From the Guidelines
Treatment for a hoarse voice typically involves rest, hydration, and avoiding vocal strain, as recommended by the most recent clinical practice guideline 1. To manage a hoarse voice, it is essential to:
- Rest your voice by speaking less and avoiding shouting or whispering
- Drink plenty of water (at least 6-8 glasses daily) to keep your vocal cords hydrated, as suggested by the clinical practice guideline 1
- Use a humidifier, especially while sleeping, to maintain moisture in the air
- Avoid irritants like smoking, alcohol, caffeine, and spicy foods that can worsen hoarseness
- Consider over-the-counter throat lozenges containing menthol or honey for temporary relief For persistent hoarseness, a doctor might prescribe medications like proton pump inhibitors (such as omeprazole 20mg daily) if acid reflux is contributing to the symptoms 1. Voice therapy with a speech pathologist is strongly recommended for patients diagnosed with hoarseness that reduces voice-related quality of life, as stated in the clinical practice guideline 1. Hoarseness lasting more than two weeks warrants medical evaluation to rule out more serious conditions like vocal cord nodules, polyps, or rarely, cancer. Most cases of hoarseness result from inflammation of the vocal cords due to overuse, infection, or irritation, and will improve with these conservative measures within 1-2 weeks. It is crucial to note that surgery may be indicated for certain conditions that cause hoarseness, such as suspected malignancy, benign soft tissue lesions, glottic insufficiency, and laryngeal dystonia 1. However, the primary treatment for the majority of hoarse patients is not surgery, but rather a combination of rest, hydration, and voice therapy.
From the Research
Treatment Options for Hoarse Voice
The treatment for a hoarse voice depends on the underlying cause. According to 2, the treatment of hoarseness has been studied in only a few randomized controlled trials, all of which were on a small scale.
- Voice therapy is often successful in the treatment of functional and organic vocal disturbances.
- Surgery on the vocal cords is indicated to treat tumors and inadequate vocal cord closure.
- The only entity causing hoarseness that can be treated pharmacologically is chronic laryngitis associated with gastro-esophageal reflux, which responds to treatment of the reflux disorder.
Pharmacological Treatment
The empirical treatment of hoarseness with antibiotics or corticosteroids is not recommended 2. However, treatment of gastroesophageal reflux disease (GERD) can improve symptoms of hoarseness, as seen in a case report where a patient's symptoms improved dramatically with empirical treatment for GERD 3.
Effective Treatments
Voice therapy, vocal cord surgery, and drug therapy for appropriate groups of patients with hoarseness are well documented as effective by the available evidence 2. It is essential to evaluate hoarseness immediately in patients with risk factors, especially smokers, by laryngoscopy.