I've seen this question frequently on social media and forums, and have also struggled with losing my voice from overuse. At first it's scary, especially when it feels like it may never come back. So, what are the reasons you're losing your voice and how can you fix it? There are various causes…
1. Age
We all know great artists who just don't sound like they used to, it happens. It could be that your voice is a little "worn" (that doesn't mean it sounds bad though!) or it could be from other factors like puberty if you're younger.
If you sing frequently without daily scales and warm-ups, your vocals can start to change not only when you're singing, but also when you're talking. Some of the top singers that have timeless voices recommend always doing scales, and really it doesn't take much time. Scales exercise your vocal cords and helps 'stretch' them so they don't 'breakdown'. If your voice loss/change happens in the 11-14 year-old age range, your factor is probably puberty. For some, this is the end of their singing, but I'd say most people are able to - just continue practicing.
2. Acute Laryngitis
What It Is: Acute laryngitis is the most common cause of hoarseness and voice loss that is suddenly onset. Most cases of acute laryngitis are caused by a viral infection that then leads to swelling of the vocal cords. When your vocal cords swell, they vibrate differently; therefore leading to hoarseness and often slight discomfort.
Treatment: The best treatment is to stay well hydrated and to rest or reduce your voice use. Serious injury to your vocal cords can result from strenuous voice use during an episode. Because acute laryngitis is caused by a virus (often), antibiotics just aren't effective. Bacterial infections of the larynx are much rarer, but do happen. This is often associated with difficulty breathing on top of hoarseness and a sore throat. The best thing I can recommend on top of water is hot tea and a doctors visit.
3. Chronic Laryngitis
What It Is: Chronic laryngitis is a non-specific term and there's an underlying cause which you should try to identify. Chronic laryngitis can be caused by acid reflux disease, exposure to irritating substances such as smoke (even frequent bonfire smoke), and by low grade infections like yeast infections of the vocal cords in people who use inhalers for asthma.
Treatment: Once again, nothing wrong with a little check up. This will help you pinpoint what the underlying problem is and can save you time and get you back to singing.
4. Laryngopharyngeal Reflux Disease (LPRD)
What It Is: Reflux of stanch juice into the throat (yeah, it sounds pretty gross) can cause a variety of symptoms in the esophagus (your "swallowing tube") as well as in your throat. Hoarseness (chronic or intermittent), swallowing problems, a lump in your throat sensation, or throat pain are common symptoms of stomach acid irritation of the throat.
Treatment: There are over the counter things that can provide some help, like anti-acid tablets. But if this persists and you just don't seem to be getting better, seek treatment.
5. Voice Misuse and Overuse
What It Is: The title pretty much covers it. Speaking is a physical task that requires coordination of breathing with the use of several muscle groups. Signing is the same way, and like any physical task there are efficient and inefficient ways to use your voice. Excessively loud, prolonged, and/or wrong voice use can lead to vocal difficulties. If you're in a metal band and you aren't correctly screaming/letting your air out (in general with any genre), you have more of a chance of messing up your voice. Excessive tension in the neck and laryngeal muscles, along with poor breathing technique during singing or (prolonged) speech can lead to vocal fatigue, increased vocal effort (trying to it a range you aren't ready for, etc.), and hoarseness. Voice misuse and overuse puts you at risk for developing (benign) vocal cord lesions or even a vocal cord hemorrhage; both are painful and pricey to fix.
Treatment: Fix what you're doing. If it's screaming, breathing, whatever, just stop. You might need a vocal coach to help you improve your techniques, which in the long run is much cheaper than the cost of (potential) surgeries.
Common situations that are associated with voice misuse
6. Benign Vocal Cord Lesions
What It Is: These are non-cancerous growths that occur on the vocal cords which are most often caused by voice misuse or overuse, which can cause trauma to the vocal cords. These lesions (bumps) on the vocal cord(s) alter vocal cord vibration and change the sound as well as lead to hoarseness. The most common vocal cord lesions are nodules, polyps, and cysts. Vocal nodules (singer nodes) are similar to calluses of the vocal cords. They occur on both vocal cords opposite of each other at the point of maximal wear and tear. The picture (a literal picture even) isn't pretty.
Treatment: Therapy can help eliminate the vocal trauma that's causing lesions in most cases. Contrary to a fairly common myth, vocal nodules are highly treatable and intervention leads to improvement in the majority of cases. Using your voice improperly can sometimes require microsurgical treatment as the cure, along with voice therapy during and after during recovery.
7. Vocal Cord Hemorrhage
What It Is: If you experience sudden loss of voice following screaming, yelling, shouting, or other strenuous vocal tasks (whatever that may mean to you), you may have developed a vocal cord hemorrhage. Vocal cord hemorrhage results when one of the blood vessels on the surface of the vocal cord rupture and the soft tissues of the vocal cord fill with blood. This is considered a vocal emergency.
