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Stages of Laryngitis & Recovery Timeline

A cartoon of a woman with laryngitis.

Laryngitis is an inflammation of the larynx (voice box) in the throat. It is a common condition that can affect people of all ages. Laryngitis is usually a mild and self-limited condition that resolves within a week. However, sometimes, laryngitis can last longer and be a sign of a more serious underlying health condition. Please continue reading to learn about the stages of laryngitis and the recovery timeline for this condition.

What is the difference between acute laryngitis and chronic laryngitis?

Acute laryngitis is a short-lived, self-limited condition that lasts 3-7 days. If laryngitis symptoms last for more than 3 weeks, it is called chronic laryngitis.

What causes laryngitis?

Laryngitis can be due to infectious and non-infectious causes. The most common cause of acute laryngitis is viral infections of the upper respiratory tract. Viral laryngitis can be caused by many different viruses, such as rhinovirus, adenovirus, coronavirus, respiratory syncytial virus (RSV), and others. 

Occasionally, bacterial infections develop on top of the viral infections. Symptoms of a bacterial infection typically occur around a week after acute laryngitis symptoms start. 

Fungal laryngitis is rare, but chronic laryngitis can occur due to a fungal infection of the voice box. This is sometimes seen in patients with a weakened immune system or those taking inhaled steroid medications, for example, asthma patients

Non-infectious causes of laryngitis include injuries from inhaled noxious substances, voice abuse or overuse (vocal cord strain in singers, cheerleaders, and other people who use their voice professionally), pollution, smoking, allergies, asthma, and gastroesophageal reflux disease (GERD). GERD is a condition in which backflow of stomach acid irritates the vocal cords and causes reflux laryngitis.

Risk factors for developing chronic laryngitis include voice abuse, smoking, heavy alcohol consumption, and gastroesophageal reflux disease.

What are the symptoms of laryngitis?

The main symptoms of laryngitis are a hoarse voice and sore throat due to inflammation in the areas around the vocal cords. Other laryngitis symptoms may include:

  • Voice changes, such as a raspy, croaky, or coarse voice
  • Difficulty speaking 
  • Dry cough
  • Frequent throat clearing
  • Low-grade fever
  • Other symptoms of an upper airway viral infection such as runny nose, sore throat, and swollen glands
  • Early voice fatigue in professional voice users

When to see a doctor for laryngitis?

The presence of symptoms such as increasing pain, trouble swallowing, and breathing difficulties (trouble breathing, noisy breathing, or shortness of breath) could indicate a more serious underlying health condition. 

If your symptoms last more than three weeks or you have difficulty breathing, you should be evaluated by your primary care provider or throat specialist without delay. 

In particular, smokers and people with weakened immune systems should seek timely medical care because they are at a higher risk of serious infections, malignancies, and other potentially life-threatening conditions which can mimic the symptoms of laryngitis.

How is laryngitis diagnosed?

A healthcare provider can diagnose laryngitis based on your health history and physical exam. For example, a history of respiratory infections or GERD (stomach acid reflux) provides clues because they are potential causes of laryngitis. Doctors can also use an instrument called a laryngoscope, which has a light and small mirror, to look directly at your vocal cords and diagnose an inflamed larynx.

What is the healing process for laryngitis?

Acute laryngitis occurs in response to an infectious or non-infectious trigger that causes local inflammation of the vocal cords and surrounding tissues. The symptoms of infectious laryngitis come on suddenly and get worse during the first 3 days. Acute laryngitis is usually a self-limited condition and resolves within 2 weeks. 

In laryngitis caused by non-infectious causes, the symptoms may persist beyond 2-3 weeks, and this is a transition to chronic laryngitis. In such cases, the healing process is longer. The chronic hoarseness can last for several weeks, depending on how soon the underlying cause is identified and treated.

Does coughing worsen laryngitis?

Yes, coughing can worsen laryngitis by causing the vocal cords to rub together sharply. This causes increased swelling and irritation of the voice box (larynx). The body also responds to coughing by secreting more mucus to protect the vocal cords, which can make the problem worse. If you have throat irritation due to laryngitis, instead of coughing, try taking strong swallows, sipping on cold, fizzy drinks, or try gentle throat clearing instead of coughing.

Other things that can make laryngitis worse include smoking or exposure to secondhand smoke, alcohol and caffeine intake, and talking or singing loudly or for too long, 

How long does it take to get a voice rest for laryngitis?

The best cure for laryngitis is to rest your voice. Avoid talking for at least 3 days and up to a week if possible. This will help your vocal cords heal. If complete voice rest is not possible, try to avoid hard coughing, singing or shouting, speaking too much, crying, and clearing your throat. Speaking softly is preferable to whispering, which can cause more strain on the voice cords.

What is the best laryngitis treatment?

Acute laryngitis is usually self-limited and resolves within a week when the respiratory infection clears. You do not usually need to get this type of laryngitis treated. It is worth remembering that antibiotics do not kill viruses. Therefore they are not useful in treating viral infections. 

However, if there is a superimposed bacterial infection, your healthcare provider may prescribe antibiotics. Corticosteroids are sometimes given to control inflammation and reduce swelling. However, they are usually reserved for severe cases, for example, laryngitis associated with croup in a young child. If there is a fungal infection (rare), your doctor may prescribe an antifungal medication.

Treatment for chronic laryngitis consists of identifying and treating the underlying cause. 

Is laryngitis contagious?

Laryngitis itself is not contagious. However, if laryngitis is caused by an infection, the infection may be contagious.

How to prevent laryngitis?

Here are some tips that can lower your risk of developing laryngitis:

  • Avoid shouting, speaking for long periods, or habitual overuse of your voice.
  • Limit alcohol and caffeine intake (they have a dehydrating effect).
  • Avoid smoking and exposure to secondhand smoke. Cigarette smoke irritates the voice box and vocal cords.
  • Drink plenty of water. Drinking plenty of water thins the mucus in your throat and makes it easier to clear.
  • Avoid spicy foods that can trigger heartburn and gastroesophageal reflux disease (GERD).
  • Eat healthy foods such as fresh fruits, vegetables, and whole grains that help to keep the mucous membranes of your throat healthy.
  • Avoid the temptation to clear your throat excessively (this causes abnormal vibrations of your vocal cords and leads to the secretion of more mucus). 
  • Take precautions to prevent upper respiratory infections, such as washing your hands and avoiding contact with people sick with coughs and colds. 
     

References:

  1. https://www.ncbi.nlm.nih.gov/books/NBK534871/
  2. https://www.ncbi.nlm.nih.gov/medgen/102342
  3. https://www.nhsaaa.net/media/1691/20170511laryngitis.pdf#:
  4. https://www.mayoclinic.org/diseases-conditions/laryngitis/symptoms-causes/syc-20374262