Overview
Laryngitis is inflammation of the larynx (voice box), causing a hoarse, weak, or temporarily lost voice. The most common cause is a viral upper respiratory tract infection. Acute laryngitis usually resolves within 1 to 2 weeks. Chronic laryngitis (lasting more than 3 weeks) has distinct causes and may require specialist investigation.
How common is it?
Acute laryngitis is extremely common, particularly during winter months alongside colds and influenza. Most adults experience it at least once. Chronic laryngitis from voice overuse or reflux is common in teachers, singers, and other vocal professionals.
Causes and risk factors
Acute laryngitis is almost always viral. Chronic laryngitis reflects persistent irritation from reflux, voice overuse, smoking, or other environmental exposures.
Common risk factors
- Viral infection (rhinovirus, influenza, parainfluenza)
- Bacterial laryngitis (less common; Streptococcus, Haemophilus)
- Voice overuse or misuse (screaming, prolonged singing)
- Laryngopharyngeal reflux (stomach acid reaching the larynx)
- Smoking and alcohol
- Dry or dusty environment
- Inhaled corticosteroid deposition (from asthma inhaler)
- Fungal laryngitis (Candida, in immunocompromised patients)
Symptoms
- Hoarse, rough, or weakened voice
- Dry, tickly cough
- Sore or raw throat
- Voice fatigue, especially towards end of day
- Complete voice loss (aphonia) in severe cases
- Mild throat pain and swallowing discomfort
When to see a doctor
See a doctor if hoarseness persists more than 3 weeks (must be investigated to exclude malignancy, particularly in smokers over 45). Also seek assessment for stridor (noisy breathing), difficulty swallowing, or neck lump.
Diagnosis
Clinical assessment. Laryngoscopy (direct or flexible fibre-optic) for cases lasting more than 3 weeks or with concerning features. Culture swab if bacterial or fungal infection suspected. Reflux assessment if suspected cause.
Treatments
Voice rest
Resting the voice (avoiding speaking above a whisper, whispering avoided as it strains the vocal cords as much as normal voice) is the primary treatment for acute laryngitis.
Steam inhalation and hydration
Inhaling steam and drinking plenty of water keeps the laryngeal mucosa moist. Breathing through the nose warms and humidifies air before reaching the larynx.
Treatment of underlying cause
Proton pump inhibitors for reflux-related laryngitis. Antifungals for candidal laryngitis. Speech therapy for voice misuse. Smoking cessation for chronic laryngitis.
Antibiotics
Not indicated for viral laryngitis. Reserved for confirmed bacterial secondary infection.
Self-care and lifestyle
- Avoid whispering (it is just as straining as normal voice)
- Avoid throat clearing (use a silent swallow instead)
- Stay well hydrated
- Avoid caffeine, alcohol, and smoking
- Use humidifiers in dry environments
Prevention
Proper vocal technique, treatment of reflux, stopping smoking, and good respiratory hygiene (handwashing during respiratory illness season) reduce laryngitis risk.