What is Hoarseness?

What is Hoarseness? - What is Hoarseness?

Most people have experienced changes in the voice during an upper respiratory infection or after misuse or overuse of the voice. These abnormal changes in the voice are referred to as hoarseness . When your voice is hoarse, it can sound breathy or strained, or you may have a more raspy voice than usual. Changes in the volume and pitch of your voice are also common.


Being hoarse is related to the parts of the "voice box", specifically the vocal folds of the larynx. During speech or singing, the vocal folds come together and vibrate as air leaves the lungs, which produces sound. A hoarse voice is the result of swelling or lumps on the vocal folds, which hinders vibration and alters the quality, volume, and pitch of the voice.

Causes of hoarseness can include:

  • Acute laryngitis occurring during a cold, viral upper respiratory infection, or vocal strain
  • Vocal misuse including speaking in noisy situations, telephone use with handset on the shoulder, using inappropriate pitch, not using amplification during public speaking, and excessive use of the voice
  • Benign vocal cord lesions vocal nodules, polyps, or cysts that occur when using the voice too much or too loudly for extended periods of time
  • Vocal hemorrhage sudden loss of voice following a yell or other strenuous vocal use considered a vocal emergency and should be treated with absolute vocal rest and should be examined by an ENT
  • Allergies
  • Trauma to the voice box
  • Gastroesophageal or Laryngopharyngeal Reflux
  • Smoking
  • Neurological diseases and disorders including Parkinson’s, stroke, or spasmodic dysphonia
  • Menstruation
  • Laryngeal cancer

Treatment & Prevention

Treatment of hoarseness depends largely on the cause. Many common causes can be treated by vocal rest of modifying how the voice is used. If it is caused by cold or flu, a hoarse voice can be evaluated and treated by your family doctor, pediatrician, or internist. However, vocal issues are best treated by professionals who know and understand how the voice functions, including otolaryngologists (ENT’s), speech/language pathologists, or voice teachers of singing, acting, and public speaking. You should seek the care of an otolaryngologist if you are hoarse for longer than three weeks, are coughing up blood, have difficulty swallowing, feel a lump in the neck, experience voice loss or severe changes lasting longer than a few days, experience pain while speaking or swallowing, experience difficulty breathing along with vocal changes, cannot perform as a vocalist, or if a hoarse voice interferes with your livelihood.