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Hoarseness of voice in an adult: treatment with medicines and folk remedies
Last reviewed: 04.07.2025
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A symptom such as decreased sonority, muffled or hoarse voice in an adult, teenager or child appears quite often with various respiratory diseases. In such cases, they say that the voice "disappeared" or "died".
However, this voice production (phonation) disorder, which has the code R49 according to ICD-10, can be one of the symptoms of much more serious diseases.
Causes adult voice hoarseness
In clinical practice, the causes of hoarseness in adults are grouped into inflammatory (infectious and non-infectious), structural (neoplastic), systemic, neurological and specific, including iatrogenic. But this does not mean that a combination of several causes is impossible. Therefore, some clinicians - in the absence of a single classification - divide hoarseness into types by etiology: if hoarseness is caused by inflammation of the larynx, it is considered organic (or true), in other cases it is classified as a functional symptom.
Otolaryngological statistics confirm that hoarseness in laryngitis (acute viral inflammation of the mucous membrane of the larynx) is the most common case, since this is where the vocal folds are located.
Hypothermia and infection, leading to inflammation of the nasopharynx and upper respiratory tract, cause hoarseness during a cold, when an intense cough begins with possible complications in the form of laryngitis, tracheitis or bronchitis. And hoarseness during pharyngitis is a consequence of the inflammatory reaction of the mucous membrane of the pharynx to its viral or bacterial infection.
In 85% of cases, a viral infection causes the pathogenesis of bronchial inflammation, when a strong cough (especially a long-term unproductive cough that tears the throat) produces a symptom such as hoarseness in bronchitis.
Due to swelling of the larynx and vocal cords, hoarseness may occur with tonsillitis - follicular or lacunar tonsillitis, as well as monocytic tonsillitis, which develops when affected by the Epstein-Barr virus. Almost all patients experience slight hoarseness with tracheitis - an acute or chronic inflammatory process localized in the upper part of the windpipe and leading to swelling of the mucous membrane of its walls and narrowing of the lumen.
But hoarseness of the voice with pneumonia most often occurs in cases of lung damage by a common type of obligate intracellular bacterium Chlamydia pneumoniae and the development of chlamydial pneumonia with a sore throat, as with pharyngitis, and a cough, as with bronchitis.
Fungal infections of the respiratory organs are also infectious inflammatory causes of dysphonia. Thus, the ubiquitous Candida albicans causes candidal pharyngitis - pharyngomycosis and hoarseness. Although this yeast-like fungus usually does not cause problems with the respiratory tract, its activation is facilitated by the death of normal (competing) flora as a result of antibiotic treatment or general immunosuppression of the body.
In the case of any of the above-mentioned diseases, the pathogenesis of the voice formation disorder is obvious: the disruption of the formation of the glottis when the vocal cords close occurs due to the limitation of their mobility (in order for there to be sound, the vocal folds must vibrate when exhaled air passes). And the mobility of the folds (consisting of the vocal cord and vocal muscle) is sharply reduced as a result of inflammatory edema, which occurs due to damage to the cells of the mucous epithelium by viral or bacterial toxins and an increase in the volume of interstitial fluid.
Non-infectious inflammatory causes of phonation disorders include chemical or thermal burns of the throat with subsequent partial necrosis of the mucous tissues, as well as hoarseness and allergies - with their characteristic tissue edemas. Hoarseness and cough with wheezing during inhalation are characteristic of allergic bronchitis, and hoarseness in bronchial asthma is aggravated by periodic difficulty breathing up to asphyxia.
Hoarseness may be a consequence of irritation of the ligaments and their failure to close due to acid (gastroesophageal) reflux, for example, with a hiatal hernia.
But the main risk factor for dysphonia, not related to infection, is present in smokers and those who, for various reasons, constantly overstrain their vocal cords. This almost always results in hoarseness in the morning, and any attempt to force it can provoke aphonia (lack of sound). The key factor in the pathogenesis of this condition is chronic swelling of the cords - the so-called Reinke's edema.
Structural, neurological and other causes of hoarseness
Hoarseness in adults can be caused by structural neoplastic processes - pathological formations on the vocal folds in the form of benign granulomatous nodes (in sarcoidosis, tuberculosis of the larynx, secondary syphilis), cysts or polyps, as well as laryngeal papillomas when affected by the human papillomavirus (HPV).
