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Hoarseness: causes and home remedies

by Josephine Andrews
Published: Last Updated on 388 views

Hoarseness (medical: dysphonia) is a common symptom: those affected speak rough and softer than usual; sometimes the voice is completely gone. Doctors refer to this as aphonia. Hoarseness is usually harmless and temporary. Frequently, colds, sore throat or voice strain are responsible for the hoarse voice. But smoking and throat cancer can also be associated with hoarseness. Read everything you need to know about the causes and treatment options for hoarseness here.

quick overview

  • Description : rough, hoarse voice with reduced volume. Hoarseness can be acute or chronic.
  • Causes : e.g. B. Voice overload or improper strain, colds, vocal cord nodules or paralysis, tumors on the vocal cords, nerve damage, pseudocroup , diphtheria , acute bronchitis, chronic bronchitis, COPD, tuberculosis, reflux disease, allergies, stress, medication
  • Home remedies : Depending on the trigger, it can help not to eat too hot or spicy food, to drink warm drinks, to suck lozenges, to put warm neck wraps around the neck, to ensure high humidity; Bach flowers or essential oils can also be used.
  • When to the doctor? Hoarseness that lasts more than three weeks or keeps coming back, acute hoarseness without cold symptoms and with tightness or shortness of breath, in children, when the hoarseness is accompanied by a barking cough.
  • Examinations : e.g. consultation with the patient, physical examination, pharyngeal endoscopy/smear, laryngeal endoscopy, tissue removal, blood test, lung function test , gastroscopy , computed tomography (CT)
  • Therapy : depending on the cause, eg with medication, speech therapy or surgery.

hoarseness description

Hoarseness is caused by pathological anatomical or functional changes in the vocal tract: the voice sounds rough or “busy”, the volume is reduced. Sometimes “the voice is gone” (lack of voice, aphonia).

Depending on how long the hoarseness lasts, doctors differentiate between acute and chronic hoarseness:

  • Acute hoarseness : It is usually due to an inflammation of the larynx and vocal cords, as often occurs with a cold. It usually subsides after a few days.
  • Chronic hoarseness : hoarseness that lasts longer than three to four months. It can have many causes, such as vocal cord nodules, vocal cord polyps, or throat cancer . There are also congenital causes of chronic hoarseness.

Hoarseness: origin and causes

There can be many reasons why the voice doesn’t sound the way it used to – benign as well as serious. The main causes of hoarseness are:

  • Voice overload or incorrect strain : Anyone who sings along at the top of their lungs throughout a concert evening will probably respond to this with acute hoarseness in their vocal cords. People who habitually use their vocal cords extensively (such as teachers, singers, call center workers) or are prone to poor vocal technique may even experience recurrent hoarseness.
  • Common cold : The common cold is a mostly harmless infection of the upper respiratory tract with viruses . It is usually accompanied by a runny nose , hoarseness, stuffy nose, cough and possibly a slight fever .
  • Inflammation of the throat ( pharyngitis ): Hoarseness is often also caused by inflammation of the pharyngeal mucosa. Acute sore throat usually occurs with a cold. It is normally harmless and heals quickly with bed rest, home remedies and, if necessary, painkillers (for the sore throat). If the pharyngitis lasts longer than three months, it is considered chronic. Triggers are external factors that damage the mucous membranes, such as heavy smoking or radiation therapy (in the case of cancer).
  • Laryngitis: Acute laryngitis often accompanies a cold It triggers acute hoarseness (sometimes to the point of loss of voice), urgency to clear your throat, irritation of the throat, burning and scratchy throat and possibly fever. Chronic laryngitis can be caused by, for example, smoking, frequent inhalation of dust or dry air, chronic vocal overload, alcohol dependence or vocal cord nodules. Sometimes it is also a side effect of medications such as antidepressants.
  • Vocal fold polyps : Polyps on the vocal folds are benign mucosal changes. They usually form after an acute laryngitis when the patient has not kept to the voice rest recommended by the doctor. The hoarseness then persists even after the laryngitis has subsided. By the way: Smoking favors such polyps.
  • Vocal cord nodules (“singer nodules”, “screaming nodules”): Frequent talking, singing or shouting, improper breathing, cigarette smoke, dry air – there are many factors that can overuse and irritate the vocal cords. The mucous membrane then swells at the most stressed point (usually in the middle of the vocal folds). With continued overuse, the swelling can develop into a nodule that causes hoarseness. If the voice is protected and trained accordingly, vocal cord nodules can disappear again.
  • Vocal cord paralysis (recurrent nerve paralysis): Vocal cord paralysis (vocal cord paralysis) is often unilateral and is accompanied by hoarseness. It is triggered by damage to the nerve that is important for the function of the vocal tract (recurrent nerve). For example, the nerve can be injured during thyroid surgery (or other operations in the neck area) orconstricted by space-occupying processes (such as laryngeal tumor, sarcoid , aortic aneurysm). In addition, viral infections (such as flu , herpes infection), toxins (such as alcohol, lead), rheumatic diseases and diabetes can also result in nerve damage with paralysis of the vocal cords and hoarseness. Sometimes the cause of the paralysis remains unclear.
  • Pseudocroup : In the context of laryngitis, the larynx outlet can swell considerably, especially in infants and small children. As a result, in addition to acute hoarseness, a barking cough and shortness of breath occur. Doctors speak of pseudocroup or croup cough. In the case of severe coughing fits with shortness of breath, call the emergency doctor immediately!
  • Inflammation of the epiglottis ( epiglottitis ): In rare cases, hoarseness can indicate an inflammation of the epiglottis. However, the following symptoms of epiglottitis are much more characteristic: pharyngitis, pain when swallowing, severe sore throat, high fever and, above all, shortness of breath – it can very quickly turn into life-threatening attacks of suffocation !
  • Diphtheria (Real Krupp): This highly contagious infectious disease is caused by bacteria. The pathogens primarily trigger inflammation in the nasopharynx. This pharyngeal diphtheria can progress to laryngeal diphtheria with the symptoms of hoarseness, voicelessness and a barking cough. In addition, there are increasing breathing problems up to the risk of suffocation.
  • Acute bronchitis : Acute bronchitis is an inflammatory respiratory infection caused by viruses or (more rarely) bacteria. It is very common and, in addition to hoarseness, also causes fever, cough, pain behind the breastbone and headache, muscle and body aches.
  • Chronic bronchitis : In chronic bronchitis, the bronchi are not only temporarily inflamed (as in acute bronchitis), but permanently. Men are particularly affected, primarily smokers and ex-smokers. In addition to hoarseness, chronic bronchitis is mainly characterized by a chronic cough with tough sputum.
  • COPD : Chronic bronchitis can lead to narrowing (obstruction) of the bronchi over time. If this chronic obstructive bronchitis is accompanied by pulmonary distension ( pulmonary emphysema ), doctors speak of COPD . Those affected suffer primarily from chronic coughing, sputum production and shortness of breath. Hoarseness can also occur.
  • Thyroid enlargement (goiter, goiter ): The thyroid can be enlarged for various reasons, such as iodine deficiency, iodine utilization disorders, hormone synthesis disorders in the thyroid gland or benign or malignant tumors. Possible symptoms of a goiter include hoarseness, difficulty swallowing, shortness of breath and a feeling of tightness in the throat.
  • Underactive thyroid (hypothyroidism): An underactive thyroid can also be associated with hoarseness. Other symptoms include weight gain , tiredness, dry and scaly skin , dry and brittle hair, constipation and goiter. Hypothyroidism can be congenital or acquired.
  • Tuberculosis (consumption): Tuberculosis (TB) is a chronic bacterial infectious disease that can affect the larynx (laryngeal tuberculosis) – either alone or in addition to the lungs (pulmonary tuberculosis). The main symptoms of laryngeal tuberculosis are hoarseness and difficulty swallowing. Coughing and weight loss are also common.
  • Reflux disease : Reflux disease (gastroesophageal reflux) is understood by physicians as the backflow of acidic stomach contents into the esophagus . In addition to typical symptoms such as heartburn, reflux disease can also cause hoarseness.
  • Laryngeal cancer (larynx carcinoma): Mainly heavy smokers develop laryngeal cancer, especially if they consume a lot of alcohol at the same time. The symptoms of this malignant tumor include persistent hoarseness with difficulty swallowing, a foreign body sensation and coughing up blood.
  • Food allergies : Hoarseness is one of the possible symptoms of a food allergy (e.g. peanut allergy) along with swelling of the oral mucosa, skin rash, watering eyes, etc.
  • Mental Stress : Sometimes acute or chronic mental stress triggers hoarseness. Fear, excitement, depression and lovesickness can be to blame if the voice is suddenly gone.
  • General weakness : People who are generally weak due to old age or a serious illness often have a hoarse, limp voice.
  • Injury to the larynx : External injuries such as bruises or choking can result in acute hoarseness; sometimes the voice is temporarily gone.
  • Side effects of medication : Cortisone sprays, such as those often used by asthma patients, can cause hoarseness and fungal infection of the oral mucosa (oral thrush) as side effects. Other medications such as allergy (antihistamines) and depression (antidepressants), water tablets (diuretics) and female sex hormones (estrogens, such as in hormonal contraceptives) can also cause hoarseness.

