Hoarseness

That scratchy, croaky voice that makes you sound like you’ve been up all night at a concert? It’s one of the most common complaints I hear in my practice. And while most people assume it’s just a cold, there’s usually more to the story.

Your voice box sits right at the intersection of everything that can go wrong in your throat. Infections, allergies, overuse—they all show up as hoarseness. The key is figuring out which problem you’re dealing with.

Laryngitis Tops the List

This is inflammation of your vocal cords, and it’s the most common culprit. Usually it starts with a viral upper respiratory infection. You get a cold, then your voice goes scratchy or disappears completely.

I see this all the time after the holidays when people have been talking and laughing more than usual. Add a respiratory virus into the mix, and boom—you wake up barely able to whisper.

Laryngitis from a virus typically improves in a week or two. If it hangs on longer, we need to look at other causes like acid reflux or vocal strain.

Acid Reflux Sneaks Up

A lot of patients are shocked when I tell them their hoarse voice is from stomach acid. They don’t even have heartburn. But acid can creep up at night and irritate your voice box while you sleep.

I had a teacher come in last year who’d been hoarse for months. She assumed it was from talking all day. Turns out it was reflux. We adjusted her eating schedule and added some medication, and her voice cleared up within weeks.

Vocal Overuse and Strain

If you talk for a living—teachers, salespeople, coaches—you’re at higher risk. Your vocal cords are muscles, and like any muscle, they can get tired and inflamed.

The combination of talking all day plus a minor throat irritation can leave you voiceless by evening. Resting your voice actually helps, even though it’s tough to do.

Allergies Create Chronic Issues

Post-nasal drip from allergies irritates your throat and vocal cords constantly. You clear your throat a hundred times a day, which makes things worse. It becomes a vicious cycle.

I recommend treating the allergies first. Once we get the drainage under control, the hoarseness often improves on its own.

When to Worry

Most hoarseness resolves within two weeks. If yours lasts longer than three weeks, we need to investigate. Persistent hoarseness can signal more serious problems like nodules, polyps, or rarely, something more concerning.

Sudden voice loss with difficulty breathing needs immediate attention. That’s not regular laryngitis—that could be a severe allergic reaction or throat swelling that’s dangerous.

Bottom line? Give your voice a rest, stay hydrated, and avoid irritants like smoking. If it’s not better in a couple weeks, it’s time to dig deeper.