Coughing is a reflex action that helps clear irritants or secretions from the lungs and airways. It is common to experience occasional coughing when you have a cold, flu, or allergies. However, chronic or excessive coughing can potentially cause damage to your vocal cords and voice over time. In this article, we will explore whether frequent coughing can harm your voice, the mechanisms involved, risk factors, and ways to prevent potential vocal damage from coughing.
Can excessive coughing damage your vocal cords?
Yes, chronic or forceful coughing can potentially injure your vocal cords and lead to voice problems. Here’s why:
Coughing exerts force on the vocal cords
When you cough, air is forcefully expelled from the lungs through the trachea and vocal cords at high speeds. This places significant pressure on the vocal cords, forcing them to slam together repeatedly. Over time, the repetitive trauma of coughing can irritate, inflame, and damage the vocal cord tissues.
Coughing can cause vocal cord hemorrhage
Studies show prolonged coughing episodes can cause minor hemorrhages or small bleeds on the vocal cord surface. This is known as a vocal cord hemorrhage or submucosal hemorrhage. The blood vessels just under the vocal cord lining (mucosa) can rupture from the shear forces of repeated coughs.
Coughing leads to vocal cord swelling
The trauma and irritation from frequent coughing triggers inflammation and swelling (edema) of the vocal cords. Vocal cord edema narrows the vibrating portion of the cords, impairing vibration and altering voice production.
Coughing promotes vocal cord lesions
Repeated irritation from coughing can cause benign vocal cord lesions such as nodules, polyps, and cysts. These noncancerous growths on the vocal cords interfere with normal voice function.
How can excessive coughing alter your voice?
Frequent coughing can lead to several types of voice problems:
Hoarse, breathy voice
Inflammation and swelling makes the vocal cords unable to come together properly. This causes a hoarse, raspy, or breathy voice.
Loss of vocal range and projection
Vocal cord lesions and swelling reduces the mucosal waves needed for controlled voice modulation. This impairs vocal range, power, and projection.
Vocal fatigue
Overworking the voice through repeated coughing episodes can cause muscle tension and vocal fatigue. This makes it difficult to sustain phonation.
Vocal cord scarring
In severe cases, chronic trauma may produce vascular changes and permanent scarring of the vocal cord tissues. This can lead to long-term hoarseness and vocal dysfunction.
Who is at risk for cough-related vocal cord damage?
Certain individuals are at higher risk for their voice being affected by frequent coughing:
People who cough chronically due to medical conditions
Those with chronic cough-producing illnesses like asthma, COPD, bronchitis, GERD, post-nasal drip, and smoking have greater risk as they cough repeatedly throughout the day.
Singers or vocal performers
Singers, teachers, coaches, and other heavy voice users are vulnerable as their vocal demands are high. Any vocal impairment from coughing can significantly impact their abilities.
Children and the elderly
Children and older adults tend to have more sensitive vocal cord tissues that are more prone to injury from excessive coughing.
Individuals with prior voice disorder history
Those with a past history of vocal trauma, nodules, or surgery have increased vulnerability. Their vocal cords are unable to withstand the same degree of stress.
How to prevent voice damage from coughing
You can take steps to protect your voice from frequent coughing:
Treat the underlying cause of coughing
Address medical conditions causing chronic cough through proper treatment. This reduces cough frequency.
Avoid throat clearing
Throat clearing further strains the vocal cords. Use conservative voice use and sip water instead.
Maintain vocal hygiene
Stay well hydrated, limit caffeine/alcohol, avoid yelling/whispering, and rest your voice after prolonged coughing.
Use cough drops/lozenges
Cough drops can soothe throat irritation and suppress the cough reflex. Avoid menthol lozenges as they may promote coughing.
Use a humidifier
Humidifying the air helps hydrate and lubricate vocal cord tissues made drier by frequent coughing.
Try honey or herbal remedies
Honey and herbs like licorice, marshmallow, and slippery elm may coat and soothe irritated throat and vocal cord tissues.
See an otolaryngologist if hoarseness persists
Seek medical help if your voice remains hoarse for over 2 weeks after your cough subsides to assess for potential vocal cord injury.
When to see a doctor
Consult your physician promptly if you experience:
– Hoarseness lasting over 2 weeks
– Blood-tinged sputum after coughing
– Difficulty speaking or voice loss
– Shortness of breath or wheezing with cough
This can indicate a possible vocal cord lesion, respiratory infection, or other problem requiring medical attention.
Diagnosing cough-related voice disorders
To assess voice changes after prolonged coughing, the otolaryngologist may perform:
Laryngoscopy
Using a thin, flexible endoscopic camera inserted via the nose to visually inspect the vocal cords. This detects swelling, lesions, scarring, or abnormal movement.
Stroboscopy
Laryngoscopy with stroboscopic light allows assessment of vocal cord vibratory function in slow motion detail.
Acoustic voice analysis
Records and analyzes parameters like vocal intensity, range, perturbation, and frequency to identify abnormalities.
Patient history and examination
Your doctor will ask about your cough duration, voice symptoms, and risk factors. A neck and throat exam is done to feel for swelling or masses.
Treatment options for cough-damaged vocal cords
Treatments your doctor may recommend include:
Voice therapy
Working with a speech-language pathologist to retrain vocal function through vocal hygiene education and voice exercises.
Medications
Corticosteroids help reduce vocal cord swelling and inflammation. Cough suppressants can provide temporary relief.
Surgery
Removal of vocal cord lesions, polyps, or nodules by laser or microsurgery. Injected bulking agents treat glottal insufficiency.
Vocal rest
Avoiding talking and whispering for several days allows the vocal cords to heal after excessive coughing.
Preventing further vocal cord damage
After treatment for cough-related voice problems, continue protecting your vocal health by:
– Drinking plenty of water
– Avoiding irritants like smoke
– Managing reflux if present
– Using amplification if needed vocally
– Practicing vocal relaxation techniques
– Doing vocal warmups and gentle strengthening exercises
– Following up with your otolaryngologist
With proper care, most cases of cough-damaged voices can heal and regain normal function over time. Seek prompt attention for any persistent voice changes after frequent coughing.
Conclusion
Chronic or severe coughing can indeed harm vocal cord tissues, leading to inflammation, lesions, scarring, and hoarseness. Those at highest risk include people with chronic coughs and heavy voice users. To help prevent vocal damage from frequent coughing bouts, treat the underlying cause, use cough suppression methods, maintain vocal hygiene, and see a doctor if voice problems persist. With the proper diagnosis and management, the prognosis for cough-induced voice disorders is generally good. Paying attention to vocal health is important for anyone prone to repeated coughing spells.