual or if a child younger than 3 months is hoarse.
Tips to Prevent Hoarseness
• Don’t smoke and avoid second hand smoke;
• Avoid caffeine, alcohol, and other things that can make you dehydrated;
• Stay hydrated by drinking plenty of water;
• Avoid spicy foods; and
• Avoid straining your voice -– use a microphone if possible when speaking to a large group and avoid situations that require speaking loudly or yelling.
If you are hoarse, don’t speak or sing unless absolutely necessary to keep from making hoarseness worse.
Sources:
American Academy of Otolaryngology – Head and Neck Surgery
National Institutes of Health – Medline Plus