Laryngitis

What is laryngitis

Laryngitis is an inflammation of the larynx (or voice box) and usually produces an inability to talk, with a hoarseness in the voice.

The larynx is the entry to the trachea (windpipe) which joins the back of the throat (pharynx) to the trachea.

The larynx is made up of muscle and cartilage tissue and it also has 2-3 membranes across it – the vocal chords – which are responsible for your voice. Any and all of these membranes can become inflamed during a bout of laryngitis.

Most cases of laryngitis are not serious and will resolve quickly, although some cases are serious and require medical attention.

Laryngitis is either:

• Acute – usually due to a upper respiratory viral infection and is short term
• Chronic – usually due to other recurrent factors (smoking, GERD, allergic rhinitis, asthma, allergy, sinusitis) and is long term

Facts about laryngitis

• Most cases of acute laryngitis resolve within a short time, as they are due to a viral infection
• Most cases of acute laryngitis are due to a viral infection
• Laryngitis is usually caused by a virus which means antibiotics have no effect in treating it
• Smoking can cause chronic laryngitis
• Straining the voice too much when singing can cause irritation to the larynx and result in laryngitis
• Chronic laryngitis affects up to 20% of Western populations
• The larynx is required for swallowing, breathing, coughing and creating sounds to make the voice
• The larynx may have a special immunological role as it sits right between the upper respiratory system and the lower gastrointestinal respiratory systems

Symptoms of laryngitis

General symptoms of acute laryngitis (caused by a virus) are:

• Congestion
• Dry cough (does not produce any mucous)
• Fatigue
• Fever
• Hoarseness
• Inability to talk
• Lethargy
• Sore throat

Viral laryngitis symptoms are normally at their worst for about 2-3 days after infection and then symptoms gradually improve over the following week.

General symptoms of chronic laryngitis (caused by a factors such as smoking, GERD, allergic rhinitis, asthma, allergy, sinusitis, thyroid illness) are:

• Dry cough (does not produce any mucous)
• Hoarseness
• Inability to talk
• Sore throat

Simply over-using the voice (singing, shouting) can cause laryngitis.

Causes of laryngitis

The main cause of laryngitis is:

• Viral respiratory infection

Laryngitis can also be caused by the following conditions:

• Allergies
• Bronchitis
• Cold
• Excessive alcohol intake
• Flu (influenza)
• Gastro-oesophageal reflux disease (GERD)
• Overstraining the voice by singing or shouting
• Pneumonia
• Polyps (nodules on the vocal chords)

Other causes

Some other reasons for laryngitis that need further investigation (or even immediate medical attention) are:

• Chemical irritants
• Croup – in children, requires medical attention
• Epiglottitis – in children, requires medical attention
• Irritants
• Smoking (including second hand smoke from others)
• Syphilis
• Thyroid disorders
• Tuberculosis

Prevention of laryngitis

Non-preventable risk factors

Laryngitis may be unpreventable in certain circumstances:

• Allergies – people with allergies can often experience a sore throat due to their condition and this can easily develop into laryngitis which is not easily preventable due to the allergic condition
• Epiglotitis – if the epiglottis, which is located at the back of the throat becomes infected (epiglottitis), it can also cause infection of the larynx resulting in laryngitis. People with epiglottitis must seek medical treatment to prevent complications
• GERD – people with gastro-eosophageal reflux disease (GERD) have some of the acidic content of the stomach rise up the eosophagus which can sometimes go as far as the throat and into the lungs. This can cause coughing and asthma-like symptoms, which can irritate not just the eosophagus but the whole upper respiratory area, including the larynx, which can become very inflamed and result in laryngitis
• Pneumonia – the condition pneumonia causes inflammation and infection of one or both of the lungs by an invading pathogen (viral, bacterial or fungal) and laryngitis can develop through the act of coughing constantly due to the pneumonia. People with suspected pneumonia must seek medical treatment to prevent complications
• Polyps on the vocal chords – nodular growths on the vocal chords are a common risk factor for the development of laryngitis, as the vocal chords sit on top of the larynx and if the vocal chords are inflamed due to the polyps, the larynx can also become inflamed and hoarse resulting in laryngitis
• Tuberculosis – the lung condition tuberculosis, is rare in developed countries today, but it does still occur in random outbreaks. The tuberculosis infection can also cause the larynx and throat to be irritated, inflamed and infected causing laryngitis. People with tuberculosis must seek medical attention as it is a highly contagious bacterial condition
• Vocal chord polyps – nodular growths on the vocal chords are a common reason for the development of laryngitis as the vocal chords sit on top of the larynx and if the vocal chords are inflamed due to the polyps, the larynx can also become inflamed and hoarse, which are typical symptoms of laryngitis

