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Main Line Pediatrics

Are You Sick?

Hoarseness

Is this your symptom?

  • Voice is hoarse, raspy, scratchy, or deeper than usual
  • If hoarseness is severe, the adult can do little more than whisper
  • A cough is often also present

Some Basics...

  • Laryngitis is the medical term for an inflamed voice box (called the larynx).
  • It may be caused by many things. Often it is caused by a cold or the flu. It may also be caused by hay fever, acid reflux, smoking, and overuse of the vocal cords.
  • The main symptoms are hoarseness and a dry scratchy throat.
  • Usually it gets better within a couple days to a week.
  • People with hoarseness that lasts more than 2 weeks should see a doctor.

Causes

Common causes of hoarseness or laryngitis are:

  • Common cold and upper respiratory tract infection
  • Gastroesophageal reflux
  • Hay fever (nose allergies)
  • Overuse of the vocal cords (singing, shouting)
  • Smoking

Less common causes of hoarseness are:

  • Breathing in smoke or fumes
  • Cancer of larynx or throat
  • Small foreign object in trachea (windpipe)
  • Hypothyroidism
  • Severe allergic reaction (anaphylaxis)
  • Vocal cord nodule

Here are some clues based on timing of symptoms and some possible causes:

  • Sudden onset over seconds to minutes: Unexplained, sudden-onset hoarseness can be caused by a serious allergic reaction (anaphylaxis).
  • Slow onset over hours to days: Slow onset of hoarseness in an adult with a recent cold is usually from mild laryngitis caused by a virus.
  • Slow onset over weeks to months: Hoarseness in a smoker without cold symptoms raises the concern of cancer of the larynx.

When to Call for Hoarseness

When to Call for Hoarseness

Call 911 Now

  • Severe trouble breathing (struggling for each breath or can't speak)
  • Started right after a bee sting, taking medicine, or eating an allergic food
  • Can't swallow (drooling or spitting)
  • Tongue or face swelling
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Hoarseness lasts more than 30 minutes after a choking spell
  • Fever over 103° F (39.4° C)
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Severe sore throat pain
  • Fever lasts more than 3 days
  • Fever returns after being gone more than 24 hours
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Hoarseness lasts more than 2 weeks
  • Hoarseness off and on for weeks or months (is frequent, comes and goes)
  • You have other questions or concerns

Self Care at Home

  • Hoarseness from a common cold or upper respiratory infection
  • Hoarseness from overuse of vocal cords (shouting, singing)
  • Hoarseness from hay fever (nose allergies)

Call 911 Now

  • Severe trouble breathing (struggling for each breath or can't speak)
  • Started right after a bee sting, taking medicine, or eating an allergic food
  • Can't swallow (drooling or spitting)
  • Tongue or face swelling
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Hoarseness lasts more than 30 minutes after a choking spell
  • Fever over 103° F (39.4° C)
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Severe sore throat pain
  • Fever lasts more than 3 days
  • Fever returns after being gone more than 24 hours
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Hoarseness lasts more than 2 weeks
  • Hoarseness off and on for weeks or months (is frequent, comes and goes)
  • You have other questions or concerns

Self Care at Home

  • Hoarseness from a common cold or upper respiratory infection
  • Hoarseness from overuse of vocal cords (shouting, singing)
  • Hoarseness from hay fever (nose allergies)

Care Advice

Hoarseness

  1. What You Should Know:
    • Laryngitis is the medical term for an inflamed voice box (called the larynx).
    • It may be caused by many things. Often, it is caused by a cold or the flu. It may also be caused by hay fever, acid reflux, smoking, and overuse of the vocal cords.
    • The main symptoms are hoarseness and a dry scratchy throat.
    • You usually can treat hoarseness from laryngitis at home.
    • Here is some care advice that should help.
  2. Rest Your Voice:
    • Talk as little as possible or write notes for a few days. Also avoid throat-clearing.
    • Talking and even throat clearing can strain the vocal cords.
    • Avoid shouting or speaking loudly.
  3. Drink Warm Liquids
    • Drink warm soothing liquids.
    • Hot water with honey is good. Hot tea with sugar and lemon is also good.
    • You can also suck on hard candy or cough drops.
  4. Avoid Tobacco Smoke:
    • Avoid smoking or breathing in second-hand smoke.
    • This can make coughs and hoarseness much worse.
  5. Expected Course:
    • Usually hoarseness from laryngitis gets better within a couple days to a week.
    • If your hoarseness lasts more than 2 weeks, you should see a doctor.
  6. Call Your Doctor If:
    • Trouble breathing occurs
    • Hoarseness lasts more than 2 weeks
    • You think you need to be seen
    • You get worse

Treatment for Hay Fever

  1. What You Should Know:
    • Allergic rhinitis is an allergic reaction of the nose and sinuses to substances in the air. These include pollen, mold, and dust. Hay fever is a type of nasal allergy.
    • You should see a doctor if your symptoms are more than mild.
    • You can treat hay fever at home.
    • Here is some care advice that should help.
  2. Antihistamine Medicine for Hay Fever Symptoms:
    • Antihistamines help with hay fever symptoms like sneezing, itching, and runny nose.
    • During pollen season you may need to take this drug every day. It can help keep your allergies under control.
    • You can take one of the following drugs for hay fever: diphenhydramine (Benadryl), fexofenadine (Allegra), cetirizine (Zyrtec), or loratadine (Claritin, Alavert).
    • They are over-the-counter (OTC) drugs. You can buy them at the drugstore.
    • Use the lowest amount of a drug that makes your hay fever feel better.
    • Diphenhydramine (Benadryl) may make you feel drowsy. Loratadine, cetirizine and fexofenadine do not cause you to feel as sleepy. They are also long-acting so they last 24 hours.
    • Read the instructions and warnings on the package insert for all medicines you take.
  3. Warning - Antihistamine Medicines:
    • Do not drink, drive or use dangerous machinery while taking them.
    • Caution: antihistamines can make you feel sleepy.
    • Caution: do not use antihistamines if you have prostate problems.
    • Read the instructions and warnings on the package insert for all medicines you take.
  4. Call Your Doctor If:
    • Trouble breathing occurs
    • Hoarseness lasts more than 2 weeks
    • You think you need to be seen
    • You get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2023.

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