Vocal Health & Hygiene Considerations
“What can I do to promote healthy vocal function during the winter months, Justin?”
“Do you have any recommendations for keeping my voice healthy?”
“What can I do to support my child’s vocal health during audition season?”
For the past several years I’ve presented and guest lectured on the importance of vocal hygiene at music studios, universities, and various arts organizations. While many people have received the advice to “drink 8-10 eight ounce glasses of water a day,” that isn’t exactly true for all individuals. While my background is in vocal performance and vocal pedagogy, over the past twelve years of teaching voice, I’ve come to the realization that there are a lot of myths and “not quite truths” that are perpetuated by well-meaning individuals. In this article I hope to demystify and provide clarity on what vocal hygiene is, provide tips on how to promote vocal health and longevity, as well as provide guidance to a wider audience than the students I see on a weekly basis in my studio.
What is Vocal Hygiene?
Vocal Hygiene can be defined as the proper maintenance and usage of the voice.
It’s important to have good vocal hygiene if you use your voice regularly in your work or personal life.
Proper vocal hygiene is not just limited to singers and actors, but also to any sort of public speaker or person who uses their voice the majority of the time they’re at work: teachers, preachers, broadcasters, singers, actors, telemarketers, are just a few professions where regular voice use occurs.
Why is Vocal Hygiene Important?
We’re born with one vocal instrument. We may be close to the day when vocal fold tissue may be repaired completely back to optimal health or medically replaced through tissue grown in a lab, but we aren’t there quite yet for the vast majority of the population.
Anyone who uses their voice on a daily basis (see: the vast majority of the human population) should be mindful of what they put their voice through and ways to help promote longevity and overall vocal wellness for optimal vocal function
A basic, generalized knowledge of things you can do daily to promote vocal wellness and longevity will serve you well long term and helps to ensure your voice is ready to go for performances, presentations, or simply socializing with friends.
Have you ever lost your voice due to screaming and shouting at a loud party or concert for a day or two? Imagine if that “day or two” lasted significantly longer - weeks, years, the rest of your life. How devastating would that be to you?
General Structure of the Singing Mechanism & Definitions
Epiglottis : A duck-bill shaped piece of cartilage housed within the larynx responsible for directing air to the trachea or food/beverage to the esophagus.
Glottis : The space between your vocal folds.
Vocal Folds : Also sometimes referred to as “Vocal Cords,” these are housed within the larynx and vibrate as air passes upward between them. They consist of five layers (epithelium, superficial/intermediate/deep lamina propria, and the thyroarytenoid “TA” muscle) and are roughly the size of your pinky nail.
Adduction : As it refers to the voice, the coming together of the vocal folds (also known as vocal fold approximation).
Abduction : As it refers to the voice, the separation of the vocal folds (opposite of adduction).
Supraglottis : The area above the glottis.
Subglottis : The area below the glottis.
Trachea : A large membranous tube reinforced by rings of cartilage, extending from the larynx to the bronchial tubes and conveying air to and from the lungs; the windpipe.
Esophagus : Connects the throat to the stomach.
Phonation : The process through which sound is made via the vocal folds.
Vocal Health’s Contributing Factors
There are a multitude of things that play into optimal vocal function on a day-to-day basis. The stage of physical maturity of an individual can play a large role, especially those going through the effects of puberty, pregnancy, hormonal imbalances, etc. Various medications and vitamins/supplements can have immediate and/or lasting adverse effects of optimal vocal function. The purpose of this workshop is to provide a springboard for continued investigation/research into vocal health. This class is not intended to be an exhaustive compilation of vocal hygiene research from the vocal pedagogy / vocology literature.
Basic Daily Short-Term Vocal Health Advice
There are three easy things that you can do on a daily basis to help facilitate optimal vocal function:
Hydration Limiting Irritation Vocal Rest
Hydration
Much of the advice I heard growing up in choir as well as in various health classes suggested drinking 8 to 10 8oz servings of water per day.
The amount of water an individual must ingest daily varies from person to person. Your level of activity, age, height, weight, and environment all factor into how much liquid you must ingest to be sufficiently hydrated.
A common misconception is that you only need to drink water during a performance for the voice to stay hydrated. Drinking water does not immediately hydrate the vocal folds! It takes roughly 9-24 hours for the water that you ingest to actually reach the vocal folds. If it did immediately touch the vocal folds: you would choke or drown.
