Unless you’re a mime, actors need to speak as part of their job. The range of parts an actor encounters may require strange uses of their voice. For instance, a horror movie might require an actor to scream a lot. Other parts might require forced whispering or some other unnatural way of speaking. It’s all part of the job; trained actors have to learn how to take care of their voices.
But sometimes that training isn’t enough, or an actor fails to use it. When the voice is abused it causes trauma in the voice box. This trauma can cause vocal lesions to develop in the mouth. These lesions include polyps, nodules, and cysts.
These conditions are feared by actors because they can cause a permanent change in the voice if they aren’t removed. If trauma continues despite the presence of lesions, even surgery might not completely fix the problem. Fortunately, if the lesions are caught early and removed, the voice can be retrained and regained to prevent further damage. Good vocal hygiene is essential to keep these from forming. Here are the types of lesions:
A vocal polyp forms similarly to how a blister forms on the hand. If the vocal folds rub together too much, the point of contact grows bigger and fills with fluid. As they swell, they will interfere with your voice. Unlike other kinds of polyps, vocal polyps are NOT cancerous but they do need treatment.
A vocal nodule looks like a small callus. It’s formed similarly to a vocal polyp but in a smaller area. Instead of fluid, these are filled with thickened tissue. These are more common in singers since their voices are much more controlled, but actors are not immune.
Vocal cysts are more likely to occur when you are sick. The bacteria find a home in a damaged spot and form a cyst, sort of like a cross between a polyp and a node in consistency. They need to be removed and the illness treated.
Regardless of the type of lesion, the symptoms that you have one are the same. If you are hoarse, lose tone, start getting breathy, start speaking in multiple tones, or it gets harder to use your voice, then something is wrong and you need an examination.
You will need to go to a specialist for a full exam. These lesions can be quite tiny but can have a major impact on your voice. Special scopes can examine all of your vocal folds to identify all problem areas and help the doctor determine what types of vocal therapy will work best for you.
A lot of actors that come to us want to know if they can just rest the voice. The answer is no. Resting the voice will help it heal, but if the underlying cause of the trauma is not treated you’ll only make the problem worse.
Surgery may or may not be necessary to remove the lesion, but voice therapy is always necessary to treat the real problem, misuse of the voice. All those rules you learned about your voice are there for a reason! If you do need surgery, expect to be out of work for some time on voice rest to allow the surgery to heal.
If you ignore the problem too long, it is possible to get permanent hoarseness from these lesions. You do not want to force your way through the problem. Actors rely on their voices. No voice, no work! So don’t ignore the symptoms.
Vocal Disorder Prevention
Preventing lesions starts with good vocal hygiene. At a minimum, you need to drink enough water during the day and stop smoking or working in smoky areas. The vocal folds are covered in a thin layer of mucus as protection. If these dry out, it’s much easier for trauma to form. Similarly, breathing in smoky air dries out that mucus and makes it stop working.
You may also need to start using vocal warm up and cool down exercises during your workday to keep the voice in good order. Your speech therapist can give you appropriate exercises for your specific issues. If your work situation allows it, using amplification can help you avoid strain as well.
Finally, try not to use unnatural voice patterns. This may be easier said than done. If you have to scream a lot, cry often, talk in a falsetto, do a lot of vocal sound effects, or do regular voice acting, you may need to take special care. Speak with a vocal coach or speech therapist to minimize damage and get plenty of rest.
A vocal lesion doesn’t have to mean the end of your career if you take care of it quickly. But the best thing to do is to prevent them from happening at all by taking good care of your voice.