Does your throat hurt after a long day of talking or a night of karaoke? Do you wake up hoarse after an evening of screaming at a ball game or concert? Beware: If this happens too often, you can damage your vocal cords.

Occasional vocal cord injury usually heals on its own. However, those who chronically overuse or misuse their voices run the risk of doing permanent damage, says voice care specialist Claudio Milstein, PhD.

He offers tips on the best ways to protect your vocal cords, and what to do when you’ve been too rough on your voice.

What causes vocal cord injury?

As you might imagine, too much yelling isn’t good for your vocal cords. Whether it’s too many rock concerts or frustration that needs a healthier outlet, chronic screaming will strain your vocal cords and can damage them over time.

Other less-known ways you can damage your vocal cords include:

1. Smoking. According to Dr. Milstein, “Smoking can put you at risk for developing cancer of the throat. “And a combination of tobacco and alcohol can increase that risk.
2. Singing too loudly or with poor technique. “People try to imitate what they see on shows like American Idol or The Voice,” Dr. Milstein says. “But if you try to belt out notes like that without knowing how to do it safely, you can damage your voice.”
3. Uncontrolled acid reflux. People often don’t realize that not controlling chronic acid reflux can have an impact on your vocal cords over time.
4. Forcing your voice when you have a cold or bronchitis. If you have a sickness that’s affecting your voice, give your vocal cords a break. Refrain from overuse while you recover.

Vocal cord injuries that these activities cause include:

• Rupture of vocal cord lining and subsequent bleeding.
• Nodules (callus-like growths).
• Fibrosis (thickening of the vocal fold lining)
• Polyps or cysts (fluid collecting in sac-like bumps).

How can you protect your voice?

If your voice is tired after a long day of talking or teaching (or you’re feeling the burn after a night of karaoke), try these tips:

1. Give your voice a rest. If you need to speak, speak quietly and only briefly.
2. Drink plenty of fluids.“Anything that’s soothing is fine,” says Dr. Milstein, whether that’s a cup of hot herbal tea or cooling water.
3. Avoid alcohol and caffeine. These can dehydrate your vocal cords.
4. Avoid the offending activity. If your voice problems are becoming chronic, the best way to avoid damage is to stop doing what you’ve been doing.

“Audiences always clap when people sing those big loud notes,” Dr. Milstein says. “But if people are singing that way without using proper technique, they may end up having voice problems.”

Damage isn’t likely to occur overnight, but you need to take care of your voice over the long term, he says.

“If it’s been going on for a short time and you modify how you sing, it’s reversible,” Dr. Milstein says. “If you continue to do the things that cause the damage, it’s more difficult to treat.”

What if you’ve damaged your voice?

If you have one or two episodes of overuse and your voice gets a little hoarse, you probably haven’t done any serious damage. “If, by the next day, your voice is back to normal, there’s no need to worry,” Dr. Milstein says.

But if you have hoarseness that lasts for more than two weeks, it’s time to see a voice specialist, he says.

Your doctor may prescribe treatment beyond rest and behavior modification, including antibiotics, steroids and anti-reflux medication.

If there is a lesion that doesn’t go away with those treatments, you may need surgery, Dr. Milstein says. And, it’s very important to take care of your voice afterward.

“What people do after surgery is as important as the surgery itself,” he says.

For example, a teacher who has surgery to repair vocal damage and then quickly returns to teaching full time is likely to develop problems again. You need to allow time for your vocal folds to heal before returning to full voice use. If you are a singer or do use your voice a lot, you may need four to six weeks of careful voice use for a full recovery, he says.