Laryngitis Treatments and Medications

Laryngitis results from inflammation of the larynx, near the very top of the windpipe, called the voice box. The larynx, also called the Adam’s apple, primarily protects the respiratory system from breathing in food while eating. It also houses the vocal cords (vocal folds), which is why hoarseness or voice loss results when the larynx is swollen. Acute laryngitis (short-term laryngitis), a common condition, usually resolves in three to seven days, but chronic laryngitis, which is less common, is an inflammation of the larynx that lasts for three weeks or longer. Treatment focuses on voice rest, steam inhalation, and treating any underlying cause.

How is laryngitis diagnosed?

A laryngitis diagnosis is usually made based on symptoms, medical history, and a physical examination. It is usually diagnosed and treated by a general practitioner or registered nurse practitioner, but a speech-language pathologist may also be involved in diagnosis and treatment.

Symptoms of laryngitis most commonly include: 

• Voice changes (hoarseness, raspiness, or voice loss) 

• Early vocal fatigue 

• Throat pain or “tickling”

• Frequent throat clearing 

• Dry cough

Other symptoms might include difficulty breathing, shortness of breath, wheezing, drooling, or difficulty swallowing. But these often indicate a more serious condition, such as epiglottitis, a swelling of the epiglottis, the flap of tissue that covers the larynx to prevent food from going down the trachea (windpipe).

The history of the symptoms will help the healthcare professional nail down a cause. Risk factors of laryngitis that may point to a cause include:

• Recent illness or exposure to sick people

• Acid reflux

• Allergies

• Asthma

• Immune status

• Travel

• Medications

• Smoking

• Alcohol use 

• Recent injuries or neck surgery

• Activities or occupations that involve overuse of the voice (teachers, coaches, call center employees, singers, etc.)

In most cases, symptoms and history are enough for a diagnosis. If there’s any suspicion of a more serious problem or the laryngitis has persisted for more than three weeks, the provider will use laryngoscopy to view the larynx itself. The procedure can be performed during an office visit without medications. Imaging, such as X-rays or CT scans, will not usually be necessary.

Laryngitis treatment options 

Laryngitis typically resolves in a few days, even without treatment, so treatment is largely conservative and supportive. Voice rest, steam inhalation, over-the-counter pain relievers, irritant avoidance, and treatment of the underlying cause are the pillars of laryngitis treatment.

Supportive care

No matter what the cause, laryngitis is best treated by giving the voice a rest by reducing vocal activity as much as possible. Steam inhalation and drinking fluids also help to soothe irritated tissue, reduce symptoms, and support healing.

Medications

Pain, sore throat, and dry cough are most effectively relieved with over-the-counter pain relievers. In severe cases, or for voice professionals, a healthcare provider may prescribe oral or inhaled corticosteroids to rapidly reduce swelling. Other medications will be used only to treat the underlying cause, not the laryngitis itself. Because laryngitis is not usually caused by a bacterial infection, healthcare providers rarely prescribe antibiotics.

Underlying cause

When identified, the underlying condition must be managed. If laryngitis is caused by acid reflux, dietary changes and medications that reduce stomach acid may be prescribed. 

Laryngitis caused by medications or irritants will be treated by discontinuing the medication or avoiding the irritant. In particular, tobacco users will be advised to quit smoking to relieve chronic laryngitis due to smoking. Allergies will be treated with allergy medications and lifestyle changes. Laryngitis due to an upper respiratory infection caused by bacteria or a fungus will be treated with the appropriate antimicrobial medications, either antibiotics or antifungals. 

Voice therapy

In cases of chronic laryngitis, voice therapy trains patients in vocal behaviors and lifestyle changes that help preserve the voice. Sessions are directed by speech-language therapists and usually last for four to eight weeks. 

Types of laryngitis medication 

Most cases of laryngitis resolve in a few days with adequate voice rest and supportive care. Over-the-counter pain medicines, such as Tylenol (acetaminophen) or an NSAID such as Motrin (ibuprofen), can help relieve symptoms while you recover. 

Over-the-counter laryngitis medicine

Sore throat pain, throat irritation, and dry cough are best handled with over-the-counter (OTC) analgesics such as acetaminophen, ibuprofen, naproxen, or aspirin. Topical medications or remedies such as saltwater, over-the-counter throat lozenges, sore throat syrups, hard candy, herbal teas, herbal sprays, or herbal lozenges only work by coming in contact with inflamed or irritated tissues and so will help only with irritation in the throat itself, but will not treat the underlying swelling. 

Corticosteroids

For severe laryngitis cases or voice professionals, a physician may prescribe an oral or inhaled corticosteroid, such as prednisone, to rapidly reduce swelling. Because of the side effects, corticosteroids are only rarely used. 

In most cases, the best treatment for laryngitis is vocal rest, steam inhalation, and proper hydration. Medications are used to treat a possible underlying cause or to provide symptom relief.

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