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What causes hoarseness? 28 possible conditions


Hoarseness, an abnormal change in your voice, is a common condition that’s often experienced in conjunction with a dry or scratchy throat. If your voice is hoarse, you may have a raspy, weak, or airy quality to your voice that prevents you from making smooth vocal sounds.

This symptom commonly stems from an issue with the vocal cords and may involve an inflamed larynx (voice box). This is known as laryngitis. If you have persistent hoarseness lasting for more than 10 days, seek prompt medical attention, as you may have a serious underlying medical condition.

Common Underlying Causes of Hoarseness

Hoarseness is typically caused by a viral infection in the upper respiratory tract. Other common factors that can cause, contribute to, or worsen your condition include:

  • acid reflux
  • smoking
  • drinking caffeinated and alcoholic beverages
  • screaming, prolonged singing, or otherwise overusing your vocal cords
  • allergies
  • inhaling toxic substances
  • coughing excessively

Some less common causes of hoarseness include:

  • polyps (abnormal growths) on the vocal cords
  • throat, thyroid, or lung cancer
  • damage to the throat, such as from the insertion of a tube
  • male adolescence (when the voice deepens)
  • poorly functioning thyroid gland
  • aortic aneurysms (swelling of a portion of the aorta, the largest artery of the heart)
  • nerve conditions that weaken the voice box muscles

What Happens at the Doctor’s Office

While hoarseness is typically not an emergency, it may be linked to some serious medical conditions. Speak with your doctor if your hoarseness becomes a persistent issue, lasting more than one week for a child and 10 days for an adult. 

See your doctor promptly if hoarseness is accompanied by drooling (in a child) and difficulty swallowing or breathing. A sudden inability to speak or put together coherent sentences may indicate a serious underlying medical condition.

If you arrive at your doctor’s office or the emergency room and are experiencing breathing difficulty, the first mode of treatment may be to restore your ability to breathe. Your doctor may give you a breathing treatment (using a mask) or insert a breathing tube to assist you in breathing.

Your doctor will likely want to take an inventory of your symptoms and a thorough medical history to determine the underlying cause. Your doctor may ask about the quality and strength of your voice and the frequency and duration of your symptoms. They may ask about factors that worsen the condition of your symptoms, such as smoking and shouting or speaking for long periods. They’ll assess any additional symptoms, such as fever or fatigue.

Your doctor will likely examine your throat with a tiny mirror to look for any inflammation or abnormalities. Depending on your symptoms, they may take a throat culture, run a series of X-rays of your throat, or recommend a CT scan (a type of X-ray). 

Your doctor may also take a sample of your blood to run a complete blood count. This assesses your red and white blood cells and hemoglobin levels.

Addressing and Easing Symptoms

Follow some self-care routines to help alleviate hoarseness:

  • Rest your voice for a few days: Avoid talking and shouting. Don’t whisper, as this actually strains your vocal cords even more.
  • Drink plenty of hydrating fluids. Fluids may relieve some of your symptoms and moisten your throat. 
  • Avoid caffeine and alcohol: They can dry out your throat and worsen the hoarseness.
  • Use a humidifier to add moisture to the air: It can help open your airway and ease breathing.
  • Take a hot shower: The steam from the shower will help open your airways and provide moisture.
  • Stop or limit your smoking: Smoke dries and irritates your throat.
  • Moisten your throat by sucking on lozenges or chewing gum: This stimulates salivation and may help soothe your throat.
  • Eliminate allergens from your environment: Allergies can often worsen or trigger hoarseness.
  • Don’t use decongestants for your hoarseness: They irritate and dry out the throat.

See your doctor if these preventative home remedies don’t lessen the duration of your hoarseness. Your doctor will be able to help determine the cause of your symptoms and the proper treatment.

If you have persistent and chronic hoarseness, a serious underlying medical condition may be the cause. Early intervention can often improve your prognosis. Identifying the cause of your persistent hoarseness may prevent your condition from worsening and limit any damage to your vocal cords or throat.

Preventing Hoarseness

You can take several actions to prevent hoarseness. Some prevention methods that may help protect your vocal cords are listed below.

Stop smoking and avoid secondhand smoke: Breathing smoke can cause irritation of your vocal cords and larynx and can dry out your throat.

