Why the voice becomes hoarse
The voice is made by the two vocal cords vibrating in the voice box (larynx). When they are swollen they cannot vibrate freely, and the voice becomes hoarse or weak. The most common cause is laryngitis during a cold or flu, which usually goes away by itself within one to two weeks. Straining the voice, coughing or clearing the throat for a long time, acid from the stomach reaching the throat, and allergies to dust and fumes can also make the voice hoarse.
What helps in the first days
Speak as little as possible, and neither whisper nor talk loudly: both strain the voice. Drink plenty of fluids, keep the air in the room moist, do not smoke, and stay away from smoky and dusty places.
When to have it examined
See a doctor if the hoarseness has not improved after two weeks, or if voice problems keep coming back. A hoarse voice that lasts more than three weeks should be examined by a doctor, especially from the age of forty-five. Most of the time the cause is not serious; an examination is the way to find out. Difficulty breathing needs medical help at once.
How the voice box is examined
An ear, nose and throat doctor looks at the vocal cords with a small mirror or with a thin endoscope passed through the nose, which takes a few minutes in the consulting room. If an area looks abnormal, a small sample of tissue (a biopsy) may be taken, usually under a short general anaesthetic, to be examined under a microscope.
What follows
Treatment depends on the cause: resting the voice, treating reflux or an infection, voice therapy, or removing a growth from a vocal cord. When a growth is found on a vocal cord, what is done next depends on what the sample shows.
This article gives general information; it does not replace an examination, a diagnosis or treatment.