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Laryngitis results from inflammation of the larynx, near the very top of the windpipe, called the voice box. Resting and breathing in steam can soothe the tissue, normally bring the voice back to normal in a few days. For more severe cases caused by GI or environmental issues, medications, or even voice therapy, might be needed.
What is laryngitis?
Laryngitis is swelling of the larynx, the top part of the “windpipe” (trachea) as it branches off from the esophagus. The most common cause of laryngitis is either a viral infection (such as cold, flu, or croup), gastroesophageal reflux disease (GERD), or overuse of the vocal cords, such as loud or prolonged singing or shouting. Other causes of laryngitis include allergic reactions, smoking, environmental irritants, asthma, medications (such as decongestants or steroids), bacterial infection, and, rarely, a fungal infection.
The larynx, a sturdy, rigid structure about two inches long, primarily protects the respiratory system from breathing in food while eating. Also called the Adam’s apple, the larynx feels like a hard bone at the front of the neck right below the chin. The larynx also houses the vocal cords (vocal folds), a double pair of fibrous tissue strung across the laryngeal cavity. Hoarseness or voice loss result when the pair of vocal folds responsible for producing sound is swollen.
Acute laryngitis (short-term laryngitis), a common condition, usually resolves in three to seven days, but chronic laryngitis, which is less common, is inflammation of the larynx that lasts for three weeks or longer. Treatment focuses on voice rest, steam inhalation, and treating any underlying cause.
How is laryngitis diagnosed?
A laryngitis diagnosis is usually made based on symptoms, medical history, and a physical examination. It is usually diagnosed and treated by a general practitioner or registered nurse practitioner, but a speech-language pathologist may also be involved in diagnosis and treatment.
Symptoms of laryngitis most commonly include:
- Voice changes (hoarseness, raspiness, or voice loss)
- Early vocal fatigue
- Throat pain or “tickling”
- Frequent throat clearing
- Dry cough
Other symptoms might include difficulty breathing, shortness of breath, wheezing, drooling, or difficulty swallowing. But these often indicate a more serious condition, such as epiglottitis, a swelling of the epiglottis, the flap of tissue that covers the larynx to prevent food from going down the trachea (windpipe).
The history of the symptoms will help the healthcare professional nail down a cause. Risk factors of laryngitis that may point to a cause include:
- Recent illness or exposure to sick people
- Acid reflux
- Allergies
- Asthma
- Immune status
- Travel
- Medications
- Smoking
- Alcohol use
- Recent injuries or neck surgery
- Activities or occupations that involve overuse of the voice (teachers, coaches, call center employees, singers, etc.)
In most cases, symptoms and history are enough for a diagnosis. If there’s any suspicion of a more serious problem or the laryngitis has persisted for more than three weeks, the provider will use indirect laryngoscopy to view the larynx itself. The provider uses a tool to hold the tongue forward and a mirror held at the back of the throat to view the larynx and its structures. The procedure can be performed during an office visit without medications. Imaging such as X-rays or CT scans will not usually be necessary.
Laryngitis treatment options
Laryngitis typically resolves in a few days even without treatment, so treatment is largely conservative and supportive. Voice rest, steam inhalation, over-the-counter pain relievers, irritant avoidance, and treatment of the underlying cause are the pillars of laryngitis treatment.
Supportive care
No matter what the cause, laryngitis is best treated by giving the voice a rest by reducing vocal activity as much as possible. Steam inhalation and drinking fluids also help to soothe irritated tissue, moderate symptoms, and speed healing.
Medications
Pain, sore throat, and dry cough are most effectively relieved with over-the-counter pain relievers. In severe cases, or for voice professionals, a doctor may use oral or inhaled corticosteroids to rapidly reduce swelling. Other medications will be used only to treat the underlying cause, not the laryngitis itself. Because laryngitis is not usually caused by a bacterial infection, doctors rarely use antibiotics.
Underlying cause
When identified, the underlying condition must be managed. If laryngitis is caused by acid reflux, dietary changes and medications that reduce stomach acid may be prescribed.
Laryngitis caused by medications or irritants will be treated by discontinuing the medication or avoiding the irritant. In particular, tobacco users will be advised to quit smoking to relieve chronic laryngitis due to smoking. Allergies will be treated with allergy medications and lifestyle changes. Laryngitis due to an upper respiratory infection caused by a bacteria or fungus will be treated with the appropriate antimicrobial medications, either antibiotics or antifungals.
