What Is Laryngitis?
Laryngitis is inflammation of the voice box (larynx), causing hoarseness, voice changes, or complete voice loss. It is one of the most common conditions in primary care.
Acute laryngitis comes on suddenly and lasts less than 3 weeks. It is almost always caused by a viral infection (cold, flu, or similar). Straining your voice — such as yelling at a sporting event — can also trigger it. It is especially impactful for people who rely on their voice for work, like teachers, singers, and speakers.
Chronic laryngitis lasts longer than 3 weeks and has many possible causes:
- Acid reflux reaching the throat (LPR) — the most common cause. Stomach acid irritates the vocal folds over time.
- Ongoing voice overuse or misuse
- Allergies or inhaling irritants like smoke or chemicals
- Chronic sinus drainage (post-nasal drip)
- Underactive thyroid
- Certain medications — inhaled steroids (without rinsing the mouth) or ACE inhibitors
Rarely, ongoing hoarseness can signal something more serious, such as vocal cord growths or throat cancer. Any hoarseness lasting more than 3 weeks — especially in smokers or adults over 40 — should be evaluated by an ENT specialist.
Telehealth works well for acute laryngitis caused by a clear viral illness or voice strain. At Innocre Telehealth, our board-certified provider evaluates patients in Delaware, Maryland, and Washington. Your provider will review when symptoms started, voice use habits, reflux symptoms, smoking history, and current medications. If acid reflux is suspected, medication may be started. If steroids are needed for an urgent voice commitment (such as a performance or presentation), a short course may be prescribed. Patients with red-flag signs — hoarseness beyond 3 weeks, a neck mass, difficulty swallowing, or coughing up blood — are referred urgently to an ENT specialist.
Common Symptoms
Hoarseness or raspy voice
Change in voice quality — rougher, lower-pitched, strained
Complete loss of voice (aphonia)
Inability to produce sound; may be whisper only
Throat soreness or rawness
Discomfort localized to the laryngeal area, worsened by speaking
Dry, tickling cough
Non-productive cough triggered by laryngeal irritation
Frequent throat clearing
Compulsive urge to clear the throat, which worsens inflammation
Voice fatigue
Voice worsens with sustained use throughout the day
Heartburn or acid reflux symptoms
In reflux laryngitis — often without classic heartburn (silent reflux)
Associated URI symptoms
Runny nose, sore throat, low-grade fever with acute viral laryngitis
How Innocre Treats Laryngitis Online
For acute viral laryngitis — the most common type — treatment focuses on three things:
- Voice rest: Complete silence for 48–72 hours lets the vocal folds heal. Whispering is NOT a safe alternative — it actually puts more strain on the voice box and can make things worse.
- Humidification: Steam inhalation and a humidifier help keep the throat moist. This is especially important in low-humidity environments.
- Hydration: Drink 64–80 oz of water daily to thin throat secretions.
Your provider will also advise you to avoid things that dry out the vocal folds, including alcohol, caffeine, antihistamines, and throat sprays with alcohol or menthol.
Steroids (such as a short prednisone course) may be considered if you have an urgent voice need — a performance, a critical work presentation, or a wedding. This is supported by medical evidence but must be weighed against the short-term side effects.
Antibiotics are almost never needed for laryngitis. The vast majority of cases are viral. Bacterial laryngitis is extremely rare and typically only seen in people with weakened immune systems.
For reflux-related laryngitis (LPR): Treatment includes an acid-reducing medication like omeprazole, taken twice daily before meals for 8–12 weeks. Lifestyle changes also help:
- Raise the head of your bed
- Avoid eating late at night
- Cut back on acidic foods, caffeine, and alcohol
Improvement from reflux treatment is gradual — expect 4–8 weeks before you notice a difference. Your provider may also prescribe famotidine as an additional acid blocker. If hoarseness lasts beyond 3 weeks, or if you smoke, drink heavily, or have trouble swallowing or a neck lump, you will be referred to an ENT specialist for a direct exam of the vocal folds.
⚠️ When to Go to the Emergency Room
Telehealth is appropriate for uncomplicated acute laryngitis. Seek emergency care immediately if you experience:
- • Stridor — a high-pitched, harsh sound during inhalation indicating significant airway narrowing that may require emergency intervention
- • Significant difficulty swallowing saliva or liquids, or active drooling — may indicate epiglottitis or supraglottic airway emergency
- • "Hot potato" voice (thick, muffled voice quality as if speaking with a hot potato in the mouth) combined with fever and severe throat pain — signs of peritonsillar or retropharyngeal abscess
- • Visible neck swelling that is rapidly progressing, or signs of Ludwig's angina (floor of mouth swelling, drooling, inability to protrude tongue)
- • Difficulty breathing that worsens when lying down, or any sensation that the airway is closing off