hoarse throat

An occasional hoarse voice is normal: You’ve strained your voice shouting to be heard over loud music or while cheering on your favorite sports team, for example. But a chronic hoarse voice can have many different causes, from benign to serious. When you understand what’s at the root of hoarseness, you can take steps to treat it and prevent it in the future.

Common Causes of a Hoarse Voice

Normally, your vocal cords stay apart while you breathe and come together when you speak. As you exhale, this causes a vibration that results in sound. But if you develop swelling, growths, or other damage to your vocal cords, your voice can be affected.

In general, a hoarse voice has the following characteristics:

  • Raspy
  • Strained
  • Breathy
  • Changes in pitch or volume

While some causes of hoarseness are temporary, others may require a visit with your physician. Typical culprits include:

  • Laryngitis. Acute laryngitis is the most common reason for hoarseness. It occurs when your vocal cords swell, usually due a cold, upper respiratory infection, or straining your voice. It’s important to rest your voice when you have acute laryngitis, because trying to speak loudly could damage your vocal cords.
  • Improper voice use. Shouting isn’t the only act that can make your voice hoarse. Excess talking, speaking at an abnormally high or low pitch, and even cradling a telephone between your ear and shoulder can contribute to this problem.
  • Vocal cord lesions. People who use their voice frequently (such as singers) can develop benign nodules, polyps, and cysts on the vocal cords that can lead to hoarseness.
  • Reflux. Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux disease (LPRD) can trigger hoarseness. In these conditions, stomach acid can rise through the esophagus and throat, irritating the vocal cords.
  • Smoking. As you might imagine, smoking can make your voice hoarse. It can also increase your risk of throat cancer, another cause of hoarseness.
  • Other disorders. Neurological conditions such as Parkinson’s disease, spasmodic dystonia, and stroke can affect the voice, as can thyroid disease, allergies, and laryngeal cancer.

When to Call Your Doctor for Hoarseness

Temporary hoarseness can be normal, especially if you have a cold, allergies, or recently strained your voice. Everyone is different, but you should contact your physician if your voice is still hoarse after three weeks, you have difficulty swallowing, feel like you have a lump in your throat, experience throat pain, or are coughing up blood. Also seek medical attention if you suddenly and completely lose your voice after shouting or straining: This could be a sign of a vocal cord hemorrhage, which is considered an emergency.

For more information on hoarseness or to schedule an appointment with one of our ENT doctors, please visit the UPMC Voice Center website.