This helps against hoarseness

Treatment will vary depending on how severe the hoarseness is, how long it has lasted, and how likely it is to be caused by a serious condition.

This is how the doctor can treat hoarseness

If the doctor has diagnosed a treatable disease as the cause of the hoarseness, he will initiate appropriate therapy. It can include, for example, the administration of certain medications (e.g. for laryngitis) or speech therapy (speech therapy, for example when the vocal cords or vocal cord nodules are overloaded). Sometimes surgical interventions are also necessary (e.g. in the case of larynx cancer, vocal fold polyps).

Home remedies for hoarseness

  • Rest : In the case of hoarseness due to overuse of the voice, rest is the order of the day. So talk as little as possible!
  • Speaking in a low voice : Many people begin to whisper when they are hoarse, but this only strains the vocal cords. Speaking in a low voice, on the other hand, is permitted.
  • Sticking to a “diet” : If acute or chronic laryngitis is to blame for the hoarseness, you should stick to the “larynx diet”: Don’t eat too hot or too spicy. Avoid cold foods (like ice cream) and drinks. Don’t smoke and don’t talk too much (save your voice!). These tips also do no harm if the hoarseness has causes other than laryngitis (e.g. pharyngitis or vocal cord nodules).
  • Warm drinks : Drink plenty of warm drinks if you have a hoarse voice. In the case of acute laryngitis, for example, a tea mixture of 50 g fern frond herb (Herba Adiantis capillis veneris), 20 g mallow leaves (Folium Malvae sylvestris) and 30 g thyme herb (Herba Thymi vulgaris) is recommended. Drink five cups of this tea daily.
  • Plantain tea : Plantain tea can also relieve hoarseness: Pour 250 ml of hot water over two teaspoons of the tea drug and let it steep for 15 minutes. Drink a cup twice a day. You can gargle with the tea as well.
  • Ginger tea : It is also suitable as a remedy for hoarseness: drink several cups a day or gargle with it.
  • Inhalation : Chamomile, fennel and peppermint tea are effective for sore throats, which are often associated with hoarseness. Inhale the fumes from the hot tea before drinking it.
  • High humidity : If you are hoarse, ensure that the humidity in the room is sufficiently high. The inhalation mentioned above is also good for the throat and vocal cords – either with just hot water or you add some salt or medicinal herbs ( chamomile , fennel, etc.) to the water.
  • Fennel milk : Fennel milk is also a popular remedy for hoarseness due to a sore throat: Boil 3 teaspoons of fennel seeds in half a liter of milk; then strain and sweeten the milk with honey.
  • Suck yourself healthy : Adults and older children who suffer from hoarseness and sore throats can turn to sage or Iceland moss lozenges.
  • Neck wrap : If you are hoarse as a result of colds, sore throats or other throat infections, you should keep the neck area evenly warm: Put a scarf around your neck and/or make a neck wrap for a sore throat, for example a warm potato wrap: Boil the potatoes, mash them in wrap a cloth and place it on your neck (check the temperature!). The wrap remains on the neck until it cools down.
  • Stay abstinent : No matter what the cause of the hoarseness – avoid alcohol and avoid smoky and dusty rooms.
  • Bach flowers : If you want to try Bach flower therapy for hoarseness, you should take Star of Bethlehem several times , a perennial, herbaceous plant (also called umbel milk star).
  • Essential oils : Aromatherapy uses essential oils such as eucalyptus, pine needle, marjoram, rosemary and thyme oil to treat cold symptoms such as hoarseness, cough and runny nose – either for rubbing in or inhaling.

