What is laryngitis?

Laryngitis^[1] is an inflammation of the larynx. The larynx, commonly called the voice box, is an organ found in the top of the neck. It’s involved in breathing and is responsible for producing sound. An inflamed larynx can cause you to lose your voice or develop a painful cough. Laryngitis is frequently caused by a virus. However, the condition can also occur when your larynx becomes overused or irritated. The larynx^[2] is a hollow organ connected to the top of your windpipe. Inside the larynx are your vocal cords—two bands of smooth muscle tissue that cover muscle and cartilage. Your vocal cords open when you breathe and vibrate as you talk or sing. Laryngitis causes your vocal cords to become inflamed or irritated. When your larynx becomes inflamed, the sounds produced by air passing through it are distorted, making your voice sound hoarse. In some cases of laryngitis, your voice may become nearly silent for a few days. Laryngitis may be short-lived (acute) or long-lasting (chronic). Acute laryngitis^[3] typically lasts for a period of 3–7 days and can be resolved through self-care. Cases of acute laryngitis that are triggered by vocal strain or a temporary viral infection are usually not serious.

How common is laryngitis?

Because acute laryngitis commonly goes unreported, it’s hard to know exactly how common the condition is. Acute laryngitis usually affects^[4] people between 18–40 years of age, but it may be seen in children as young as 3 years old. One 2013 study^[5] found that 3.47 in every 1,000 people in the US had been diagnosed with chronic laryngitis. Up to 21% of the US population may develop chronic laryngitis in their lifetime.

What is chronic laryngitis?

Chronic laryngitis^[6] is defined as laryngitis with symptoms that persist for longer than three weeks. The symptoms of chronic laryngitis are the same as those of acute laryngitis. Viral infections rarely lead to chronic laryngitis; bacterial causes are more common. Chronic laryngitis is also often caused by exposure to irritants over time. Acute laryngitis may become chronic. You should see your provider if your case of laryngitis has not gone away after three weeks. If left untreated, chronic laryngitis can cause damage to the vocal cords.

Laryngitis causes

Acute laryngitis^[7] is usually caused by an infection (viral, bacterial, or fungal) or physical trauma. Most cases of acute laryngitis are temporary, and symptoms generally improve after the underlying cause of the condition is treated. Most cases of acute laryngitis are caused by viruses⁷. Viruses that commonly cause laryngitis include rhinovirus, adenovirus, influenza, and parainfluenza, respiratory syncytial virus (RSV), and coronavirus. Bacterial infection⁷ is another cause of acute laryngitis. It can be difficult to distinguish between viral and bacterial infections. The two may exist alongside each other, with an existing viral illness allowing a new bacterial infection to occur. Commonly identified bacteria that cause laryngitis include Streptococcus pneumoniae, Haemophilus influenzae B (HiB), Streptococcus pneumoniae, Staphylococcus aureus, hemolytic streptococci, Moraxella catarrhalis, and Klebsiella pneumoniae. Fungal infection can also cause laryngitis, but these are frequently undiagnosed. Fungi that cause fungal laryngitis include Histoplasma, Blastomyces, Candida, Cryptococcus, and Coccidioides. Vocal strain, or phonotrauma, is a non-infectious cause of acute laryngitis. Vocal strain is caused by excessive voice use or misuse, which can result in damage to the outer layer of the vocal fold. Injury from vocal strain is often limited to the outer layers of the vocal fold, but repeated episodes of vocal strain can lead to persistent laryngitis symptoms and long term changes to your vocal cords. Chronic coughing or habitual throat clearing can also damage your larynx, causing acute or chronic laryngitis. Laryngitis becomes a chronic condition if symptoms last longer than three weeks. Chronic laryngitis can damage or cause growths (polyps or nodules) on your vocal cords. Injuries that cause chronic laryngitis include:

• Inhaled irritants, such as chemical fumes, allergens, or smoke
• Acid reflux
• Chronic sinusitis
• Excessive alcohol use
• Habitual overuse of your voice
• Smoking

