Nodules are thickenings the vocal folds (commonly called vocal cords) and are generally caused by repeated trauma, such as excessive talking, yelling or screaming. They are often described as ‘callouses’ on the vocal folds, and like callouses on the skin respond well to rest from the trauma. A person with nodules may sound husky or breathy and their voice may be lower in pitch than it used to be. As nodules are caused by a problem with the way a person uses their voice, the best treatment initially is speech therapy, to help retrain vocal technique and increase awareness of vocal use. Left untreated nodules can harden and may require surgical removal.