Before using essential oils on children, you should consult a therapist or doctor. Because some essential oils such as eucalyptus oil, mint oil or camphor can cause spasms in the respiratory muscles in small children with the risk of suffocation!

Home remedies have their limits. If the symptoms persist over a longer period of time, do not get better or even get worse, you should always consult a doctor.

Homeopathy for hoarseness:

Homeopathic remedies that are recommended for hoarseness are, for example, Ferrum phosphoricum 30 CH (laryngitis and dry hoarseness), Carbo vegetabilis 30 CH (hoarseness in the evening), Causticum 12X and Spongia 6X (for hoarseness caused by overexertion of the vocal cords). Patients with hoarseness, dry cough, sore throat, and fever with chills are often given Drosera . You should speak to a homeopath about dosage and frequency of intake.

The concept of homeopathy and its specific effectiveness are controversial in science and not clearly proven by studies.

Hoarseness: when do you need to see a doctor?

The hoarseness often goes away on its own or thanks to home remedies. In the following cases of hoarseness, however, a doctor’s visit is urgently recommended:

  • Hoarseness that lasts longer than three weeks – especially if you have no idea what the cause might be (suspected throat cancer!)
  • recurring hoarseness, especially after prolonged vocal strain
  • Acute hoarseness to voicelessness if there are no cold symptoms but an increasing feeling of tightness or shortness of breath
  • acute hoarseness and barking cough in the child

On the other hand, there is usually no reason to worry about hoarseness in male adolescents: a rough, husky voice at the beginning of the voice break is normal.

Hoarseness: what does the doctor do?

To find out what caused the hoarseness, the doctor will first ask you about your medical history (anamnesis). Important information is for example:

  • How long has the hoarseness existed?
  • Are there any accompanying symptoms such as coughing, shortness of breath or fever?
  • Do you smoke?
  • Do you often drink alcohol?
  • Do you have chronic diseases such as asthma?
  • Do you take any medication?
  • What is your job (e.g. a job that strains your voice such as a teacher or opera singer)?

Important examinations for hoarseness

From this information, the doctor usually gets a guess as to what might have caused the hoarseness. Further investigations can confirm the suspicion:

Physical examination : This is routine in the evaluation of hoarseness and is particularly indicated when the common cold, acute bronchitis and asthma are possible causes of hoarseness.

Throat endoscopy ( pharyngoscopy ): The doctor examines the throat using a small mirror or a special endoscope (a tube-shaped medical instrument) if he suspects a sore throat as the cause of hoarseness.

Throat swab : If the acute bacterial infection diphtheria is the cause of hoarseness, the doctor takes a throat swab with a spatula to create a bacterial culture. If diphtheria bacteria can actually be cultured from the smear, this confirms the doctor’s suspicion.

Laryngeal endoscopy ( laryngoscopy ): An endoscopic examination of the larynx is carried out if, for example, laryngitis, epiglottis or laryngeal cancer is suspected to be the cause of the hoarseness.

Biopsy : As part of the larynx endoscopy, the doctor can also take a tissue sample (biopsy) if he discovers suspicious cell proliferations (tumors), for example on the vocal cords or the larynx.

Examination of the sputum ( sputum examination ): The patient’s sputum is analyzed with regard to color, smell, consistency, composition, etc. if the doctor suspects acute bronchitis as the cause of hoarseness.

Blood samples : A patient’s blood sample is examined for infectious agents if chronic bronchitis or tuberculosis is suspected. In addition, a blood test to record the hormone status (thyroid hormones) is used to diagnose hypothyroidism as the cause of hoarseness.

X-ray examination: An X-ray examination serves to clarify asthma, chronic bronchitis, COPD and tuberculosis as possible causes of hoarseness.

Lung function test: A test of lung function using spirometry reveals whether bronchial asthma may be causing the hoarseness.

Gastroscopy ( esophago-gastroscopy ) : A look with the endoscope into the esophagus and stomach shows whether acidic stomach contents are flowing back into the esophagus (reflux disease) behind the hoarseness.

Ultrasound examination ( sonography ): In the ultrasound image, the doctor can identify an enlarged thyroid gland (goiter, goiter) as the cause of hoarseness.

Computed tomography ( CT ): A computed tomography is used to clarify tumors (such as laryngeal cancer) as possible causes of hoarseness . CT is also used when there is a suspicion of vocal cord paralysis.

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