What causes hoarse voice?

Misuse of the voice, such as prolonged talking or shouting, is a common cause of hoarse voice. Other possible causes include tobacco use, marijuana use, and exposure to chemicals—even those found in some household cleansers—or pollutants.

Hoarse voice can also be a result of allergies, inflammation, colds, flu, or reflux disorders (regurgitation of stomach acids and digestive enzymes up into the throat) and, in some cases, neurologic disorders, thyroid or hormonal disorders, or laryngeal cancer.

Common causes of hoarse voice

Hoarse voice may be caused by several types of common throat injuries including injury from:

  • Excessive voice use
  • Marijuana use
  • Speaking loudly for extended periods
  • Using unnatural inappropriate pitch when speaking
  • Tobacco use
  • Vocal hemorrhage following strenuous vocal use

Respiratory causes of hoarse voice

Hoarse voice may be caused by several respiratory-related disorders including:

  • Allergies
  • Common cold (viral respiratory infection)
  • Inflammatory disorders such as laryngitis
  • Influenza (flu)
  • Tumor of the larynx
  • Vocal cord lesions

Gastrointestinal causes of hoarse voice

Hoarse voice can also be caused by several reflux disorders (regurgitation of stomach acids and digestive enzymes up into the throat) including:

  • Gastroesophageal reflux disease (GERD)
  • Laryngopharyngeal reflux (LPR)

Other causes of hoarse voice

Other body system functions and disorders can also contribute to hoarse voice. These instances include:

  • Goiter
  • Paralysis of the vocal cords
  • Spasmodic dysphonia (involuntary movements of vocal cord muscles)
  • Thyroid nodules or tumors

Serious or life-threatening causes of hoarse voice

In some cases, hoarse voice may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

  • Epiglottitis (life-threatening inflammation and swelling of the epiglottis, a tissue flap between the tongue and windpipe)
  • Laryngeal cancer
  • Serious hemorrhage

Questions for diagnosing the cause of hoarse voice

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your hoarse voice including:

  • How long have you had a hoarse voice?
  • Do you recall straining your voice recently?
  • Does your throat feel painful or dry?
  • Have you had a cough?
  • Are you having any difficulty breathing? Difficulty swallowing?
  • Have the glands in your neck felt swollen or tender to the touch?
  • Do you use tobacco or marijuana?
  • Have you been vomiting recently?
  • Do you ever experience food from your stomach regurgitating up into your throat?
  • Do you have any other symptoms?
  • What medications are you taking?
  • Have you been exposed to any chemicals or fumes?

What are the potential complications of hoarse voice?

Left untreated, a chronically misused or overused larynx, the most common cause of hoarse voice, can lead to thickening and calluses on the surfaces of the vocal folds. Because hoarse voice can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, many of these complications can be avoided. For that reason, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Inflammation due to continual irritation
  • Loss of or permanent damage to voice
  • Spread of cancer
  • Spread of infection


  1. Throat problems. FamilyDoctor.org. http://familydoctor.org/familydoctor/en/health-tools/search-by-symptom/throat-problems.html.
  2. Tips for Healthy Voices. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/content/tips-healthy-voices.

What is hoarse voice?

Hoarse voice is an abnormal change in your voice caused by disorders in the vocal cords of the voice box, or larynx. The vocal cords are normally open but make sounds by coming together when you speak, sing or hum. As air leaves the lungs, it makes the closed folds vibrate, producing the sound of your voice. When your voice is hoarse, it is an indication that these vibrations of the vocal folds... Read more about hoarse voiceintroduction


What other symptoms might occur with hoarse voice?

Hoarse voice may accompany other symptoms, which will vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the respiratory system may also involve other body systems.

Respiratory symptoms that may occur along with hoarse voice

Hoarse voice may accompany other symptoms affecting the respiratory system including:

Read more about hoarse voicesymptoms

Medical Reviewer: Cynthia Haines, MD Last Annual Review Date: Aug 2, 2013 Copyright: © Copyright 2014 Health Grades, Inc. All rights reserved. May not be reproduced or reprinted without permission from Health Grades, Inc. Use of this information is governed by the HealthGrades User Agreement.

This Article is Filed Under: Ear, Nose and Throat

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