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Face Masks and Virtual Communication Affect Your Voice: Problems and Solutions

April 26th, 2021 | 5 min. read

By Michael P Underbrink, MD

face masks and your voice2


The current global pandemic has resulted in many changes, including many people communicating virtually throughout the day, and many others having to communicate while wearing face coverings. 

Voice professionals are seeing more individuals with functional voice issues, which might be related to changes in how they're using their voices while they talk on Zoom, maintain social distancing, and wear masks. With individuals with existing voice issues, added vocal tension (muscle tension dysphonia) in their larynx could lead to hoarse voice and in some cases, throat pain and other problems.

They could be contributing factors for individuals, like teachers, whose jobs require them to talk throughout the day, as well as for healthcare providers who must wear the thicker N95 masks. Plus, it isn't just one thing that is causing voice issues either. It's typically a combination of things, and video calls and masks are likely contributing factors, according to these voice professionals.


How Face Masks Impact Good Vocal Health and Make it Difficult to Communicate

Studies have shown that wearing face masks can interfere with speech intelligibility by decreasing projection, and making it more challenging to breathe in, and from the loss of visual feedback of articulatory movements. This causes voice users to increase effort to try to project more and causes vocal fatigue, which worsens the more they speak. 

Specific ways facial masks can impact virtual communication include:

  • Facial masks change what individuals hear by decreasing the loudness they hear and filtering out various parts of sounds, particularly the high-frequency sounds that are essential for the intelligibility of spoken language. This issue is more serious when using a phone while wearing a facial mask because these higher important frequencies are filtered out even more.
  • Using face masks decreases visible cues of facial expressions, as well as lip reading people use for enhancing communication. This can make face-to-face communication harder and people must rely more on inference from eye expression. Masks take away your ability to see facial expressions and read lips, which can help you better understand what you're hearing. 
  • Masks muffle sound, which makes it harder to understand certain higher-pitched voices and speech.
  • Masks could be uncomfortable for individuals wearing cochlear implants or hearing aids.
  • Speaking with a mask on could be difficult for individuals with communication issues, like voice problems and aphasia.
  • Masks are created from various fabrics and some resist airflow more, which makes it more difficult to breathe normally, leading to more fatigue.
  • People speak louder and with more effort, leading to increased communication frustration and vocal fatigue as a result of the mask's airflow resistance, the decrease in the distortion of sounds, and the loudness individuals hear.

Basically, facial masks increase:

  • Difficulties in speech intelligibility
  • Perception of vocal effort
  • Difficulty in speech coordination and breathing
  • Auditory feedback

And, this is regardless of why the mask is being used, although there’s a greater perception of symptoms of vocal discomfort and fatigue, coordination of breathing and speech, effort, and difficulties in speech intelligibility in people who are using face masks for essential and professional activities.



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Physical Distancing, Face Masks, and Voice Problems

Physical distancing could also create communication challenges. For instance:

  • Speech could sound quieter because the levels of sound go down with distance.
  • You can't get closer, lean in, or use similar strategies to assist in the breakdown of communication.
  • Focusing your attention on speech could be difficult at a distance with the environmental sounds, like a loud car stereo or the chirping of birds.
  • It's harder to see visual cues like the speaker's lips or facial expression at a distance


Voice Health Signs to Be Aware Of

Vocal health symptoms to keep an eye out for are:

  • Vocal fatigue: It can become harder to speak for long periods of time. Your voice is tired. Your muscles around your throat might feel tight, and you may experience general body fatigue.
  • Change in voice quality: You may hear breathiness, hoarseness, pitch breaks, or cracks.


7 Tips to Communicate Better While Physical Distancing and Wearing a Facial Mask

  1. Talk a little louder.
  2. Ensure you have the full attention of your communication partner.
  3. Talk a little slower.
  4. Face your partner and ensure nothing is obstructing your view.
  5. Ask them if they understand you; if not, write it down or say it a different way.
  6. Use body language and your hands.
  7. Move to a quieter place.


20 Tips To Improve Your Voice and Virtual Communication While Wearing a Face Mask

  1. Perform vocal warm-ups. On the way to work, hum a few scales to help get the blood flowing to your neck. You wouldn't jog 10 miles without first warming up. The same should go for your voice. You should prepare for a long day of using your voice by warming it up. This goes for anyone who has to speak through a mask for long time periods. 
  2. Avoid irritants. Caffeine or spicy, high fat, or acidic foods can irritate your larynx and throat.
  3.  Take time to engage in activities that you enjoy that help you manage stress and relax.
  4.  Take a breath, engaging the diaphragm and abdominals to support your voice.
  5. Talk at the top of your breath, using the air to help carry your voice.
  6. Try to keep your neck and throat relaxed as you talk.
  7. Massage your neck to try to keep the muscles relaxed if needed.
  8. Try using exaggerated prosody, varying your pitch, rather than increasing your volume.
  9. Try to over-articulate, exaggerating movements of the lips, teeth, and tongue instead of getting louder.
  10. Make sure that you have good posture as you are speaking.
  11. Relax your jaw. Unclench your jaw, drop your shoulders and try keeping your entire vocal mechanism as relaxed as you can.
  12. Use an amplification system when in large groups or for teaching class.
  13. Speak with clear speech. Pause between thoughts, use enhanced articulatory precision, use a comfortable speaking rate.
  14. Maintain social distance in order to stop the spread of Covid-19.
  15. Ensure you're facing the individual with whom you're having a conversation.
  16. Don't hesitate to ask for clarification of information or for them to repeat themselves.
  17. Increase your body language use: Body and hand movements and gestures, facial expressions.
  18. Speak with intent. Clearly articulate your words. This doesn't mean you need to exaggerate your regular speech patterns. It means ensuring you're finishing your words, using careful pronunciation, and aren't slurring your words in a sloppy way together.
  19. Avoid vocal strain.  Vocal strain can be similar to any other type of injury. You could typically rehabilitate an injury, but you'd be more vulnerable to experiencing similar issues down the road. 
  20. Above all, maintain your health in general, getting adequate rest, exercise, and nutrition.

Remember, whether you are communicating with people in person, or virtually, make sure you are caring for yourself and your voice during this stressful time. It's how you communicate and connect with the world around you. If you're continually exposing it to the same repeated damage and you don't make any adjustments, there could be certain long-term impacts with that. That’s why it’s important to try to build voice breaks into your schedule, to give your voice time to rest.



Hydration is An Essential Part of Good Vocal Health Too

Hydration (along with good nutrition) is essential for overall health with increased requirements as your activity increases. Your vocal folds require great surface lubrication for maintaining healthy vocal fold vibration. 

Externally, breathing with an open mouth posture, cold and dry air and certain medicines could cause tissue dehydration. Internally, specific medicines, sweating without replacing fluids, and caffeine could cause tissue dehydration. It's essential you take in around 60 to 80 ounces of water or more each day in order to remain hydrated.


Consult a Voice Specialist at The Houston Voice Center

 If you have voice difficulties lasting more than three weeks, consider scheduling a voice evaluation with a fellowship-trained laryngologist.

If you have any questions, please feel free to contact The Houston Voice Center, at Houston ENT & Allergy in Memorial City at 713-461-2626.


Michael P Underbrink, MD