Cool mist humidifiers are your friend during the winter months or in especially dry environments. Once the furnace kicks on to heat your home, the humidity of the air you breathe begins to decline which in turn causes you to begin losing moisture internally. That means your vocal folds will also begin to lose hydration.
Tip: Put a humidifier in your bedroom and use it at night.
As a singer, coffee is practically my lifeblood. Ingesting beverages that have diuretic (drying) effects should be offset with equal parts water.
Personal Recommendation: Ingest 1.5x the amount of water for every beverage that has drying effects to help offset any diuretic impact it may have on the voice.
Vocal Fold Hydration - Why is it important?
As previously mentioned the vocal folds have five layers:Epithelium |
How does one promote adequate hydration of the vocal folds?
Drink Water / Consume High Water Content Foods - Indirectly Hydrating the Vocal Folds
As previously mentioned, many literature sources cite that the average person must ingest 8-10 eight ounce glasses of water per day. This varies person to person, but is a good general rule of thumb.
Consume foods that have high water content such as melons, vegetables, soups, etc.
Keep in mind, the liquids you ingest will take around 9-12 hours to reach the vocal fold tissue.
Increase Environmental Humidity - Directly Hydrating the Vocal Fold Tissue
During the winter months especially I advise my students to invest in a cool mist humidifier for their bedroom. When we sleep, especially when using space heaters or the furnace is on, we breathe in dry air and breathe out humid air. If you’re anything like me and you cocoon yourself in comforter blankets and sweat a lot at night, you’re also losing moisture through your sweat.
Do you often wake up with thickened mucus in the mornings? This can be an indicator of dryness in your sleeping environment.
Search Amazon for “cool mist humidifier” for a plethora of results at different price points. Check the square footage output for each unit and also keep the water tank and ultrasonic mechanism clean of lime scale and mold by following manufacturing instructions on cleaning the device.
Take a steamy shower first thing in the morning and breathe in the steamy air. Keep in mind, if you’re standing in the hot shower water, you will likely be sweating, so while the steam itself will directly apply a bit of hydration to the vocal folds, you may likely also sweat in the warmth of the shower.
Invest in a personal nebulizer such as the Vocal Mist Personal Nebulizer (or if cost prohibits, search for “mesh nebulizer” on Amazon for cheaper options) which is used 20-30 minutes prior to warming up to directly hydrate the vocal fold tissue. Nebulizers create microscopic water particles through ultrasonic vibration which can then be inhaled. The water particles pass over the vocal fold tissue during inhalation and are absorbed directly into the outer layers (cover) of the vocal folds.
When using a nebulizer, you must use a .9% Saline Solution. Do not use tap water with a nebulizer as contaminants found in tap water can be directly inhaled into the lungs, increasing risk of respiratory infection. Utilizing a .9% Saline Solution also aids in the absorption into the vocal fold tissue and mucosal lining of the airways.
Always follow the instructions that come along with your nebulizer for optimal function and benefits.
After you’ve used your voice in performance or rehearsal, you can help restore moisture lost during singing/speaking by using a personal steamer. Vicks (the manufacturers of VapoRub and DayQuil) has an affordable personal steamer generally for around $40 USD that can be used to help restore vocal fold hydration.
When using a personal steamer it is recommended to use filtered water, though it is generally thought to be safe to use tap water in steamers that boil water. Using filtered water, however, will help with reducing buildup / scale in the device itself.
Limiting Irritation
We’ve all been there: Breathing normally during a performance and then the HVAC kicks on and dust particles are thrown into the air and then audience members (or yourself) begin coughing profusely. No? Just me?
When we breathe in, air and other fumes pass directly over the vocal folds as they travel down the trachea, through the bronchial tubes, and into the lungs.
If you are someone who is particularly sensitive to dry, dusty, or overly odiferous environments, try to avoid them if possible. Wearing a K95 mask can be helpful in avoiding a coughing fit when you’re in an environment with allergens and/or other airborn particles.
If you’re particularly sensitive to pollen or pet dander, be sure to monitor pollen indexes or clean / treat surfaces that track pet dander regularly.