Treatment: Absolute voice rest until the hemorrhage resolves. Talking will make it worse. Since this is considered a vocal emergency, you need to a/your Otolaryngologist ASPA
8. Vocal Cord Paralysis and Paresis
What It Is: Hoarseness and other problems can occur related to problems between the nerves and muscles within the voice box or larynx. The most common (neurological) condition that affects the larynx is a paralysis or weakness of one or both vocal cords. Involvement of both vocal cords is rare and is usually manifested by noisy breathing or difficulty getting enough air supply while breathing or talking. When one vocal cord is paralyzed or weak, voice is usually the problem. One vocal cord can also become paralyzed or weakened (paresis) from a viral infection of the throat, after surgery in the neck area or chest, from a tumor or growth along the laryngeal nerves, or for other underlying/unknown reasons. Vocal cord paralysis typically presents itself with a soft and breathy voice.
Treatment: Many cases of vocal cord paralysis recover within several months. In more extreme cases, the paralysis will be permanent and may require active treatment to improve and re-strengthen the voice again. Treatment choice really depends on the nature of the vocal cord paralysis, the degree of vocal impairment (how far gone), and the patient's vocal needs. One option is surgery for unilateral vocal cord paralysis that repositions the vocal cord to improve contact and vibration between the cords. Therapy is a given for paralysis and paresis.
9. Laryngeal Cancer
What It Is: Throat cancer, which is a very very serious condition requiring immediate medical attention. Chronic hoarseness warrants evaluation by an otolaryngologist to rule our laryngeal cancer. It is important to remember that prompt attention to changes that seem 'odd' or 'different' within the voice can help facilitate early diagnosis. Remember to listen to your voice because it might be telling you something without words.
Treatment: Laryngeal cancer is highly treatable if diagnosed in it's early stages.
Conclusion
If you have a career in music and rely on your voice, it's just a good (okay, great) idea to find a otolaryngologist before any of things might happen.
An additional note (which while I'm sure you know, I still feel obligated to tell), I am not a doctor. Not a shocker, obviously, but that means that this is not medical advice. If you feel like something is seriously wrong with your voice, just go to a doctor. Don't wait until it gets so bad that you can never sing again. Singing is a very enjoyable thing, and I would hate for anyone to ignore a vocal issue that needs treatment.
1. Age
We all know great artists who just don't sound like they used to, it happens. It could be that your voice is a little "worn" (that doesn't mean it sounds bad though!) or it could be from other factors like puberty if you're younger.
If you sing frequently without daily scales and warm-ups, your vocals can start to change not only when you're singing, but also when you're talking. Some of the top singers that have timeless voices recommend always doing scales, and really it doesn't take much time. Scales exercise your vocal cords and helps 'stretch' them so they don't 'breakdown'. If your voice loss/change happens in the 11-14 year-old age range, your factor is probably puberty. For some, this is the end of their singing, but I'd say most people are able to - just continue practicing.
2. Acute Laryngitis
What It Is: Acute laryngitis is the most common cause of hoarseness and voice loss that is suddenly onset. Most cases of acute laryngitis are caused by a viral infection that then leads to swelling of the vocal cords. When your vocal cords swell, they vibrate differently; therefore leading to hoarseness and often slight discomfort.
Treatment: The best treatment is to stay well hydrated and to rest or reduce your voice use. Serious injury to your vocal cords can result from strenuous voice use during an episode. Because acute laryngitis is caused by a virus (often), antibiotics just aren't effective. Bacterial infections of the larynx are much rarer, but do happen. This is often associated with difficulty breathing on top of hoarseness and a sore throat. The best thing I can recommend on top of water is hot tea and a doctors visit.
3. Chronic Laryngitis
What It Is: Chronic laryngitis is a non-specific term and there's an underlying cause which you should try to identify. Chronic laryngitis can be caused by acid reflux disease, exposure to irritating substances such as smoke (even frequent bonfire smoke), and by low grade infections like yeast infections of the vocal cords in people who use inhalers for asthma.
Treatment: Once again, nothing wrong with a little check up. This will help you pinpoint what the underlying problem is and can save you time and get you back to singing.
4. Laryngopharyngeal Reflux Disease (LPRD)
What It Is: Reflux of stanch juice into the throat (yeah, it sounds pretty gross) can cause a variety of symptoms in the esophagus (your "swallowing tube") as well as in your throat. Hoarseness (chronic or intermittent), swallowing problems, a lump in your throat sensation, or throat pain are common symptoms of stomach acid irritation of the throat.
Treatment: There are over the counter things that can provide some help, like anti-acid tablets. But if this persists and you just don't seem to be getting better, seek treatment.
