Musicians can present a unique group of skin rashes related to their profession or avocation. Some of these rashes are so common they have characteristic names such as fiddler’s neck, flautist’s chin, guitarist’s nipple and harpist’s finger.
In a recent survey, 21 percent of musicians reported some type of instrument-related rash. Some of these rashes are mechanical in nature, such as chaffing, erosions or blistering and callusing due to repeated trauma.
Many of the rashes are allergic in origin and the common causes are exotic woods, metals, resins, stains and varnishes. The most common allergic metals used in instruments are chromium, cobalt and nickel. Many wind instrument users develop skin or lip rashes from their instruments.
Woods that have a high allergic potential are ebony, cocobolo, African Blackwood, Brazilian and Indian rosewood. Also, cane reed used in mouthpieces can cause allergic problems.
Paraphenylendiamine is a black dye that causes allergy and is commonly found in stringed bows and chin rests. Propol is also known as bee glue and is used in violin varnish and is a strong allergen. Colophony – a solid form of resin obtained from pines and some other plants, mostly conifers – is also a significant allergen for violinists, violists and cellists.
The metals that cause allergy are not only found in wind instruments (brass), but also in string instruments – especially guitars, cellos, violins, sitars and harps.
The key (pun intended) to diagnosing the cause of these rashes is that they occur in the specific body parts that touch the instrument.