An air purifier can be very helpful around the home and at work. Be sure to regularly change your furnace filters to ensure that dust does not get thrown back into the air circulating in your home.
Limit how often you shout or speak at an elevated level. If you’re someone who has to get the attention of others regularly, either use amplification (mic & PA System) or rely on white noise sounds (“Shh,” “Ssss,” “Ffff”) in various atypical patterns, as they provide an audible signal which spans low, mid, and high frequencies which can typically be heard regardless of other noises taking place. Using varied rhythmic patterns that are unique to certain tasks can help cue others to what you’re requesting without expending any vocal effort. Work smarter, not harder, and don’t abuse your voice!
Try not to excessively clear your throat, cough, or speak in vocal fry. Excessively clearing your throat or coughing typically cause the vocal folds to adduct forcefully. Instead, swallow or hum gently. While vocal fry has therapeutic applications for the voice, habitual usage can lead to irritation of the vocal fold tissue.
Excessive glottal attacks (forceful adduction of the vocal folds, typically followed by phonation or abrupt release of subglottal pressure) should be avoided in daily speech (and singing unless otherwise called for). According to Karla O’Dell, MD, assistant professor of clinical otolaryngology and a laryngologist from the USC Voice Center at Keck Medicine of USC, “Whispering requires more effort than using our voice at a regular volume.”
Avoid whispering when possible! Instead, speak at a lower volume.
If you smoke or are around people who smoke regularly: quit and/or limit your time around others who do. This includes, but is not limited to cigarettes/cigars, marijuana, vape products, etc. When you smoke or inhale substances, the vapors of those substances come in direct contact with the vocal folds and can cause irritation, have drying effects, increase mucus, etc. Fumes from everyday items (cleaning supplies, beauty products, air fresheners) can also have irritating effects on the voice. If you are someone who is sensitive to certain smells, be mindful of your time spent around them.
Monitor the foods you ingest. Certain foods can cause you to develop excess mucus, cause irritation of membranes within the vocal tract, incite acid reflux, or trigger inflammation. For example, if you know that spicy foods cause bad acid reflux, avoid or limit ingesting them, or if dairy products cause a huge glob of mucus in your throat for a few hours, you probably shouldn’t drink a milkshake prior to singing.
Develop and maintain vocal warm up & cool down habits that can be executed first thing every morning, especially on days you know will require intensive vocal use. This can be simple as five minutes of intentional humming, lip trills, or straw-phonation as you’re getting ready in the morning. Speak with your voice teacher / vocal coach for their assistance in developing a system that works for you! Looking for guidance on warming up? Sign up for a voice lesson with one of our voice specialists!
Vocal Rest
Just as we rest our bodies when we sleep, so too should we rest our voice throughout the day. With my students, I use the mental image of a fuel gauge for “vocal fuel” we have throughout the day. That gauge can only be refilled through sleep and resting the voice.
Did you know that you can mentally practice songs when giving your voice a rest? I often interact with people who shamefully exclaim after failed auditions that their voice was tired during their audition. I typically ask those individuals if they were singing their song(s) repeatedly prior to the audition to rehearse the words, and unsurprisingly the majority of the time they say yes. The time for preparation is not the day of or hours leading up to a performance or audition, but the days and weeks (sometimes months!) leading up to a performance. Spare your voice when you can and work on memorization or developing character / intent silently.
Make sure you warm up AND cool down the voice before and after extended voice usage. Effective, low-impact ways to warm up or cool down the voice are lip trills, straw phonation, and light to humming for a few minutes.
A simple exercise I like to have my notoriously vocally hoarse students complete for a week or two is to (honestly) track their voice usage throughout the day whether it be socializing with friends, speaking at work, warming up / practicing / cooling down the voice, in a daily log detailing an approximate amount of vocal usage versus vocal rest. If the only time you’re resting your voice is while you sleep, consider scheduling “silent” times for yourself.
Long Term Vocal Maintenance
There are a multitude of things one can do to promote long-term vocal health.
Eat a healthy diet and regularly exercise.
Practice good vocal habits: limit loud usage, sing songs appropriate to your vocal register, develop a functional vocal technique.
Warm-Up/Cool Down the voice daily.
Don’t overexert your voice.