According to doctors, when this symptom persists for three or more weeks in the absence of anatomical and neurological factors or obvious signs of inflammation of the respiratory system, malignancy should be suspected. Hoarseness in laryngeal cancer - like sore throat, hoarseness and ear pain, enlarged cervical lymph nodes - are included in the list of symptoms of laryngeal and pharyngeal carcinoma. And when Kaposi's sarcoma is localized in the pharynx, phonation disorder is combined with difficulty swallowing.
Hoarseness and thyroid disease are closely related etiologically. With enlargement and fibrosis of the thyroid gland, the pathogenesis of dysphonia lies in the mechanical pressure on the adjacent larynx, which interferes with the free vibration of the vocal cords. Hoarseness in hypothyroidism (deficiency of the hormone thyroxine) and thyroiditis (inflammation of the thyroid gland) is the result of swelling of the vocal cords and their thickening. In addition, due to swelling of the mucous membrane lining the nasal cavity, hoarseness and nasal congestion are observed, and swelling of the tissues of the middle ear reduces hearing in patients with hypothyroidism.
Hoarseness of voice may occur with osteochondrosis of the cervical spine, and this is explained by the fact that as a result of the protrusion of the intervertebral discs, the nerve endings are pinched. In addition to hoarseness, their irritation and disruption of the conduction of nerve impulses leads to such symptoms of cervical osteochondrosis as headache and dizziness, deterioration of coordination of movements, hearing and vision loss.
Autoimmune diseases, one of the symptoms of which is a decrease in the sonority of the voice, include the same thyroiditis, as well as sarcoidosis, Sjogren's syndrome and rheumatoid arthritis (affecting the joints of the neck in the larynx area).
Hoarseness of voice is observed in such neurological pathologies and neurodegenerative disorders as Parkinson's disease, multiple sclerosis, spinocerebellar atrophy, myasthenia gravis, stroke. Partial paralysis (paresis) of the superior laryngeal nerve may result from malignant tumors of the lungs, other tumors of the mediastinum or aneurysm of the thoracic aorta, and patients, in addition to hoarseness, have chronic cough, laryngospasms, and a feeling of a lump in the throat.
Hoarseness of the voice on nervous grounds is often called a spastic form of functional psychogenic dysphonia, and its pathogenesis is directly associated with stress, which makes muscles tense, including the muscle fibers of the vocal folds. However, this is a diagnosis of exclusion.
A specific cause of hoarseness is considered to be chondroperichondritis of the larynx – inflammation of the tissues and membranes of its cartilages, to which the vocal folds are attached, caused by trauma or infection.
Iatrogenic risk factors include not only hoarseness after chemotherapy, but also trauma to the vocal folds (with subsequent scarring) during endotracheal intubation under general anesthesia; damage to the laryngeal nerves during operations on the neck or chest; atrophic changes in ligament tissue after long-term use of inhaled corticosteroids in asthma and chronic pulmonary obstruction.
It should be noted that hoarseness during pregnancy: in the first trimester, vomiting due to toxicosis irritates the mucous membrane of the pharynx and larynx, and the same thing can happen to the ligaments as with gastroesophageal reflux (see above). And in the later stages, the cause of hoarseness lies in gestosis, which leads to persistent tissue swelling.
[ Risk factors
By the way, when naming risk factors for phonation disorders, otolaryngologists, pulmonologists, endocrinologists and neurologists list all diseases and pathologies, the development or presence of which, with a greater or lesser degree of probability, leads to the appearance of such a symptom as hoarseness.
So it remains to add the well-known unfavorable factors: smoking, alcohol, the habit of forcing the voice (which is fraught with persistent hypertonicity of the muscle fibers of the ligaments), old age (over the years, the vocal folds lose elasticity), too dry and polluted air, harmful industrial conditions for the respiratory organs. And, of course, weak immunity, which reduces the resistance of the respiratory tract to infections.
Symptoms adult voice hoarseness
The first signs of this type of dysphonia are a significant decrease in the strength of the voice, that is, a decrease in the frequency with which the ligaments vibrate, regulating the size of the glottis. However, the symptoms of hoarseness in most cases are interconnected with other manifestations of diseases and in different variants are combined with comorbid symptoms.