Wash your hands frequently: Hoarseness is often caused by a viral respiratory infection. Washing your hands will help prevent the spread of germs and keep you healthy.

Stay hydrated: Drink at least eight 8-ounce glasses of water a day. Fluids thin the mucus in the throat and keep it moist.

Avoid fluids that dehydrate your body, such as caffeinated beverages and alcoholic drinks. These operate as diuretics and cause you to lose water.

Try to resist the urge to clear your throat. This may increase the inflammation of your vocal cords and overall irritation in your throat.

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See a list of possible causes in order from the most common to the least.


Strep Throat

Strep throat is a bacterial infection that causes inflammation and pain in the throat. It's especially common in children. Look out for sudden fever, a red throat with white patches, headache, and chills.

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Croup is a viral condition that causes swelling around the vocal cords. It is characterized by breathing difficulties and a bad cough that sounds like a barking seal. Many of the viruses responsible for croup also caus...

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Laryngitis occurs when the voice box or vocal cords become inflamed from overuse, irritation, or infection. It can be short or long term. The inflammation that causes laryngitis can be tied to a variety of conditions...

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This condition is considered a medical emergency. Urgent care may be required.

Epiglottitis is a life-threatening condition characterized by inflamed epiglottis tissue. Once the airway becomes blocked, an adult or child may exhibit bluish discoloration of their skin or lips from lack of oxygen.

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Laryngeal Cancer

Laryngeal cancer is a type of throat cancer that affects the larynx. The larynx is your voice box and it contains cartilage and muscles that help you talk. This type of cancer can damage your voice. When not treate...

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Chronic Laryngitis

Laryngitis occurs when your voice box (larynx) and vocal cords become swollen and irritated. This fairly common condition often causes hoarseness or loss of voice. A range of issues can cause laryngitis, includin...

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A goiter is the abnormal increase in the size of your thyroid gland, a gland in the neck. Goiters have many possible causes, including iodine deficiency. The primary symptom of a goiter is noticeable swelling in you...

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Esophageal Cancer

Esophageal cancer occurs when a malignant (cancerous) tumor forms in the lining of the esophagus, which is the muscular tube responsible for moving food from the throat to the stomach. As the cancer grows, it can affec...

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Thyroid Nodule

A thyroid nodule is a lump in your thyroid gland that can be solid or filled with fluid, and is rarely cancerous.

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Myasthenia Gravis

Myasthenia gravis is a neuromusclar disorder. It results in weakness of the skeletal muscles, and can cause double vision and drooping of the eyelid.

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Diphtheria is a sometimes fatal bacterial infection that affects the nose and throat's membranes. Diptheria of the skin may show up as a red rash.

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Thyroid Cancer

Thyroid cancer is a cancer that affects the thyroid, a gland at the base of the throat that forms an important part of the endocrine system.

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Acromegaly is a rare condition. It causes excess growth in the bones and soft tissues of the body. Children with the condition can grow to abnormal heights. They may also have an exaggerated bone structure that give...

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Hashimoto's Disease

Hashimoto's disease is a condition that damages the thyroid's ability to function properly. It can cause a goiter, or enlarged thyroid, which can make the front of the neck look swollen.

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Types of Acid Reflux

Acid reflux symptoms are caused when stomach contents flow up from the stomach back into the esophagus, causing symptoms like heartburn, stomach pain, and burping.

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Peritonsillar Abscess

Peritonsillar abscess is a common bacterial infection that usually results from untreated strep throat or tonsillitis. Swollen glands in the throat and jaw, as well as a sore throat, can be signs of this condition.

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Food Allergy Basics

Food allergies are overblown responses by the immune system to foods that aren't typically harmful - like eggs and peanuts. Continue reading and learn more about food allergies, and how to prevent or treat sever...

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Sjogren's Syndrome

Sjögren's syndrome is an autoimmune disorder that affects the glands that help the body create moisture in the eyes and mouth. Women are most likely to be affected.

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The thyroid gland produces a hormone that controls how your cells use energy (metabolize). Hypothyroidism occurs when the body doesn't produce enough. Untreated, it can cause complications like obesity and heart disease.

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Lung Cancer Overview

Lung cancer is a cancer that originates in the lungs. Lung cancer often goes undetected in the early stages, since symptoms don't usually present themselves until the advanced stages of the disease.

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.