If you’re serious about using the voice long term for speaking or singing, develop a baseline of healthy vocal function by scheduling an appointment with an otolaryngologist (Ear Nose Throat Doctor) who specializes in working with singers, and have a stroboscopy performed.
Consult medical professionals (specifically an ENT) if you experience any of the following for longer than two weeks:
Long term hoarseness that refuses to go away.
Frequent vocal fatigue.
Experience frequent vocal strain.
Experience frequent heartburn.
Have moderate to severe allergies which interfere with phonation.
For those of you accessing this information from the Central Ohio area, The Ohio State University is host to an excellent otolaryngology department. Dr. Forrest, Dr. Michelle Toth, and Heath Barron all specialize in working with singers. I regularly refer students and community members to OSU’s Otolaryngology Department for assessment, and if necessary, treatment.
If you are someone heading off to, or currently studying in a voice / theater program in university, check with your department head to see if your university offers free or reduced price voice examinations.
Medications OTC/Prescribed Considerations
Various over the counter medications can affect the voice adversely and should be used with caution when heavy voice use occurs or is expected to occur to prevent vocal injury. Antihistamines and decongestants typically result in a drying effect on the vocal folds.
Aspirin, Ibuprofen, and other NSAIDS (non-steroidal anti-inflammatories) should be avoided due to their cause of an increased risk in vocal fold hemorrhage (the bursting of one or more blood vessels within the vocal fold and yields hoarseness in the singing and/or speaking voice). These products thin the blood by coating platelets that form a clot. A single dose of aspirin will affect the platelets for 7 days; a single dose of ibuprofen or other NSAID will affect them for 48 hours. Acetaminophen, does not possess the same effects, and is generally considered safer for singers. A complete list of aspirin & NSAIDS may be found by googling “NSAID List.” Alcohol & THC have similar thinning effects on the blood and should be avoided or eliminated entirely, especially before or during voice usage.
Have you added or changed a medication into your daily routine recently? Check with your healthcare provider what side effects your medication may have on the voice. Common acne medications, certain ADHD medications, and other prescribed medications often have drying side effects which can impact vocal function.
Final Recommendations
While this article is a brief and general overview for promoting one’s vocal health, this is not the end of your learning! Ask your teacher (if you have one) for their advice. Do independent reading of your own on the topic. Check with your healthcare provider for their recommendations. Nothing in this article is meant to be medical advise, so seek out a secondary professional opinion from a laryngologist or speech language pathologist (SLP) who specializes in vocal health.
Sing (and speak) with a well supported sound. If you begin to run out of breath at the end of a sentence: breathe! Don’t be a hero and try to squeeze out the last few ounces of air in your lungs as it will often lead to excess tension in the intrinsic (internal) and extrinsic (external) muscles of the larynx, your expiratory musculature, and potentially as far up as your tongue and chewing muscles in your jaw.
Be mindful of your voice usage.
Try to avoid exerting a great deal of excess tension, especially when making sounds with your voice that could be potentially harmful (vocal fry, growling, yelling, etc).
About the AuthorJustin T. Swain has served as an Instructor of Commercial & Musical Theater Voice at Otterbein University and served four years on the voice faculty at Ohio University where he was Assistant Professor of Instruction in Voice & Lyric Diction, served as a Faculty Fellow in the Center of Teaching, Learning, and Assessment, and advised several student acapella student organizations. He is currently pursuing his Doctor of Musical Arts in Vocal Pedagogy with a specialization in Voice Research through the Shenandoah Conservatory at Shenandoah University. Swain has also earned the Master of Music in Vocal Performance, Master of Arts in Vocal Pedagogy, and Bachelor of Music in Vocal Performance degrees from The Ohio State University and is a graduate of New York University's Vocology Certificate program. He also holds certificates in Vocal Pedagogy from the Voice Study Center (University of Wales) and the Boston Conservatory at Berklee.As a pedagogue, Swain was recognized by the National Association of Teachers of Singing and was privileged to serve as a NATS Intern (2023-2024) at Florida State University where he worked with Master Teacher Mike Ruckles and performed in a myriad of vocal masterclasses and workshops. He serves on the board of directors for the Ohio Chapter of the National Association of Teachers of Singing and regularly presents and guest lectures on vocal health, contemporary voice pedagogy, and teacher education. |
