Laryngitis: causes, duration and treatment

Medical disclaimer: This page is general health information for education only. It is not medical advice and is not a substitute for diagnosis or treatment by a qualified health professional. It has not been reviewed by a clinician. In an emergency, call 911 or your local emergency number.

Laryngitis is inflammation of the voice box that can leave your voice hoarse, weak or gone for a while. This guide explains what causes laryngitis, how long it usually lasts, what clinicians do, and when hoarseness needs a closer look. It is part of our plain-language library of health conditions.

What is laryngitis?

Laryngitis is swelling and irritation of the voice box, also called the larynx. It most often causes hoarseness or loss of voice.

The larynx sits at the top of your windpipe (trachea) and holds your vocal cords. When the vocal cords become inflamed or infected, they swell, and your voice changes. MedlinePlus describes how swollen vocal cords cause hoarseness.

Common symptoms include:

• Hoarseness, with a voice that sounds strained, rough, breathy or weak
• Short-term loss of your voice
• A tickling or raw feeling in your throat
• A sore or dry throat and a dry cough
• Fever or swollen glands in the neck, when an infection is the cause

The Mayo Clinic laryngitis symptom list includes these voice and throat changes.

This page covers laryngitis in adults. It does not cover croup or epiglottitis, which are forms of laryngitis in children that can block the airway.

Acute vs chronic laryngitis

Acute laryngitis lasts less than three weeks. Laryngitis that lasts longer than three weeks is called chronic laryngitis.

Mayo Clinic and Cleveland Clinic both use the three-week mark to separate the two types. Cleveland Clinic explains the acute and chronic forms of laryngitis.

• Acute laryngitis symptoms are often short-lived, lasting three to seven days.
• Chronic laryngitis can also come from ongoing postnasal drip due to chronic sinusitis.
• Chronic laryngitis is more likely than acute laryngitis to cause a barking-like cough.

The three-week cutoff describes how long symptoms last. It is not a diagnosis, and it does not tell you what is causing lasting hoarseness.

What causes laryngitis?

A viral infection is the most common cause of laryngitis. It often happens along with an upper respiratory infection such as a cold.

Other causes named by MedlinePlus in its laryngitis overview include:

• Allergies
• Bacterial infection
• Bronchitis
• Gastroesophageal reflux disease (GERD), when stomach acid flows back up
• Injury to the throat
• Irritants and chemicals
• Overuse of the voice

Laryngitis often shows up during a cold. Our guide to the common cold and flu covers those infections. Allergies are another trigger, and our page on allergic rhinitis and hay fever explains them.

You are more likely to get laryngitis if you have a respiratory infection, are exposed to cigarette smoke, or overuse your voice. Heavy drinking also raises the risk. Many infectious causes of laryngitis are contagious and can spread from person to person.

This list is not complete. Hoarseness has other causes beyond laryngitis, and a rare but serious cause of hoarseness that lasts is cancer of the voice box, according to MedlinePlus on hoarseness.

How long does laryngitis last?

Acute laryngitis often gets better on its own within a week or so. Most cases linked to a cold improve within one to two weeks.

Sources describe the timeline a little differently:

The Mayo Clinic guide to laryngitis treatment gives the one-week estimate. Put simply, laryngitis from a cold or voice strain is usually a short problem. Hoarseness that keeps going past two weeks is the signal to get checked. If you are unsure whether you have a cold or something else, our comparison of a sinus infection vs a cold may help.

These timelines apply to acute laryngitis. They do not apply to chronic laryngitis or to hoarseness that comes with the warning signs below.

When should you see a clinician for hoarseness?

Contact a clinician if hoarseness lasts more than two weeks, or sooner if you have trouble breathing or swallowing.

MedlinePlus advises contacting your provider in these situations:

• Hoarseness has lasted more than 2 weeks in an adult. MedlinePlus hoarseness guidance gives 2 to 3 weeks.
• Hoarseness has lasted more than 1 week in a child.
• Any hoarseness in a baby younger than 3 months.
• A small child who is not teething has trouble breathing or swallowing, or is drooling.

People who smoke and have hoarseness lasting more than a month should see an ear, nose and throat specialist (otolaryngologist).

A national clinical guideline tells clinicians to look at the vocal cords when hoarseness does not improve within 4 weeks. The clinical practice guideline on hoarseness (dysphonia) also calls for a look sooner, at any point, if a serious cause is suspected. Factors that can speed up that exam include a recent head, neck or chest surgery, a recent breathing tube, a lump in the neck, noisy or labored breathing, a history of tobacco use, and being a professional voice user.

Call 911 if anyone is struggling to breathe. Severe breathing trouble is rare with laryngitis, but it needs immediate medical attention. For a child, MedlinePlus also lists these reasons to call 911: bluish lips or skin, drooling, trouble swallowing, or a noise when breathing in that is getting worse.

This checklist does not replace a clinician’s judgment. It cannot rule out a serious cause on its own.

How is laryngitis treated?

Acute laryngitis often gets better on its own, so care usually focuses on resting the voice and easing symptoms.

Clinicians generally do the following:

• Examine you. A physical exam can often show whether a respiratory infection is behind the hoarseness.
• Look at the vocal cords when needed. A laryngoscopy uses a light and small mirror, or a thin flexible scope, to view the vocal cords.
• Take a tissue sample in rare cases. A biopsy may be done if the exam shows a suspicious area.
• Hold off on antibiotics for most cases. Laryngitis is usually caused by a virus, so antibiotics likely will not help.
• Use corticosteroids selectively. Mayo Clinic notes that corticosteroids can sometimes help reduce vocal cord swelling.
• Treat the cause of chronic laryngitis. Care targets underlying causes such as heartburn, smoking or heavy alcohol use.
• Refer for voice therapy. A speech-language pathologist can teach you to change habits that strain your voice.

The hoarseness guideline advises against routine antibiotics. It also advises against routine corticosteroids before the larynx has been examined. MedlinePlus notes that your provider decides whether antibiotics are needed.

Clinicians and health agencies commonly suggest these general voice care habits while you recover:

• Rest your voice and talk only when you need to.
• Drink plenty of fluids to keep your airways moist.
• Use a humidifier to add moisture to the air.
• Avoid smoke, including secondhand smoke.

The NIDCD guide to taking care of your voice covers these habits.

This section describes general approaches only. It is not a treatment plan, and it does not tell you which medicine, if any, is right for you.

Questions to bring to your appointment

Our guide on how to prepare for a medical appointment has more tips for a short visit.

• What is most likely causing my hoarseness?
• Is my laryngitis likely to be short-term, or could it be chronic?
• Do I need a laryngoscopy, and if so, when?
• Is an antibiotic likely to help in my case, or is this probably viral?
• Could acid reflux, smoking, alcohol or the way I use my voice play a role?
• Would voice therapy with a speech-language pathologist help me?

These questions are a starting point. They do not cover every situation, and your clinician may suggest others.