Thus, hoarseness and cough occur with almost all acute respiratory diseases (colds) and diseases of the upper and lower respiratory tract, as well as hoarseness, cough and fever.
A dry barking cough and hoarseness are characteristic of acute laryngitis and allergic bronchitis.
When the palatine tonsils become inflamed and catarrhal angina (tonsillitis) develops, the main symptoms include hyperemia or a red throat, sore throat and hoarseness of the voice due to swelling of the inflamed mucous tissues.
If there is a combination of sore throat and pain in the throat even without swallowing (and when swallowing, pain is felt in the ears), as well as hoarseness and fever, then most likely it is follicular tonsillitis. But it is also not worth excluding the possibility of monocytic tonsillitis, since its symptoms include hyperthermia and all the signs of a common tonsillitis, aggravated by a cough.
In addition, hoarseness and ear pain may be signs of not only follicular or phlegmonous tonsillitis, but also a malignant tumor in the throat. Important symptoms of a throat tumor are also considered to be a sensation of a foreign body in it, difficulty swallowing, and halitosis (bad breath).
Sore throat and hoarseness are part of the symptoms of pharyngitis, tonsillitis, and gastroesophageal reflux disease.
Often, hoarseness of the voice without a sore throat indicates pathological formations in the larynx, for example, granulomas, cysts or papillomas.
In addition to a cold with a runny nose and cough, hoarseness and nasal congestion are often noted with allergies and hypothyroidism.
By the characteristics of the manifestation of this symptom, it is easier for doctors to determine its etiology. If sudden hoarseness of the voice appears, it can be caused by: acute laryngitis or bronchitis, bronchial asthma, tonsillitis, allergies, laryngeal cancer, metastases of lung cancer.
Occasional and intermittent hoarseness is characteristic of conditions that have triggers: gastroesophageal reflux, bronchial asthma, functional psychogenic dysphonia. And constant hoarseness is one of the signs of diseases associated with structural changes in the vocal cords, tumors, thyroid problems, and neurological pathologies.
Complications and consequences
Since hoarseness is a symptom, the consequences and complications relate to diseases with this disorder.
With respiratory infections and diseases of the respiratory tract, temporary loss of voice is possible - aphonia, which goes away after treatment. And diseases not related to the respiratory organs, in addition to changes in the timbre of the voice and the inability to regulate its volume, can lead to difficulty swallowing, shortness of breath with exertion, stridor (noisy breathing due to a decrease in the lumen of the larynx), chronic unproductive cough.
Diagnostics adult voice hoarseness
Hoarseness itself does not require diagnosis: the sound of the patient's voice demonstrates the presence of the symptom. The doctor's task is to identify its cause, which requires a complete anamnesis (indicating medications taken), which may contain information important for the correct choice of examination methods.
In many cases, it is enough for an otolaryngologist to listen to the patient's complaints and examine the oropharynx and throat using a regular forehead reflector. For a more accurate diagnosis, instrumental diagnostics are performed using X-rays of the larynx, lungs and mediastinal organs; laryngoscopy; laryngostroboscopy.
If causes not related to ENT diseases are suspected, electroglottography, electromyography of the laryngeal muscles; ultrasound of the neck; CT of the cervical spine; MRI of the base of the skull and brain may be required.
Blood tests are done: general, biochemical, thyroid hormone levels, etc.
What do need to examine?
Differential diagnosis
In complex situations, it is possible to involve specialists from other specializations in determining the cause of hoarseness, and their consultations will fully ensure differential diagnostics of the existing pathology.
Treatment adult voice hoarseness
No specialist will treat hoarseness in an adult patient separately from the treatment of the disease or pathological condition that is accompanied by this symptom.
General recommendations: increase water consumption (to avoid dry throat) and keep quiet for a while (you shouldn't even whisper). And what medications to take for loss of voice and hoarseness is determined by the doctor, based on the etiology of the disease. For the most part, doctors limit themselves to information regarding respiratory infections and respiratory diseases, in particular laryngitis (as the key cause of hoarseness).