Voice therapy
In cases of chronic laryngitis, voice therapy trains patients in vocal behaviors and lifestyle changes that help preserve the voice. Sessions are directed by speech-language therapists and usually last for four to eight weeks.
Laryngitis medications
Most cases of laryngitis resolve in a few days with adequate voice rest and supportive care. Outside of pain relievers, medications are usually not used.
Pain relievers
Sore throat pain, throat irritation, and dry cough are best handled with over-the-counter analgesics such as acetaminophen, ibuprofen, naproxen, or aspirin. Topical medications or remedies such as saltwater, over-the-counter throat lozenges, sore throat syrups, hard candy, herbal teas, herbal sprays, or herbal lozenges only work by coming in contact with inflamed or irritated tissues and so will help only with irritation in the throat itself. The larynx, however, is the doorway to the lungs. If topical medications like saltwater, lozenges, or cough syrup could enter the larynx, the result would be choking or drowning.
Corticosteroids
For severe laryngitis cases or voice professionals, a physician may prescribe an oral or inhaled corticosteroid, such as prednisone, to rapidly reduce swelling. Because of the side effects, which include laryngitis, corticosteroids are only rarely used.
What is the best medication for laryngitis?
There is no “best” medication for laryngitis. In most cases, the best treatment for laryngitis is vocal rest, steam inhalation, and proper hydration. Medications are used to treat a possible underlying cause or to provide symptom relief.
| Best medications for laryngitis | ||||
|---|---|---|---|---|
| Drug Name | Drug Class | Administration Route | Standard Dosage | Common Side Effects |
| Tylenol (acetaminophen) | Analgesic | Oral | Two tablets every four hours | Nausea, stomach pain, loss of appetite |
| Advil (ibuprofen) | NSAID | Oral | One 200 mg tablet every four to six hours | Nausea, bleeding, stomach pain |
| Aspirin | NSAID | Oral | One or two 325 mg capsules or tablets with water per day | Upset stomach, heartburn, bleeding |
| Aleve (naproxen) | NSAID | Oral | One 220 mg tablet taken with food or water every eight to 12 hours | Nausea, bleeding, stomach pain |
| Prednisone | Corticosteroid | Oral or inhaled | Varies based on patient factors, 60 mg per day for three to six days | Behavior and mood changes, acne, fluid retention |
Many of the standard dosages above are from the U.S. Food and Drug Administration (FDA) and the National Institutes of Health (NIH). Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.
What are the common side effects of laryngitis medication?
Side effects are possible with all medications and vary depending on the type of medication. This is not a complete list of side effects, but a healthcare provider will be able to answer any of your questions about possible side effects.
Over-the-counter (OTC) pain relievers are not only the most effective medication for reducing laryngitis symptoms, they are also very safe. Acetaminophen can cause nausea, headache, or stomach pain, but its most serious side effect is overdose. With acetaminophen, more is not better, so follow the directions to the letter. And remember to check for acetaminophen in other OTC products you may be taking, such as cough and cold products. Taking too much acetaminophen from multiple OTC products is a common way people accidentally overdose.
NSAIDs, such as ibuprofen or aspirin, interfere with the body’s ability to form blood clots and with its ability to protect the digestive system from stomach acid. Therefore, the most common side effects are stomach pain, digestive system bleeding, bleeding problems, and bruising. Because of the risk of Reye’s syndrome, a potentially fatal drug reaction, aspirin should never be given to children or teenagers with laryngitis due to a viral infection, such as croup, cold, or flu.
Corticosteroids commonly produce side effects even when taken over a short time. These include mood and behavior changes, aggressiveness, increased appetite, weight gain, high blood pressure, high blood sugar, acne, and a weakened immune system, making patients susceptible to infections. More importantly, inhaled steroids cause laryngitis and may instigate a fungal infection in the throat and larynx. Both side effects will worsen laryngitis. Doctors, then, limit steroids for the most severe chronic cases or voice professionals.
What is the best home remedy for laryngitis?
Depending on the underlying cause, most treatment for laryngitis consists of home remedies. Fortunately, the basic home remedies for laryngitis, though not instantaneous, are highly effective.
Rest the voice
Give the vocal cords a break. Only talk when necessary and do so in a quiet voice, but not a whisper which can actually irritate the vocal cords more as explained below. The best method for voice rest is to take “vocal naps.” Take 15 or 20 minutes off from speaking—say nothing at all—every hour.
Do not whisper
When you need to speak, talk in a quiet voice. While it may seem that whispering gives the voice a rest, it actually puts more strain on the vocal cords than speaking.
