Scratchy Throat: 13 Possible Causes (& What to Do)

A scratchy throat is a very common symptom that can develop due to a cold or the flu, allergies, sinusitis, COVID-19, excessive voice use, or gastroesophageal reflux disease (GERD). These conditions can irritate or inflame the throat, larynx, or tonsils and may be accompanied by other symptoms such as coughing, difficulty swallowing, sore throat, or fever.

To relieve a scratchy throat, it’s important to stay hydrated by drinking plenty of fluids, rest, and avoid talking too much. It’s also recommended to steer clear of substances that can trigger allergies or irritate the throat.

However, it’s best to see an ENT specialist or general practitioner if the scratchy throat worsens quickly or comes with other symptoms. The doctor can identify the cause and recommend the most appropriate treatment, which may include pain relievers, anti-inflammatory medications, and, in some cases, antibiotics.

Main causes of a scratchy throat

A scratchy throat can have many different causes, ranging from mild viral infections to allergies, reflux, or even more serious conditions like throat cancer.

1. Cold and flu

Colds and flu are the most common causes of a scratchy, irritated, or sore throat. They are caused by viral infections such as influenza or rhinoviruses, which can enter through the nose and affect the throat lining.

Along with a scratchy throat, these infections can cause coughing, fever, sneezing, headaches, and body aches.

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What to do: Stay hydrated, rest, and follow your doctor’s recommendations. Over-the-counter medications such as acetaminophen, ibuprofen, or loratadine may be used to relieve pain, inflammation, or nasal congestion.

2. Pharyngitis

Pharyngitis is inflammation of the pharynx, located at the back of the throat. It can be caused by viruses such as adenovirus, rhinovirus, or influenza, or by bacteria like Streptococcus pyogenes. Common symptoms include sore throat, difficulty swallowing, and a scratchy or itchy sensation in the throat.

In some cases, fever, headache, general discomfort, and hoarseness may also occur.

What to do: Treatment depends on the cause and symptoms. Pain relievers or anti-inflammatory drugs like acetaminophen or ibuprofen may be used to reduce pain, fever, or inflammation. If a bacterial infection is confirmed, antibiotics may be prescribed. Rest and drinking plenty of fluids are also recommended.

3. Bacterial tonsillitis

A scratchy throat can also be caused by bacterial tonsillitis, which is an infection of the tonsils usually caused by Streptococcus pyogenes.

Other symptoms may include severe sore throat, difficulty swallowing, high fever, and pus in the throat.

What to do: Treatment should be prescribed by an ENT doctor and typically involves antibiotics such as amoxicillin, azithromycin, clindamycin, or cephalosporins.

4. COVID-19

COVID-19 is a respiratory infection that may initially cause fever, fatigue, and a dry cough, often accompanied by throat irritation or a scratchy sensation.

What to do: It’s important to self-isolate and get tested with a rapid COVID-19 test or a PCR test as recommended by your doctor. Treatment focuses on relieving symptoms under medical supervision.

5. Sinusitis

Sinusitis is inflammation of the sinuses, which are small air-filled cavities around the nose and eyes. It’s usually caused by allergies or viral, fungal, or bacterial infections that lead to mucus buildup.

Excess mucus can drip down the back of the throat, known as postnasal drip, causing coughing, swelling, irritation, and a scratchy throat.

What to do: Sinusitis treatment generally includes pain relievers, anti-inflammatories, nasal decongestants, or antibiotics as prescribed by an ENT doctor. Nasal saline rinses or steam inhalation can also help loosen mucus, ease breathing, and relieve symptoms.

6. Bronchitis

Bronchitis can cause throat irritation and soreness, nasal congestion, and a dry or productive cough. Other common symptoms include wheezing, shortness of breath, and chest tightness.

It occurs when the bronchi in the lungs become inflamed or irritated.

What to do: See a pulmonologist for proper diagnosis and treatment. Bronchitis medications such as pain relievers, anti-inflammatories, expectorant or mucolytic cough syrups, and, in some cases, antibiotics may be recommended.

7. Excessive voice use

Using your voice too much, especially for people who rely on it for work, such as teachers, speakers, or singers, can lead to throat irritation or swelling and sometimes vocal cord strain, resulting in a scratchy throat and hoarseness.

What to do: Resting your voice usually helps within a few days. Avoid talking excessively, yelling, singing, or whispering. If hoarseness persists or worsens, consult an ENT doctor to check for vocal cord lesions and start appropriate treatment.

8. Gastroesophageal reflux disease (GERD)

GERD occurs when stomach acid flows back into the esophagus and mouth, irritating the throat and causing a burning or scratchy sensation.

What to do: Treatment prescribed by a gastroenterologist may include GERD medications, like  antacids, H2 blockers, or proton pump inhibitors to reduce stomach acid and prevent reflux, relieving the scratchy throat and other symptoms.

Also recommended: GERD Diet: List of Foods to Eat & Avoid (& 3-Day Meal Plan)

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9. Allergies

Allergic reactions can cause throat irritation or inflammation, leading to a scratchy throat, runny nose, watery eyes, and sneezing.

Allergies occur when the immune system reacts to substances like dust, pollen, or pet dander, triggering histamine release that produces allergy symptoms.

What to do: A doctor may recommend antihistamines to relieve symptoms and help prevent allergic flare-ups.

10. Mononucleosis

Mononucleosis is a viral infection caused by the Epstein-Barr virus and spread through saliva. It causes throat inflammation, soreness, and a scratchy feeling, along with high fever, white patches on the throat, and swollen lymph nodes in the neck.

What to do: Consult a doctor for diagnosis and treatment, which typically includes rest, hydration, and medications such as pain relievers or anti-inflammatories to ease symptoms. Antibiotics may be prescribed if secondary bacterial infections develop.

11. Excessive alcohol consumption

Drinking too much alcohol can irritate the throat and increase stomach acid, which may trigger acid reflux and worsen irritation.

What to do: Avoid frequent or excessive alcohol consumption. In cases of alcohol dependence, treatment may include medications such as naltrexone or acamprosate and therapy with a psychologist or psychiatrist.

12. Exposure to irritants

Exposure to irritants like cigarette smoke or air pollution can inflame the throat, causing itching, coughing, and a scratchy sensation. Prolonged exposure can also lead to throat inflammation and mucus buildup.

What to do: Avoiding exposure to irritants is the most effective prevention. Throat lozenges containing honey, lemon, or ginger can help soothe the throat. Gargling with warm salt water can also relieve symptoms. For smokers, a doctor may prescribe medications like bupropion or varenicline to help quit smoking.

13. Throat cancer

Throat cancer may not cause symptoms in its early stages, but as it progresses, it can cause a persistent scratchy throat, unexplained hoarseness, or frequent coughing that may produce blood. Risk factors include smoking, excessive alcohol consumption, and HPV infection transmitted through unprotected oral sex.

What to do: Treatment should be managed by an oncologist and may involve surgery, chemotherapy, or radiation therapy depending on the stage and severity of the disease.

What to take

To help relieve a scratchy throat, you can use throat lozenges such as Cepacol or Chloraseptic, which contain soothing or antiseptic ingredients that reduce irritation and inflammation. These are available over the counter in the US.

Herbal teas made with lemon, garlic, and ginger, or clove tea, can also help reduce inflammation thanks to their natural anti-inflammatory, analgesic, and antimicrobial properties.

Also recommended: 11 Soothing Tea Recipes for a Sore Throat (Ingredients & Benefits)

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However, these remedies do not replace medical treatment but can be used alongside prescribed medication to ease discomfort and speed up recovery.