Throat
Hoarse voice
A rough, raspy, weak or croaky change in the voice from irritation, swelling or strain of the vocal cords — usually short-lived after a cold or overuse, but when it lasts more than three weeks it needs checking to exclude a serious cause.
Education and reference only. This explains the common causes of hoarse voice and the warning signs that need urgent help, in plain language — it is not a diagnosis or a substitute for advice from a clinician. If you feel very unwell or are worried, seek medical help.
Quick answer
What is hoarse voice?
Hoarseness is a change in the sound of the voice — it may become rough, breathy, strained, weak or croaky — and it reflects something interfering with the smooth vibration of the vocal cords in the voice box. Most hoarseness is harmless and temporary: a viral cold or laryngitis inflames the cords, or heavy voice use such as shouting, singing or cheering strains them.
- Get urgent help: Arrange an urgent appointment for a hoarse voice that has lasted more than three weeks, especially if you smoke — this needs checking to exclude cancer of the voice box, throat or lung. Seek urgent help for hoarseness with difficulty swallowing, a feeling of something stuck in the throat, or unexplained weight loss.
- Self-care: For a hoarse voice after a cold or overuse, the most helpful thing is to rest the voice: avoid shouting, prolonged talking and especially whispering, which strains the cords more than gentle speech.
About hoarse voice
Hoarseness is a change in the sound of the voice — it may become rough, breathy, strained, weak or croaky — and it reflects something interfering with the smooth vibration of the vocal cords in the voice box. Most hoarseness is harmless and temporary: a viral cold or laryngitis inflames the cords, or heavy voice use such as shouting, singing or cheering strains them. Acid rising from the stomach can irritate the back of the throat and voice box, and an underactive thyroid or chronic allergy and post-nasal drip can also affect the voice. The key rule is duration. A hoarse voice that has not settled after about three weeks, particularly in a smoker or someone over middle age, must be examined, because persistent hoarseness can be the first sign of cancer of the voice box, throat or, occasionally, the lung. Hoarseness with difficulty swallowing or breathing, or a lump in the neck, is especially important.
When to get help
Call 999 or go to A&E if hoarse voice comes with any of these warning signs:
- Arrange an urgent appointment for a hoarse voice that has lasted more than three weeks, especially if you smoke — this needs checking to exclude cancer of the voice box, throat or lung.
- Seek urgent help for hoarseness with difficulty swallowing, a feeling of something stuck in the throat, or unexplained weight loss.
- Seek urgent help if you also notice a new lump in the neck.
- Call 999 if hoarseness comes with noisy, difficult breathing or your throat feels like it is closing up.
- Get assessed for hoarseness alongside coughing up blood.
When to see a doctor
A hoarse voice that follows a cold or a day of shouting usually settles within a week or two and needs only voice rest. The important rule is that any hoarseness lasting more than three weeks, or one that keeps coming back without an obvious cause, should be assessed so the voice box can be examined — this is especially important if you smoke or have smoked. Seek urgent help if hoarseness comes with difficulty swallowing, a neck lump, unexplained weight loss or coughing up blood, and treat hoarseness with difficulty breathing or a closing throat as an emergency.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
What can cause it
Common causes of hoarse voice
Hoarse voice has many possible causes. Each links to a full, plain-language guide to that condition — what it is, how it's treated and when to seek help.
What helps
Self-care and what you can do
For a hoarse voice after a cold or overuse, the most helpful thing is to rest the voice: avoid shouting, prolonged talking and especially whispering, which strains the cords more than gentle speech. Sip water regularly to keep the throat moist, and steam inhalation or a humid room can soothe irritated cords. Avoid smoke and smoky places, cut back on alcohol and caffeine, and if reflux is contributing, avoid eating late at night and large meals before lying down. Stopping smoking protects the voice box and reduces the risk of more serious causes. Most simple hoarseness clears within a couple of weeks; if your voice has not returned to normal after three weeks, arrange to be seen.
Answers
Hoarse voice: frequently asked questions
How long should a hoarse voice last?
Hoarseness after a cold or voice strain usually settles within one to two weeks. A hoarse voice that lasts more than three weeks, or keeps returning without explanation, should always be examined.
When is a hoarse voice serious?
Persistent hoarseness beyond three weeks, particularly in a smoker, can be an early sign of cancer of the voice box, throat or lung. Hoarseness with difficulty swallowing, a neck lump, weight loss or coughing up blood needs urgent assessment.
Can acid reflux make my voice hoarse?
Yes. Acid rising from the stomach can reach and irritate the voice box, leaving the voice rough or croaky, often worse in the morning. Reducing reflux often helps the voice recover.
Does whispering rest my voice?
No — whispering actually strains the vocal cords more than gentle, quiet speech. To rest a hoarse voice, speak softly and sparingly, sip water, and avoid shouting and prolonged talking.
Sources
Where this is drawn from
- NICE CKS: Hoarseness.
- ENT UK: hoarseness and voice problems.
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