Preventable risk factors

There are ways to prevent laryngitis from occurring:

• Don’t drink alcohol excessively – excessive alcohol intake can not only cause GERD (gastro-eosophageal reflux disease) which can result in laryngitis, but the excessive alcohol intake itself can irritate the larynx even if GERD does not occur. Maintain a moderate alcohol intake to prevent laryngitis from this cause
• Lower respiratory infection – people with any type of lower respiratory infection such as bronchitis, croup, pleurisy, pneumonia and tuberculosis have an increased risk of developing laryngitis due to the infection of the lungs and increased coughing possibly also causing infection and irritation to the larynx too
• Manage health conditions – people with any type of upper or lower respiratory health conditions (allergies, bronchitis, pneumonia, croup, cold, flu, pleurisy, tuberculosis) need to ensure they are following their doctor’s treatment plan, to reduce risk of any other associated infections such as laryngitis, which is a secondary infection and may lengthen time of recovery
• Stop smoking – smoking is a very well-known cause of irritant laryngitis and it can be prevented simply by not smoking at all
• (Upper respiratory) viral infection – any type of upper respiratory infection due to a virus (cold, flu, bronchitis, pleurisy and croup in babies) can also irritate, inflame and infect the larynx (voice box) and cause laryngitis. This form of laryngitis is acute and temporary but highly unpreventable if it occurs

Complications of laryngitis

There are several complications of untreated and long-term laryngitis:

Chronic cough

One of the main complications of chronic laryngitis is a relentlessly chronic cough which does not produce any mucous (dry cough). While it is not serious in itself, it is irritating to the throat tissue to be constantly coughing.

Extended time of loss of voice

Another of the main complications of chronic laryngitis is loss of voice for an extended period beyond a few days. If the larynx becomes really inflamed from the underlying factor which caused the laryngitis, then this can be exacerbated and continue to occur.

When to see a doctor about laryngitis

People who have any of the symptoms associated with laryngitis should make an appointment to see their doctor who can diagnose the condition and make recommendations based on the cause of the laryngitis.

People who smoke should not discount their hoarse voice as simply laryngitis, but should get it investigated, to ensure it is not due to another condition. People who have a viral respiratory infection and start to lose their voice should visit their doctor to confirm the symptoms are due to laryngitis and not another condition.

Diagnosis of laryngitis

Laryngitis is initially diagnosed by a doctor through the following methods:

• Medical history – the doctor will ask a series of questions about your symptoms (especially the duration and severity), your family medical history (if anyone else has similar symptoms) and some questions about whether you smoke or have any other risk factors associated with this condition
• Physical examination – the doctor will examine the throat by viewing the inside to see if there is inflammation in the back of the throat and by feeling the outside of the throat for inflammation of the glands. The doctor will also listen to the lungs with a stethoscope, to determine if there is a lower respiratory infection

Further tests

If symptoms persist, a referral to an ear, nose and throat (ENT) specialist who may do further examinations and tests:

• Laryngoscopy – the laryngoscopy test is performed by the ENT specialist (or even regular doctor) to get a better of the view the larynx with a tube that has a special mirror and light and which that is put into the back of the throat
• Biopsy – if the laryngitis does not improve and symptoms get worse, some cells can be taken of the larynx to be examined under a microscope for malignancy (or other problems)

Conventional treatment of laryngitis

Treatment depends on the type of laryngitis – whether it is acute or chronic:

Acute laryngitis

Acute laryngitis is normally caused by a virus, so this means that antibiotics cannot help as they do nothing to viruses. Treatment is based on alleviating symptoms:

• Avoid clearing the throat – this practice does harm to the throat and is especially irritating when there is a laryngitis infection so if the throat is irritated, have some fluid and this will help
• Drink plenty of fluids – ensure the throat is hydrated with diluted juice, herbal tea (such as diluted chamomile, peppermint or rose hip teas) and water will help to hydrate the larynx and help it heal more quickly
• Humidifier (or vaporiser) – a humidifier (or vaporiser) either with just plain hot water, that produces steam or with a few drops of eucalyptus oil may help to clear up symptoms by providing more moisture and reducing the irritation to the larynx
• Painkillers – the doctor will recommend you take painkillers as required for any pain in the throat area (such as paracetemol, ibuprofen)
• Rest your voice – not talking helps the larynx heal itself and this is the best strategy which is most beneficial in ensuring quicker healing and a return of the voice
• Steam inhalation – a few drops of eucalyptus oil or Vicks may help to clear up symptoms by providing more moisture and reducing the irritation to the larynx
• Stop smoking – smoking causes more strain on the voice and larynx and is especially not recommended in the case of laryngitis

Chronic laryngitis

There are a number of reasons which cause chronic laryngitis and treatment depends on the cause:

• Allergies – antihistamine medication will be recommended for the allergies and when the allergies are healed, the laryngitis should also be relieved too
• Chronic bronchitis – the treatment for chronic bronchitis as the cause for laryngitis is the same as the treatment for acute laryngitis above
• GERD – people who have gastro-eosophageal reflux disease (GERD) will be advised to take medication to reduce the acid reflux and this will help heal the laryngitis symptoms too
• Irritants – it will be recommended to avoid any chemical irritants that have caused the laryngitis to help heal the larynx
• Polyps – people who have vocal chord polyps will be recommended the following treatment options to help heal the laryngitis:
  • Painkillers – these are recommend as required for any pain in the throat area (such as paracetemol, ibuprofen)
  • Rest – the only way to get the body to start to heal itself from the polyps and the laryngitis is through resting the voice, no talking at all
  • Surgery – this will only be recommended as a last resort if other options have not worked, to remove the polyps if necessary
• Smoking – people who smoke will be advised to stop smoking in order for the larynx to heal. Smoking irritates the whole throat tissues and people who continue to smoke will damage their larynx and run the risk of serious complications

Alternative / complementary treatment of laryngitis

There are a number of alternative/complementary treatments which are recommended for the treatment of acute laryngitis especially, but also for chronic laryngitis. Always seek the advice of your medical doctor before trying any of the alternative/complementary treatments advised:

Herbs

There are a number of excellent herbs which may help to provide relief for symptoms:

• Echinacea – studies show that the anti-viral properties of the echinacea herb help to clear up respiratory infections more quickly and reduce severity of symptoms
• Elderflower – studies show that the anti-viral properties of elderflower can help reduce severity and length of symptoms by boosting the immune system to fight the viral infection causing the laryngitis

Vitamins

There are a number of vitamins which may help to provide relief for symptoms:

• Bioflavonoids – studies show the antioxidant properties the bioflavonoids, together with vitamin C, help the body heal more quickly as they provide a boost to the immune system
• Vitamin A – studies show the potent antioxidant properties of vitamin A help the body heal more quickly by boosting the immune system. Vitamin A also helps to ensure the mucous membranes are more soft, pliable and healthy, which is vital for healing the larynx
• Vitamin B complex – the B vitamins are required to stimulate the immune system to function more effectively and studies show that this can assist with shortening the length and severity of laryngitis
• Vitamin C – studies show that the antioxidant properties of vitamin C, together with the bioflavonoids, help the body heal more quickly as they provide a boost to the immune system
• Vitamin E – studies show the potent antioxidant properties of vitamin E help the body heal more quickly by providing a huge boost to the immune system to help it deal with and heal the laryngitis more quickly

Minerals

There are a number of minerals which may help to provide relief for symptoms:

• Selenium – the antioxidant mineral selenium is recommended to boost the immune system and help to reduce severity and duration of symptoms, enabling the body to heal more quickly from laryngitis
• Zinc – studies show that zinc assists with reducing the length and severity of symptoms in all upper respiratory disorders, including laryngitis

Other nutrients

There are a number of other nutrients which may help to provide relief for symptoms:

• Coenzyme Q10 – the nutrient co-enzyme Q10 helps to increase immune system function and exchange of energy at the cellular level
• Garlic – many studies show that the anti-viral properties of garlic may help to reduce severity and duration of symptoms
• Raw, unheated, unprocessed honey – honey is very soothing on the throat and can temporarily reduce sore throat symptoms

Dietary modifications

There are a number of dietary modification strategies which may help to provide relief for symptoms:

• Eat more vegetables – the nutrients in the vegetables are beneficial in supporting the body to heal more quickly. It is recommended to eat the vegetables either raw or lightly steamed to get the most benefits

Lifestyle modifications

There are a number of lifestyle modifications which may help to provide relief for symptoms:

• Avoid clearing the throat – this practice does harm to the throat and is especially irritating when there is a laryngitis infection so if the throat is irritated, have some fluid and this will help
• Drink plenty of fluids – ensure the throat is well hydrated with diluted juice, herbal tea (such as diluted chamomile, peppermint or rose hip teas) or water, to help hydrate the larynx and ensure it heals more quickly
• Humidifier (or vaporiser) – a humidifier (or vaporiser) either with just plain hot water, that produces steam or with a few drops of eucalyptus oil may help to clear up symptoms by providing more moisture and reducing the irritation to the larynx
• Painkillers – the doctor will recommend you take painkillers as required for any pain in the throat area (such as paracetemol, ibuprofen)
• Rest your voice – not talking helps the larynx heal itself and this is the best strategy which is most beneficial in ensuring quicker healing and a return of the voice
• Steam inhalation – a few drops of eucalyptus oil or Vicks may help to clear up symptoms by providing more moisture and reducing the irritation to the larynx
• Stop smoking – smoking causes more strain on the voice and larynx and is especially not recommended in the case of laryngitis

Alternative treatments

• Naturopath – people with laryngitis should visit a naturopath who can devise an alternative/complementary health care plan (which should be done in conjunction with your doctor’s knowledge) to help reduce symptoms, improve the immune system and prevent recurrence

Always ensure that you notify your medical practitioner of any supplements that you want to take – it may interfere with other medication or conditions you have. Confirm with your doctor it is safe to take before you try it.

Living with laryngitis

Self care strategies

There are a number of strategies which are recommended to help deal with laryngitis:

• Don’t smoke – smoking causes more strain on the voice, vocal chords and larynx and is especially not recommended in the case of laryngitis. The same applies for second-hand smoke – stay away from it
• Gargle with salt – this is a very simple, but very effective remedy for reducing inflammation and pain in the throat, which has been used for centuries. Simply add some sea salt to warm water, melt the salt and add some cold water until the water is lukewarm. Drink some water and gargle for a few seconds and then spit out the water. Repeat several times with the water. Repeat this a few times a day for quick relief of throat pain associated with laryngitis
• Garlic and honey – a great remedy to make at home is to grate or crush several cloves of garlic and add them to a small cup. Then add some raw honey and mix through. Take a teaspoon of this garlic and honey mixture every hour or whenever symptoms are severe – it can just be swallowed quickly as it may not be the tastiest mixture. This mixture can be slightly heated to make it more runny
• Herbal tea – there are several herbal teas which may help to reduce severity and duration of symptoms, so are recommended for any type of respiratory condition. The best herbal teas to use are: chamomile, elderberry flower, peppermint, rosehip (or a combination of all of the teas). The warmth of the hot tea will help to soothe the irritation in the throat and the healing properties of the herbs will provide a boost to help the body heal the larynx
• Honey – raw honey is very soothing on the throat and helps reduce the irritation and hoarseness symptoms associated with laryngitis. A teaspoon of honey every few hours can help to reduce symptoms
• Humidifier (or vaporiser) – a humidifier (or vaporiser) either with just plain hot water, that produces steam or with a few drops of eucalyptus oil may help to clear up symptoms by providing more moisture and reducing the irritation to the larynx
• Plenty of fluids – ensure the throat is well hydrated with diluted juice, herbal tea (such as diluted chamomile, peppermint or rose hip teas) or water, to help hydrate the larynx and ensure it heals more quickly
• Rest the voice – one of the best ways to help the larynx heal itself is to completely rest the voice and not talk at all. Talking will irritate the larynx even more and will prolong the time it takes to heal from the laryngitis
• Painkillers – your doctor will recommend the best painkiller for you if the symptoms get worse and cause pain in the throat from the laryngitis. The most common painkillers recommended are: Ibuprofen and Paracetemol

Caring for someone with laryngitis

Partner

There are a number of simple strategies which can be useful if you have a partner with laryngitis:

• Allow your partner to rest their voice – the best treatment for laryngitis is to rest the voice and allow the body to heal itself, so allow your partner to rest their voice by providing them any communication they require while they are healing
• Don’t smoke – second-hand smoke is an irritant which can worsen symptoms in a person who has laryngitis, so it would be beneficial if you do not smoke near your non-smoking partner if they have laryngitis
• Don’t provide alcohol – excessive alcohol consumption may trigger symptoms in people with laryngitis, so it may be more beneficial to avoid providing it to your partner and limit your alcohol intake to be supportive when their symptoms are at their worst (especially if the laryngitis is due to an infection)

Friends

There are a number of simple strategies which can be useful if you have a friend with laryngitis:

• Don’t smoke – second-hand smoke is an irritant which can worsen symptoms in a person who has laryngitis, so it would be beneficial if you do not smoke near your non-smoking friend if they have laryngitis
• Don’t provide alcohol – excessive alcohol consumption may trigger symptoms in people with laryngitis, so it may be more beneficial to avoid providing it to your friend

Parents

There are a number of simple strategies which can be useful if you have a child with laryngitis:

• Don’t smoke – second-hand smoke is an irritant which can worsen symptoms in a person who has laryngitis, so it would be beneficial if you do not smoke near your child if they have laryngitis
• Humidifier (or vaporiser) – a humidifier (or vaporiser) either with just plain hot water, that produces steam or with a few drops of eucalyptus oil may help to clear up symptoms by providing more moisture and reducing the irritation to the larynx
• Medical attention – if your child’s laryngitis does not get better, or if symptoms change, they will need to see a doctor (again) as their condition may have worsened and they may have acquired a secondary or tertiary infection of the respiratory system and may need appropriate treatment (possibly a change of or extra medication)
• Notify the school – if you need to keep your child home or a few days, you need to notify their school so that they can provide any homework as necessary. If the child is going to be at school, notify the school that they may need to rest their voice so may not participate in class as normal
• Provide adequate fluids – ensure your child is properly hydrated with enough water, diluted juice or herbal tea (such as diluted chamomile, peppermint or rose hip teas) to help keep the larynx hydrated and avoid further irritation

References

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Last reviewed and updated: 14 May 2024