Thus, antibiotics for hoarseness are used systemically only in the presence of a bacterial infection. More details in the article - Antibiotics for laryngitis
Local symptomatic remedies are widely used to treat laryngitis, pharyngitis and tonsillitis. For example, tablets for hoarseness Septolete, which are antiseptic tablets for sore throat (they are supposed to be sucked in the mouth). And Lizobact for hoarseness (also lozenges) is used due to the antiseptic effect of its component lysozyme.
Recommended lozenges for hoarseness: Dekatilen, Anti-Angin, Faringosept, etc. These are also lozenges for sore throats that contain antiseptics and local anesthetics.
Any recommended syrup for hoarseness is, in fact, a cough syrup. And for coughs with phlegm, you should choose products with licorice or marshmallow root extracts, and for dry coughs, syrups containing anise seed oil or ivy extract.
Sprays for hoarseness with analgesic and antiseptic properties (Angilex, Kameton, Geksoral, etc.) are very helpful, although they are also sprays for sore throat. But the antibacterial aerosol Bioparox for hoarseness has not been produced since spring 2016 and is prohibited for use.
Inhalations are prescribed for hoarseness of the voice - alkaline mineral water, sea salt solution, medicinal solutions Dekasan (effective for fungal infections of the larynx and throat) or Miramistin. A greater therapeutic effect is given
Inhalations for hoarseness with a nebulizer - an ultrasonic inhaler that provides a finer spray of the medicinal solution, which penetrates damaged tissues more easily.
The suspension with the corticosteroid budesonide Pulmicort is not used for hoarseness: its purpose is to treat allergic cough and bronchial asthma, as well as to relieve acute stenosis of the larynx in laryngitis.
Homeopathy offers the drug Homeovox for hoarseness, which is taken orally - 5-7 times a day, two tablets; not recommended for pregnant women. There are also granules for oral administration Bryonia (with an extract of the plant white bryony) and a throat gargle Phytolacca (based on the plant American pokeweed).
Surgical treatment should be performed in cases of pathological formations on the vocal cords that do not respond to drug therapy. Malignant tumors and Reinke's edema are also removed surgically.
The prescribed physiotherapeutic treatment for voice disorders associated with inflammation of the respiratory tract consists of sessions of electrophoresis with medications, phonophoresis and galvanic currents to the collar zone (in the absence of thyroid disease).
Basic exercises for the vocal cords in case of hoarseness are aimed at developing correct breathing – to reduce tension in the muscles of the larynx.
How to cure hoarseness at home?
Traditional folk treatment is the treatment of inflammation of the larynx (laryngitis) and pharynx (phyringitis) by daily five-minute warm-moist inhalations with a solution of soda, table or sea salt (a teaspoon per 200 ml of water).
Cough can be relieved by using herbal treatment in the form of decoctions of oregano, coltsfoot, sweet clover, and wild pansy taken internally. Gargling with decoctions of sage, chamomile, calendula, yarrow, plantain, nettle, eucalyptus or laurel leaves helps relieve pain and inflammation of the throat. It is also common practice to use a mixture of raw beetroot juice with water and apple cider vinegar to gargle a sore throat with loss of voice. For more information, see – Treatment of laryngitis with folk remedies
It is recommended to take eggnog for hoarseness - a mixture of two egg yolks with a tablespoon of granulated sugar and a teaspoon of butter or heavy cream. In a slightly warm form, this is an old home remedy for a sore throat. However, the yolks are used raw, so there is a risk of intestinal infection - salmonellosis.
Among the proposed home remedies for dysphonia, you can often find very strange recipes. For example, make compresses on the neck from laundry soap with honey. Or eat boiled peanuts for hoarseness. No one gives details of the latter remedy, however, according to the Journal of Agricultural and Food Chemistry, peanuts should be boiled in unpurified water (right in the pod) and for a long time - so that the kernels absorb the antioxidants contained in the peel. It should also be borne in mind that peanuts are a strong allergen.
Prevention
Is it possible to prevent a symptom caused by so many reasons? Perhaps, even common respiratory infections are quite problematic to prevent. However, not smoking, breathing through the nose, drinking enough water and taking vitamins are ways available to everyone to maintain the normal condition of the mucous membranes of the respiratory tract.