Typical Course of Laryngitis
Most acute laryngitis is self-limited and resolves spontaneously within 7-10 days, with viral symptoms typically lasting 1-3 weeks regardless of treatment. 1
Expected Timeline
Acute viral laryngitis follows a predictable course:
- Symptom duration: 1-3 weeks is typical for viral laryngitis, which represents the vast majority of cases 1, 2
- Resolution within 7-10 days occurs in most cases when associated with upper respiratory tract infection symptoms (rhinitis, fever >101.5°F, fatigue) 1
- No specific treatment alters this natural course - the condition resolves spontaneously regardless of intervention 1, 3
When to Escalate Care
Laryngoscopy should be performed if hoarseness persists beyond 4 weeks or if serious underlying concerns exist 1. The American Academy of Otolaryngology-Head and Neck Surgery specifically recommends this 4-week threshold as the safety net for identifying pathology that won't resolve spontaneously 1.
Immediate evaluation is warranted for:
- Professional voice users (singers, teachers) who cannot afford to wait weeks for resolution 1
- Recent head/neck/chest surgery or intubation 1
- Concomitant neck mass, respiratory distress, or stridor 1
- History of tobacco abuse 1
- Symptoms suggesting bacterial infection or airway compromise 2
Management Approach
Treatment is purely symptomatic:
- Analgesics (aspirin, acetaminophen, NSAIDs) or throat lozenges for pain relief 1, 2
- Voice rest for symptom relief 2, 3
- Adequate hydration 2
Avoid ineffective interventions:
- Antibiotics provide no objective benefit for acute viral laryngitis and should not be used 2, 4
- Systemic corticosteroids lack efficacy evidence 2
- Decongestants should be discouraged 3
Important Caveats
Prolonged ulcerative laryngitis is a rare variant that can persist for 4-20 weeks (average 9.4 weeks) but is self-limited 5. This presents with characteristic lancet-shaped ulcerations on the vocal folds and requires close laryngoscopic follow-up but typically resolves without permanent structural consequences 6, 5.
Chronic laryngitis (symptoms >3 weeks) requires different consideration and laryngeal visualization to rule out vocal fold nodules, polyps, malignancy, or other structural pathology 3, 1.