Do not clear your throat
Throat clearing is a natural and almost irresistible response to irritation or “tickling” in the larynx. As relieving as it might feel, throat clearing puts great stress on the vocal cords and could cause further injury. In fact, excessive throat clearing is one way to cause laryngitis in the first place. When you feel the need to clear your throat, drink a glass of water or hot drink instead. The heat from a hot drink may help loosen mucus, reducing the “tickling” feeling. Another alternative is to “huff.” Open the mouth and, without making a sound or vibrating your throat, breathe out quickly. This can provide temporary relief without stressing the vocal cords.
Use steam
The vocal cords require lubrication to reduce friction and decrease the amount of time they are closed when generating sound. One of the best treatments for laryngitis is steam inhalation. Using a vaporizer, hot shower, or facial sauna—or just standing over a pot full of steaming water—for five to ten minutes provides significant symptom relief and helps speed healing. When not using steam, a humidifier will help keep the air moist and keep vocal cords from drying out.
Drink fluids
Dehydration increases friction on the vocal cords. Drink plenty of fluids throughout the day for proper lubrication of the vocal cords.
Frequently asked questions about laryngitis
What home remedy is good for laryngitis?
Most cases of laryngitis will resolve in a few days using home remedies such as voice rest and steam.
What should you eat when you have laryngitis?
For many cases of laryngitis, foods do not affect the condition one way or the other. Food and drink pass down the esophagus, not the larynx. For patients who have laryngitis due to gastroesophageal reflux disease (GERD), however, treating and preventing laryngitis will involve dietary changes both in the amount and types of food eaten.
How long does it take for laryngitis to go away?
Acute laryngitis typically resolves in three to seven days. If laryngitis persists for longer than two weeks, it’s time to see a healthcare professional.
How do you heal laryngitis?
Laryngitis is inflammation of the larynx, the part of the respiratory system that includes the voice box. The most universal treatment for laryngitis, then, is to give the voice a break by only talking when necessary. Steam therapy and drinking plenty of fluids are also an essential part of the healing process.
How can I get my voice back fast?
When the vocal cords swell, the air pressure required to make a sound with the vocal cords goes up, making you push harder with the breath to make a sound. If the vocal cords swell too much, the lungs cannot generate enough pressure to make a sound, causing voice loss. The voice comes back only when the inflammation of the vocal cords subsides. For most people, this happens only if the vocal cords are given rest and the body stays hydrated. However, people who make a living using their voice, such as singers or television news anchors, will be given a few days of inhaled or oral steroids to rapidly reduce the swelling so that the voice can be quickly recovered.
Does laryngitis go away on its own?
In most cases, laryngitis will clear up in a few days. Chronic laryngitis is diagnosed when the condition lasts three weeks or more. Treating chronic laryngitis will require lifestyle changes, dietary changes, or voice therapy.
Does laryngitis cause fatigue?
Some people with laryngitis may experience fatigue and malaise. This is relatively uncommon and may be partly due to the underlying cause.
Does laryngitis get worse before it gets better?
The symptoms of acute laryngitis begin quickly and will worsen over the first two days. Symptoms begin to ease off after about three days and should completely resolve in about seven.
Do hot drinks help laryngitis?
The heat of a hot drink could help loosen mucus in the larynx, reducing the “tickling” feeling and, more importantly, the impulse to clear the throat. Hot drinks, however, do not enter the larynx and directly soothe or medicate laryngeal tissues. The larynx is the entryway to the lungs, so hot drinks don’t belong there. Steam, however, considerably relieves laryngitis symptoms because it is inhaled directly into the larynx. There, the steam condenses and moisturizes laryngeal tissues and lubricates the vocal cords. So while drinking a hot drink may not help laryngitis, holding your nose over a hot drink and breathing in deeply is actually a pretty good idea.
Do cough drops help laryngitis?
For patients with laryngitis, cough drops can help with any irritation or discomfort in the esophagus. They will not help with any irritation in the larynx.
Should I go to urgent care for laryngitis?
In some cases, laryngitis may produce difficulty breathing or shortness of breath. Either of these symptoms indicates immediate medical care is needed.
Is honey good for laryngitis?
Honey is a topical remedy with soothing, antimicrobial, and anti-inflammatory properties. For honey to have an effect, it must come in contact with irritated, swollen, or infected tissues. The body, though, prevents honey and other foods from entering the larynx. If honey or tea or cough syrup enters the larynx, the result is choking, asphyxiation, and possibly death. So, as a topical medication, honey may help with a sore throat, but will probably not affect inflammation, mucus, or irritation in the larynx itself.