5. Voice Misuse and Overuse
What It Is: The title pretty much covers it. Speaking is a physical task that requires coordination of breathing with the use of several muscle groups. Signing is the same way, and like any physical task there are efficient and inefficient ways to use your voice. Excessively loud, prolonged, and/or wrong voice use can lead to vocal difficulties. If you're in a metal band and you aren't correctly screaming/letting your air out (in general with any genre), you have more of a chance of messing up your voice. Excessive tension in the neck and laryngeal muscles, along with poor breathing technique during singing or (prolonged) speech can lead to vocal fatigue, increased vocal effort (trying to it a range you aren't ready for, etc.), and hoarseness. Voice misuse and overuse puts you at risk for developing (benign) vocal cord lesions or even a vocal cord hemorrhage; both are painful and pricey to fix.
Treatment: Fix what you're doing. If it's screaming, breathing, whatever, just stop. You might need a vocal coach to help you improve your techniques, which in the long run is much cheaper than the cost of (potential) surgeries.
Common situations that are associated with voice misuse
- Excessive screaming - the wrong way.
- Speaking in noisy situations which causes vocal cord strain.
- Excessive cellular phone use - this is if you're working in an office setting or talking all day.
- Telephone use with the handset cradled to the shoulder. Yep, that's a thing.
- Using inappropriate pitch (too high or too low) when speaking or singing. If you aren't ready for a range, accept it. Work towards it. You won't be able to jump right into it.
- Not using amplification when publicly speaking, this goes back to the yelling thing.
6. Benign Vocal Cord Lesions
What It Is: These are non-cancerous growths that occur on the vocal cords which are most often caused by voice misuse or overuse, which can cause trauma to the vocal cords. These lesions (bumps) on the vocal cord(s) alter vocal cord vibration and change the sound as well as lead to hoarseness. The most common vocal cord lesions are nodules, polyps, and cysts. Vocal nodules (singer nodes) are similar to calluses of the vocal cords. They occur on both vocal cords opposite of each other at the point of maximal wear and tear. The picture (a literal picture even) isn't pretty.
Treatment: Therapy can help eliminate the vocal trauma that's causing lesions in most cases. Contrary to a fairly common myth, vocal nodules are highly treatable and intervention leads to improvement in the majority of cases. Using your voice improperly can sometimes require microsurgical treatment as the cure, along with voice therapy during and after during recovery.
7. Vocal Cord Hemorrhage
What It Is: If you experience sudden loss of voice following screaming, yelling, shouting, or other strenuous vocal tasks (whatever that may mean to you), you may have developed a vocal cord hemorrhage. Vocal cord hemorrhage results when one of the blood vessels on the surface of the vocal cord rupture and the soft tissues of the vocal cord fill with blood. This is considered a vocal emergency.
Treatment: Absolute voice rest until the hemorrhage resolves. Talking will make it worse. Since this is considered a vocal emergency, you need to a/your Otolaryngologist ASPA
8. Vocal Cord Paralysis and Paresis
What It Is: Hoarseness and other problems can occur related to problems between the nerves and muscles within the voice box or larynx. The most common (neurological) condition that affects the larynx is a paralysis or weakness of one or both vocal cords. Involvement of both vocal cords is rare and is usually manifested by noisy breathing or difficulty getting enough air supply while breathing or talking. When one vocal cord is paralyzed or weak, voice is usually the problem. One vocal cord can also become paralyzed or weakened (paresis) from a viral infection of the throat, after surgery in the neck area or chest, from a tumor or growth along the laryngeal nerves, or for other underlying/unknown reasons. Vocal cord paralysis typically presents itself with a soft and breathy voice.
Treatment: Many cases of vocal cord paralysis recover within several months. In more extreme cases, the paralysis will be permanent and may require active treatment to improve and re-strengthen the voice again. Treatment choice really depends on the nature of the vocal cord paralysis, the degree of vocal impairment (how far gone), and the patient's vocal needs. One option is surgery for unilateral vocal cord paralysis that repositions the vocal cord to improve contact and vibration between the cords. Therapy is a given for paralysis and paresis.
9. Laryngeal Cancer
What It Is: Throat cancer, which is a very very serious condition requiring immediate medical attention. Chronic hoarseness warrants evaluation by an otolaryngologist to rule our laryngeal cancer. It is important to remember that prompt attention to changes that seem 'odd' or 'different' within the voice can help facilitate early diagnosis. Remember to listen to your voice because it might be telling you something without words.
Treatment: Laryngeal cancer is highly treatable if diagnosed in it's early stages.
Conclusion
If you have a career in music and rely on your voice, it's just a good (okay, great) idea to find a otolaryngologist before any of things might happen.
An additional note (which while I'm sure you know, I still feel obligated to tell), I am not a doctor. Not a shocker, obviously, but that means that this is not medical advice. If you feel like something is seriously wrong with your voice, just go to a doctor. Don't wait until it gets so bad that you can never sing again. Singing is a very enjoyable thing, and I would hate for anyone to ignore a vocal issue that needs treatment.