The intense contact between a musical instrument and skin may exaggerate existing skin conditions or cause new skin conditions. Skin conditions like

hyperhidrosis Hyperhidrosis is a condition characterized by abnormally increased sweating, in excess of that required for regulation of body temperature. Although primarily a benign physical burden, hyperhidrosis can deteriorate quality of life from a psycholog ...

lichen planus Lichen planus (LP) is a chronic inflammatory and immune-mediated disease that affects the skin, nails, hair, and mucous membranes. It is not an actual lichen, and is only named that because it looks like one. It is characterized by polygonal, fla ...

psoriasis Psoriasis is a long-lasting, noncontagious autoimmune disease characterized by raised areas of abnormal skin. These areas are red, pink, or purple, dry, itchy, and scaly. Psoriasis varies in severity from small, localized patches to complete ...

eczema Dermatitis is inflammation of the skin, typically characterized by itchiness, redness and a rash. In cases of short duration, there may be small blisters, while in long-term cases the skin may become thickened. The area of skin involved can ...

, and

urticaria Hives, also known as urticaria, is a kind of skin rash with red, raised, itchy bumps. Hives may burn or sting. The patches of rash may appear on different body parts, with variable duration from minutes to days, and does not leave any long-last ...

may be caused in instrumental musicians due to occupational exposure and stress.

Allergic contact dermatitis Allergic contact dermatitis (ACD) is a form of contact dermatitis that is the manifestation of an allergic response caused by contact with a substance; the other type being irritant contact dermatitis (ICD). Although less common than ICD, ACD is ...

and

irritant contact dermatitis Irritant contact dermatitis is a form of contact dermatitis that can be divided into forms caused by chemical irritants and those caused by physical irritants. Chemical Chemical irritant contact dermatitis is either acute or chronic, which is u ...

are the most common skin conditions seen in string musicians.

Allergic contact dermatitis

Rosin Rosin (), also called colophony or Greek pitch ( la, links=no, pix graeca), is a solid form of resin obtained from pines and some other plants, mostly conifers, produced by heating fresh liquid resin to vaporize the volatile liquid terpene comp ...

, the material commonly used to wax string instruments is known to cause allergic contact dermatitis in musicians.

Nickel Nickel is a chemical element with symbol Ni and atomic number 28. It is a silvery-white lustrous metal with a slight golden tinge. Nickel is a hard and ductile transition metal. Pure nickel is chemically reactive but large pieces are slow ...

, a metal found in musical instruments causes allergic contact dermatitis on the fingers and hands of string instrumentalists and in the lip and neck of wind instrumentalists. Wind instrumentalists with lip and neck infection should switch to silver, gold or plastic mouthpieces if allergic dermatitis occurs. (R)-4-methoxydalbergione present in

rosewood Rosewood refers to any of a number of richly hued timbers, often brownish with darker veining, but found in many different hues. True rosewoods All genuine rosewoods belong to the genus ''Dalbergia''. The pre-eminent rosewood appreciated ...

may cause allergic contact dermatitis in violinists. Cane reed (causing chelitis in saxophone players),

propolis Propolis or bee glue is a resinous mixture that honey bees produce by mixing saliva and beeswax with exudate gathered from tree buds, sap flows, or other botanical sources. It is used as a sealant for unwanted open spaces in the beehive. Prop ...

(a wax used to close structural gaps in musical instruments), paraphenylenediamine (used to polish musical instruments) and

potassium dichromate Potassium dichromate, , is a common inorganic chemical reagent, most commonly used as an oxidizing agent in various laboratory and industrial applications. As with all hexavalent chromium compounds, it is acutely and chronically harmful to health ...

(tanning agent to the skin of the harp) also cause allergic contact dermatitis in musicians.

Irritant contact dermatitis

Fiddler's neck Fiddler's neck is an occupational disease that affects violin and viola players. It is a cutaneous condition usually characterized by redness, thickening, and inflammation on the left side of the neck below the angle of the jaw where the instrume ...

- It is seen in violinists due to non-eczematous irritant contact. Lichenification and hyperpigmentation can be seen. It is different from classical irritant contact dermatitis because the etiology is multifactorial : friction (leading to lichenification), local pressure, shearing stress and occlusion. Viola players are more pre-disposed to this condition because of the larger size of the instrument. * Cellist's chest and cellist's knee - It is seen in cello players due to the irritant contact of the instrument. * Flautist's chin - Irritant contact dermatitis seen in the chin of a wood/brass instrumentalist. * Clarinetist's cheilitis - Chelitis in a clarinet player. Caused due to friction, pressure, stress and occlusion.

Skin trauma

Frequent, chronic contact of instruments to skin may make it callous by the thickening of stratum corneum. Use of 'thumb position' in cellists may cause callosity of left thumb.

Garrod's pad Garrod's pads (also known as ''violinist's pads'') are a cutaneous condition characterized by calluses on the dorsal aspect of the interphalangeal joints, i.e. the back side of the finger joints. They are often seen in violin, viola, and cello play ...

s are seen on the dorsal left second and third fingers over the proximal interphalangeal joints in violinists. Drummer's digit is the callosity seen on the lateral phalanx of the left finger. Callosities need treatment only when they are excessive or symptomatic.

References

{{reflist Dermatitis Occupational diseases