Laryngitis: Causes, Treatment and How Long It Lasts

Quick answer

Rest the voice, hydrate, and see an ENT if hoarse over 4 weeks

Acute laryngitis is usually viral or due to voice overuse, and improves in about a week. Whispering is not recommended: it strains the vocal folds as much as speaking. Drink fluids, humidify the air, avoid smoking, reduce throat clearing and speak softly rather than shouting. Antibiotics are rarely helpful, and corticosteroids are only considered in selected cases, such as urgent voice demands. The AAO-HNSF guideline recommends laryngoscopy if hoarseness lasts more than four weeks or sooner if there are serious concerns.

Important. Hoarseness with trouble breathing or noisy breathing (stridor), drooling, difficulty swallowing, coughing blood, a neck lump or after a neck injury, surgery or intubation needs prompt assessment. In children with a barking cough and noisy breathing, seek urgent care.

What is laryngitis?

The larynx contains the vocal folds (cords), two bands of tissue that vibrate as air passes to produce sound. When they become swollen and irritated, they cannot vibrate normally, resulting in a hoarse, rough, breathy or absent voice. Laryngitis is acute when it lasts less than three weeks and chronic when it continues longer.

Causes of acute laryngitis

Viral infections: the common cold and flu are by far the most frequent causes.
Voice overuse: shouting at a match or concert, singing, prolonged talking.
Bacterial infection, much less common.
Irritants: smoke, fumes, strong chemicals and very dry air.
Acid reflux reaching the larynx.
Allergies and postnasal drip.
Inhaled steroid sprays in some people.

Causes of chronic hoarseness

Smoking and alcohol, and prolonged exposure to irritants.
Laryngopharyngeal reflux. See LPR.
Vocal fold nodules, polyps or cysts, often from voice misuse.
Vocal fold paralysis, after surgery, neck or chest disease or viral illness.
Thyroid conditions, neurological conditions, and ageing changes of the larynx.
Laryngeal cancer or precancerous lesions: uncommon but must be excluded, particularly in smokers.
Persistent hoarseness is not “just laryngitis” and should be examined.

Symptoms

Hoarse, weak, rough or lost voice.
A tickling, raw or dry throat; sore throat.
A dry cough and frequent throat clearing.
Fever, tiredness and cold symptoms if due to infection.
A voice that tires easily or changes pitch.

What to do at home

Rest your voice: speak as little as possible and softly. Avoid whispering, which strains the voice.
Drink plenty of fluids to keep the vocal folds lubricated; warm drinks soothe.
Humidify the air and inhale steam from a hot shower.
Avoid smoking and smoky places, alcohol and caffeine in excess.
Avoid throat clearing; sip water or swallow instead.
Lozenges and honey can ease irritation.
Treat reflux and allergy if present.
Do not use decongestants or antihistamines unless needed, as they can dry the throat.

Antibiotics and steroids

Antibiotics do not help viral laryngitis and the guideline advises against routine use. Corticosteroids have limited evidence and are not recommended routinely; a short course may be considered by a doctor for a singer or professional voice user who must perform. Reflux treatment is only advised if there are signs of reflux. Cough suppressants can help a troublesome dry cough.

How long does laryngitis last?

Acute viral laryngitis usually resolves in 5–10 days, and voice often returns gradually. Persistent hoarseness beyond 3–4 weeks calls for a visit to a doctor, and a specialist examination of the larynx with a flexible or rigid endoscope. Early evaluation is especially important in smokers and in people who have had neck surgery or intubation.

Laryngitis in children (croup)

In young children, viral inflammation below the vocal folds causes croup: a barking cough, hoarse voice and noisy breathing on inspiration (stridor), typically worse at night. Most cases are mild and are managed at home with calm, humid air and fluids, but seek medical care if there is stridor at rest, difficulty breathing, drooling or the child looks unwell; a single dose of steroid is often given.

Protecting your voice

Do not smoke; limit alcohol.
Stay hydrated and humidify dry rooms.
Avoid shouting; use amplification when speaking to large groups.
Warm up the voice and take breaks if you use it professionally.
Wash hands and avoid contact with people with respiratory infections.
See also 20 voice-care tips (Spanish).

When to see a doctor

Hoarseness lasting more than four weeks.
Hoarseness with noisy breathing, difficulty swallowing, pain, blood in sputum or a neck lump.
Hoarseness after surgery, intubation or neck injury.
Recurrent episodes or a professional voice user.
Persistent throat clearing, cough and a lump sensation.

Three common situations

Lost voice after a cold and a weekend of shouting: voice rest, hydration and humidification; improvement within a week.

A teacher with hoarseness every term: consider voice therapy and an ENT examination for nodules.

A smoker with hoarseness for six weeks: needs an ENT examination of the vocal folds.

Singers, teachers and other professional voice users

If you use your voice for work, laryngitis can mean cancelled performances or lost working days. Seek an early ENT assessment so the vocal folds can be examined, avoid singing or teaching on a hoarse voice, hydrate, and consider voice therapy to correct technique. Do not use numbing sprays to perform through laryngitis: they hide pain, which is the warning signal that protects your voice.

Key points to remember

Most laryngitis is mild and short-lived. Rest the voice, hydrate and avoid irritants. Do not ignore hoarseness lasting more than four weeks: it needs an examination of the larynx. Our ENT and voice team can assess and treat persistent voice problems.

This guide is for general information and does not replace an assessment by your own doctor or ENT specialist.

Questions about laryngitis

These answers are general information and do not replace an examination or individual medical advice.

How long does laryngitis last?

Acute viral laryngitis usually lasts 5–10 days; hoarseness beyond four weeks needs an examination.

Should I whisper with laryngitis?

No. Whispering strains the vocal folds; speak softly and as little as possible.

Do I need antibiotics for laryngitis?

Rarely. Most cases are viral and do not respond to antibiotics.

What helps laryngitis fast?

Voice rest, fluids, humid air, avoiding smoke and treating reflux or allergy if present.

Can laryngitis be serious?

Usually not, but persistent hoarseness can occasionally be due to a serious cause, so it needs a check.

Can reflux cause laryngitis?

Yes, reflux can irritate the larynx and cause chronic hoarseness.

Sources

This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.