How do allergies affect the voice?

It may not seem like it with the rash of rainy cold weather in Los Angeles and snow in the Northeast, but spring is just around the corner. And while we relish the change to lighter clothes and longer, brighter days, spring also brings other shifts.  The bloom of flowers and trees are thrilling to some but others feel a sense of dread.  That’s because with spring comes… pollen.

Different flowers and trees bloom at different times of year and there are geographic variations throughout the country.  However, it seems that the vast majority of allergy sufferers become symptomatic in the spring.

Symptoms include:

  • Fatigue
  • Itchy/watery eyes
  • Runny nose
  • Nasal congestion
  • Sinus pressure
  • Sore or scratchy throat

What are allergies?

Allergies are the result of an overly-aggressive immune system.  Allergens are benign elements in the environment (i.e., cat and dog dander, pollen) that don’t post a threat to health normally but, in allergic people, trigger inflammation and an immune response.

Allergies often feel like a cold because the body mounts the same defenses as it does for illness:

  • Increased nasal secretions
  • Increase eye secretions
  • Inflammation of nasal lining

The body release numerous chemicals into the bloodstream to fight this perceived threat.  The worst culprit is histamine, which is why doctors may prescribe anti-histamines.


Allergies have a profound, if subtle, effect on the voice. The nose, which is the epicenter of most allergic inflammation, is connected to the throat and larynx. Postnasal drip occurs when secretions that form in the nose and sinuses drip into the back of the nose and, from there, drop onto the vocal cords.

postnasal drip.JPG

This irritating drainage causes vocal folds swelling, which can cause:

  • Lowered pitch and range
  • Loss of high notes
  • Decreased resonance
  • Vocal fatigue or hoarseness
  • Cough
  • Increased risk of vocal injury

What should a vocal user do?

Combating allergy requires a delicate balance between drying out the allergic mucous and avoiding overdrying the vocal folds.  Options may include:

  • Sinus Rinse

A staple in the fight against allergy, saline wash rinses away allergic particles before they trigger an immune response.  It washes away mucous and promotes overall good nasal hygiene. Decreased postnasal drip will also reduce the risk of vocal symptoms.

  • Anti-histamine or steroid nasal spray

Nasal sprays are topical treatment in the nose, which is the initial point of contact of allergens in the body.  Because allergens enter through your nose in the air you breathe, fighting the immune response here makes sense.  There is almost no absorption of these chemicals into your body, making this an effective and safe first line of defense.

  • Antihistamine pills

Performers dread taking anithistamines because of a fear of over-drying the vocal folds. Some people are very prone to this side effect.  By working with your doctor (preferably a laryngologist), a balance can be struck. Uncontrolled allergic symptoms are equally damaging to medication side effects for some; neither should be taken lightly.

  • Other medications

Occasionally, the allergy sufferer may require other medications, such as steroids, inhalers, or antibiotics when an infection has occurred.

Consistent management of allergy can have a remarkable effect on vocal health, reducing the risk of injury and improving comfort around vocal use.