Laryngitis
Symptoms, Causes & Treatment
Laryngitis is inflammation of the larynx causing hoarseness, voice loss, sore throat, and cough. Acute laryngitis is almost always viral and self-limiting. Persistent hoarseness always requires medical assessment to exclude serious pathology.
What is Laryngitis?
Laryngitis describes inflammation of the laryngeal mucosa and vocal cords. Acute laryngitis — most commonly following a viral upper respiratory infection — causes hoarseness lasting up to 2 weeks. Chronic laryngitis results from persistent irritation. Any hoarseness lasting more than 3 weeks is a red flag requiring laryngoscopy to exclude malignancy.
Symptoms of Laryngitis
Laryngitis causes hoarseness and voice loss as the primary symptom. Associated symptoms help differentiate the cause.
Hoarse, croaky, or lost voice · Raw, sore throat · Dry, irritating cough · Difficulty swallowing · Throat feels tight or strained · Low-grade fever if infective cause · Fatigue
Stridor (high-pitched inspiratory noise) — possible supraglottitis or epiglottitis emergency · Drooling with sore throat and inability to swallow · Hoarseness persisting more than 3 weeks (exclude laryngeal cancer) · Progressive breathing difficulty
Stridor, drooling, difficulty swallowing, or rapid progressive breathlessness alongside laryngitis — call 999 immediately.
What Causes Laryngitis?
Laryngitis has multiple causes. Identifying whether it is acute, chronic, or due to vocal cord pathology determines the appropriate investigation and treatment.
Acute viral laryngitis is the most common type, caused by rhinovirus, influenza, parainfluenza, and adenovirus. It typically follows an upper respiratory infection and is self-limiting within 1–2 weeks. Bacterial laryngitis is rare.
Chronic laryngitis results from repeated or persistent irritation of the larynx from acid reflux, tobacco smoke, alcohol, excessive voice use, or irritant inhalation. It causes persistent hoarseness and throat clearing.
Vocal cord nodules, polyps, and cysts develop from chronic voice overuse or misuse, particularly in singers, teachers, and public speakers. They cause persistent hoarseness and require voice therapy or surgical removal.
Epiglottitis is a life-threatening infection of the epiglottis, caused by Haemophilus influenzae type b (now rare with vaccination) or Streptococcus. It causes stridor, drooling, and rapidly progressive airway obstruction. It is a 999 emergency.
Laryngeal cancer most commonly affects men over 60 with a history of smoking and alcohol use. It presents with progressive hoarseness lasting more than 3 weeks. All persistent hoarseness in a smoker requires urgent ENT referral under the 2-week wait pathway.
Acute sinusitis is usually viral and caused by rhinovirus or coronavirus. Bacterial sinusitis (less than 2% of cases) is caused by S. pneumoniae or H. influenzae and is suggested by symptoms persisting beyond 10 days, severe facial pain, and purulent discharge.
Key Risk Factors
Diagnosing Laryngitis
Acute laryngitis needs no investigation if resolving within 2 weeks. Hoarseness persisting beyond 3 weeks requires laryngoscopy to exclude vocal cord pathology and malignancy.
Treatment for Laryngitis
Acute viral laryngitis is self-limiting and requires only supportive care. Chronic laryngitis requires treatment of the underlying cause.
Supportive Measures
Rest your voice, stay hydrated, inhale steam, and avoid irritants. Most acute laryngitis resolves within 1–2 weeks with self-care.
Chronic & Recurrent Laryngitis
Recurrent or chronic hoarseness should be referred to ENT. Voice therapy from a speech and language therapist is highly effective for functional and nodule-related dysphonia.
When to Seek Help
Stridor, drooling, inability to swallow, or rapidly progressive breathlessness with sore throat — call 999. This may be epiglottitis, a life-threatening emergency.
See a GP within 2 weeks if hoarseness has lasted more than 3 weeks, particularly if you smoke. Urgent ENT referral with laryngoscopy is required.
Preventing Laryngitis
Many cases of chronic laryngitis are preventable through voice care, reflux management, and avoidance of smoking and alcohol.
Stay hydrated (drink 8 glasses of water daily) to keep vocal cords lubricated. Voice dehydration is the most common and preventable cause of vocal cord irritation and laryngitis.
Avoid shouting, whispering (which strains cords), and prolonged speaking without rest. Use amplification where needed. Voice care is essential for teachers, singers, and others who use their voice professionally.
Treat acid reflux with lifestyle changes (elevate bed head, avoid eating before lying down, reduce alcohol and fatty foods) and if necessary, a PPI. Untreated reflux is a leading cause of chronic laryngitis.
Smoking and alcohol both directly irritate the laryngeal mucosa and significantly increase the risk of chronic laryngitis and laryngeal cancer. Stopping both is the most effective preventive measure for chronic laryngitis.
Stay up to date with flu and Covid vaccinations. Viral respiratory infections are the most common trigger for acute laryngitis.
Always rinse your mouth and gargle with water after using an inhaled corticosteroid. This prevents oral and laryngeal candidiasis, which causes hoarseness and throat irritation.
Getting Treatment for Laryngitis
A GP can assess hoarseness, treat reflux laryngitis, and make urgent ENT referrals. All hoarseness persisting beyond 3 weeks requires in-person assessment with laryngoscopy.
Expert clinical advice, when you need it.
Laryngitis — Frequently Asked Questions
Acute viral laryngitis is self-limiting and typically resolves within 1–2 weeks. Rest your voice, stay well hydrated, avoid whispering (which strains the cords), and inhale steam to soothe the inflamed larynx. Antibiotics are not effective as the cause is viral.
See a GP urgently if hoarseness lasts more than 3 weeks, particularly if you are a smoker or alcohol user. Persistent hoarseness is a red flag symptom that requires laryngoscopy to exclude laryngeal cancer. Do not delay seeking assessment.
Whispering actually puts more strain on the vocal cords than speaking softly in a normal voice. True voice rest means minimal speaking — not whispering. Using a note pad or phone text to communicate is preferable during voice rest.
Yes. Acid from the stomach can reach the larynx during sleep or when lying down, causing laryngopharyngeal reflux (LPR). LPR causes chronic hoarseness, throat clearing, and globus sensation. Treatment involves PPI medication and dietary and lifestyle changes.
Laryngitis caused by an inhaled corticosteroid (for asthma or COPD) is called steroid-induced dysphonia. It occurs due to Candida overgrowth or direct mucosal effects. Rinsing the mouth after each inhaler dose prevents this. Using a spacer also reduces laryngeal deposition.
Yes. Stridor — a high-pitched sound heard on breathing in — with sore throat, drooling, difficulty swallowing, and progressive breathlessness is a medical emergency. This can indicate epiglottitis or supraglottitis, requiring immediate 999 call and hospital treatment.
Vocal cord nodules are benign callus-like growths caused by chronic vocal overuse or misuse. They are most common in singers, teachers, and people who use their voice extensively. They cause persistent hoarseness and are treated with voice therapy from a speech and language therapist.
An online or in-person GP consultation is appropriate for hoarseness lasting less than 3 weeks without red flags. GPs can prescribe PPI for reflux laryngitis, refer to ENT for persistent or concerning hoarseness, and arrange blood tests to exclude systemic causes.