Patient Basics: Chronic Laryngitis

Chronic laryngitis is swelling and irritation of the voice box (larynx) that lasts more than three weeks. The main sign is a hoarse, rough or weak voice that doesn’t get better. Common causes include acid reflux, smoking and heavy voice use. Hoarseness that lasts longer than about four weeks should be checked by a doctor who can look at your vocal cords.

Key points

• Short bouts of laryngitis usually come with a cold. Chronic laryngitis has other causes, which need to be found.
• Stomach acid rising into the throat, smoking or vaping, and overusing the voice are the most common causes.
• An ear, nose and throat doctor (ENT) can look at your vocal cords with a thin camera in a short office visit.
• Treatment means removing the cause, caring for your voice and, often, voice therapy.
• Get prompt care for hoarseness with trouble breathing or swallowing, coughing up blood, or a lump in the neck.

How the voice box works

The larynx sits at the top of the windpipe, behind the Adam’s apple. Inside are two bands of muscle and soft tissue called the vocal cords (vocal folds). When you speak, air from the lungs makes them vibrate hundreds of times a second. If they swell or stiffen, they can’t vibrate smoothly or close fully, and the voice turns hoarse, breathy or weak.

What causes chronic laryngitis

• Reflux. Stomach acid and digestive enzymes can rise up the food pipe and spill onto the larynx. This is called laryngopharyngeal reflux, or silent reflux, because many people never feel heartburn.
• Smoking and vaping. Smoke and vapor dry and irritate the vocal cords. Smoking is also the biggest risk factor for cancer of the larynx.
• Heavy voice use. Teachers, singers, coaches, call center staff and others who talk loudly or for long hours are at higher risk.
• Allergies and sinus problems. Mucus dripping down the back of the throat leads to constant throat clearing, which irritates the cords.
• Inhaled steroid medicines. Asthma and COPD inhalers can irritate the larynx or allow a yeast infection to grow there.
• Irritants in the air. Chemical fumes, dust and very dry air can all play a part.
• Heavy drinking. Alcohol dries the throat and can worsen reflux.
• Less common causes. These include tuberculosis and other infections, autoimmune conditions such as rheumatoid arthritis, and changes in the voice with age.

Often two or more causes work together.

Symptoms

• A hoarse, raspy, breathy or weak voice
• A voice that tires as the day goes on
• Trouble reaching high notes or speaking loudly
• Frequent throat clearing or a dry cough
• A dry, scratchy or raw throat
• A feeling of a lump in the throat

How it’s diagnosed

Your doctor will ask how long you’ve been hoarse, how you use your voice, and about smoking, reflux, allergies and medicines. An ENT doctor can then look directly at your vocal cords:

• Laryngoscopy. After a numbing spray, a thin, flexible camera is passed through the nose to the back of the throat. A rigid scope placed at the back of the mouth is another option. It takes a few minutes, and you stay awake.
• Stroboscopy. A flashing light shows the vocal cords in slow motion as you speak or hum, so the doctor can see how they move.

The exam may show redness and swelling, thick mucus, or growths such as nodules, polyps or cysts. If anything looks unusual, a small tissue sample (biopsy) may be taken. Allergy testing or tests for reflux are sometimes added.

Chronic laryngitis treatment

Treating the cause

• Reflux. Eat smaller meals, stop eating two to three hours before bed, raise the head of your bed, and cut back on alcohol, coffee and spicy or fatty foods if they bother you. Your doctor may suggest a trial of acid-reducing medicine such as omeprazole for a few months.
• Smoking and vaping. Quitting is the most helpful step. Your doctor can help with medicines and support.
• Allergies. Saline rinses, steroid nose sprays or other allergy medicines may help.
• Inhalers. Use a spacer and rinse your mouth and gargle after each dose. Ask whether a different inhaler would suit you.
• Infection. A yeast or other infection is treated with the right medicine.

Caring for your voice

• Drink plenty of water through the day.
• Use a humidifier if the air is dry.
• Speak at a comfortable volume. Don’t shout, and don’t whisper, which strains the cords too.
• Rest your voice during the day and use a microphone if you speak to groups.
• Try a sip of water or a swallow instead of clearing your throat.

Voice therapy

A speech-language pathologist trained in voice can teach you healthier ways to breathe and speak. Voice therapy helps many people with chronic laryngitis and is often the main treatment for nodules caused by voice strain. Surgery is needed only for some growths that don’t respond.

Living with it

With the cause treated, most people’s voices improve over several weeks to a few months. Reflux-related laryngitis can take two to three months to settle. Keeping up good voice habits helps prevent it from coming back.

When to see a doctor

• Hoarseness that lasts more than four weeks, or sooner if you smoke
• Pain when speaking or swallowing
• Ear pain on one side along with hoarseness
• A lump in the neck
• Losing weight without trying
• Your voice is needed for your job and changes keep coming back

Get emergency care if you have noisy or difficult breathing, can’t swallow your saliva, or cough up blood.

Common questions about chronic laryngitis

Why do I keep getting laryngitis?

Laryngitis that keeps coming back (recurrent laryngitis) usually has an ongoing trigger, such as silent reflux, voice strain, smoking, allergies or an inhaled steroid. Growths on the vocal cords, such as nodules, can also make the voice give out easily. If it happens several times a year, an ENT doctor can look for the cause.

Can chronic laryngitis be cured?

Usually, yes. Once the cause is treated, most people’s voices recover over weeks to months. Laryngitis is rarely permanent, but years of smoking or untreated reflux can leave the vocal cords thickened or scarred, and some voice change may stay. Voice therapy can still help in these cases.

Is chronic laryngitis dangerous?

Usually not, but long-lasting hoarseness can also be a sign of something more serious, such as cancer of the larynx or a paralyzed vocal cord. People who smoke or drink heavily have a higher risk. That’s why hoarseness lasting more than four weeks should be checked with a scope, even if you feel well.

Is laryngitis contagious?

Chronic laryngitis isn’t contagious, because it comes from things like reflux, smoke or voice strain. Short-term laryngitis from a cold or flu can be, because the virus behind it spreads to others. Washing your hands and covering coughs lowers the chance of passing it on.

How long does laryngitis last?

A bout that comes with a cold usually clears in one to two weeks. No remedy cures laryngitis in 24 hours, but resting your voice, sipping water and breathing moist air help it heal. Laryngitis that lasts more than three weeks is chronic and can take a few months to settle once the cause is treated.

Questions to ask your doctor

• What do you think is causing my hoarseness?
• Do I need a scope exam of my vocal cords?
• Could reflux be involved even though I don’t have heartburn?
• Would voice therapy help me?
• How long should it take for my voice to improve?

Learn more

• Laryngitis (MedlinePlus, U.S. National Library of Medicine)
• Laryngitis (NHS)

This guide is general information and doesn’t replace advice from your own doctor. Last updated October 2026.