Other causes of chronic hoarseness include:

• Cancer
• Vocal cord paralysis from an injury, stroke, lung tumor, or other health conditions
• Bowing of the vocal cords in old age

Laryngitis risk factors

Screaming, forceful singing, or strained voicing can all inflame your larynx. For that reason, those in professions with high vocal demands, such as professional singers, actors, and teachers, face an increased risk of developing voice disorders. Other risk factors that can cause acute laryngitis include:

• Allergies
• Gastroesophageal reflux disease
• The use of asthma inhalers
• Exposure to environmental pollution
• Smoking
• Thermal or chemical burns of the larynx

Certain health conditions, living or working environments, and habits can raise your risk of getting laryngitis:

• Respiratory infection such as a cold, bronchitis, or sinusitis
• Exposure to irritating substances such as tobacco smoke, workplace chemicals, stomach acid, or excessive alcohol intake
• Voice strain from speaking too much, speaking too loudly, shouting, or singing

Preventing laryngitis

You can take the following steps to prevent irritation to your vocal cords:

• Avoid tobacco smoke: Smoking or exposure to secondhand smoke dries your throat and irritates your vocal cords.
• Limit alcohol and caffeine: These types of drinks have a diuretic effect, which means they lead to fluid loss in your body.
• Drink plenty of fluids: Liquids help thin out and clear the mucus in your throat.
• Avoid eating spicy foods: Spicy foods may cause your body to produce more stomach acid, leading to heartburn.^[8]
• Eat enough whole grains, fruits, and vegetables: These foods contain vitamins A, C, and E, which help keep the mucous membranes lining the throat healthy.
• Avoid clearing your throat: Throat clearing causes an abnormal vibration of your vocal cords and can increase irritation or swelling.
• Prevent upper respiratory infections: Wash your hands often and avoid exposure to people with upper respiratory infections such as the flu, strep, or cold.

Laryngitis symptoms

Most cases of laryngitis are caused by something minor, and symptoms usually last less than a couple of weeks. Sometimes, however, laryngitis symptoms may be caused by a more serious and persistent condition. Some common symptoms^[9] of laryngitis include:

• Hoarseness
• A weak voice or voice loss
• Tickling sensation or a feeling of rawness in the throat
• A sore and/or dry throat
• Dry cough
• Difficult or painful swallowing

Most acute cases of laryngitis can be managed through self-care, such as resting your voice and drinking plenty of water. If you do have laryngitis, you can cause further damage to your vocal cords if you continue to strain your voice. See your provider if your laryngitis symptoms last for more than two weeks. You should seek immediate medical attention if your laryngitis symptoms suddenly get worse. Signs of a more serious condition include:

• Trouble breathing
• Coughing up blood
• Fever that won’t go away
• Increasing, severe pain
• Trouble swallowing

If your child has laryngitis, continue to monitor their symptoms as the condition progresses. Seek immediate medical attention if your child:

• Makes high-pitched breathing sounds when inhaling (stridor)
• Drools more than usual
• Has trouble swallowing
• Has breathing difficulties
• Has a fever higher than 103°F (39.4°C)

These symptoms may be signs of croup—an inflammation of the larynx and the airway underneath. They can also be signs of epiglottitis^[10], an inflammation of the flap at the base of the tongue (epiglottis) that covers the windpipe. Because it can cause an inability to breathe, epiglottitis can be a potentially life-threatening condition.

Is laryngitis contagious?

Whether your case of laryngitis is contagious depends on what caused it. Laryngitis caused by vocal strain is not contagious. Some types of viral laryngitis can be contagious, such as cases caused by the common cold virus. The common cold is contagious early on in the infection, before symptoms begin. The cold will continue to be contagious for as long as 5–7 days^[11] after the onset of symptoms. Bacterial laryngitis and fungal laryngitis can also be contagious, but such instances are much rarer. If your symptoms include fever or multiple upper respiratory symptoms (like a runny nose), you might be contagious and should take precautions. If you are unsure of whether you have a contagious infection, ask your healthcare provider.