What is hoarseness?

Hoarseness is a change in the voice that makes it sound raspy or rough; it may also involve changes in pitch or volume. Sound is produced when air passes from the lungs through the larynx, where the vocal cords are located. These cords are two bands of muscle that vibrate to produce sound. When the vocal cords are injured or affected in any way, their vibration changes, leading to hoarseness [1].

Hoarseness is a common problem that can affect the quality of daily life, especially for people who rely on their voices for their work, such as teachers, singers, and doctors. Hoarseness can be a sign of a minor or more serious health problem, so it is important to pay attention to the accompanying symptoms [2].

Common Causes of Hoarseness

There are many causes that can lead to hoarseness, ranging from simple factors to more complex medical conditions. Some of the most notable causes include:

• Overuse or misuse of the voice: Speaking too loudly, shouting, or frequent throat clearing can strain and damage the vocal cords. Excessive whispering may also strain the vocal cords [1].
• Infections: Upper respiratory infections such as colds or the flu can cause laryngitis, which leads to hoarseness [2].
• Gastroesophageal Reflux Disease (GERD): When stomach acids move into the throat, they can cause irritation and inflammation of the vocal cords, leading to hoarseness [1].
• Growths on the vocal cords: Such as nodules, polyps, or papillomas, which can form as a result of overuse of the voice or other factors [1].
• Smoking: Smoking is a major factor that irritates the vocal cords and increases the risk of laryngeal cancer, which can cause hoarseness [2].
• Vocal cord paralysis: Some neurological diseases or injuries can affect the nerves that control the movement of the vocal cords, leading to paralysis and voice changes [1].

How do you know if your voice is unhealthy?

There are several signs that your voice may not be healthy, and you need to pay attention to them. If you notice any of the following symptoms, you may have a voice problem:

• Your voice has become consistently raspy or rough [2].
• You have lost the ability to hit some high notes when singing [1].
• Your voice has suddenly become deeper [1].
• You often feel that your throat is sore, painful, or strained [1].
• Speaking has become effortful [1].
• You find yourself frequently clearing your throat [2].

When should you see a doctor?

If hoarseness persists for more than a few days or is accompanied by other concerning symptoms, it is important to consult a doctor. Early diagnosis of most voice problems increases the chances of successful treatment [1]. You should see an Ear, Nose, and Throat (ENT) specialist to determine the underlying cause of the hoarseness [2].

The doctor may perform a laryngeal examination using a laryngoscope to evaluate the condition of the vocal cords. Based on the diagnosis, the doctor may recommend voice therapy, lifestyle changes, medications, or in some cases, surgical intervention.

Tips for Maintaining Voice Health

To help maintain your voice health and avoid hoarseness, you can follow some healthy habits:

• Good hydration: Drink plenty of water to keep the vocal cords hydrated, especially when exercising. Avoid drinks containing caffeine and alcohol, or balance them with sufficient water [2].
• Take vocal rest breaks: Give your voice a rest throughout the day, especially if you use it frequently.
• Avoid smoking: Smoke irritates the vocal cords and increases the risk of serious voice problems [2].
• Avoid shouting and excessive whispering: Both strain the vocal cords. Try to speak in a natural tone [2].
• Treat GERD: If you suffer from persistent heartburn or reflux, talk to your doctor about dietary changes or medications that can help reduce episodes [2].
• Use a humidifier: Especially in dry environments or during winter, it is recommended to maintain a humidity level of 30% at home [2].

For more information about common voice disorders, you can visit Common Voice Disorders: Causes of Hoarseness, Loss, and Treatment (Arabic).

Medical references

• Voice Disorders
• Taking Care of Your Voice