Musicians Can Be Victims of Peculiar Skin Problems

Professional musicians may develop unique skin problems known as "fiddler's neck," "guitar nipple," "cellist's chest," "harpist's fingers," and “flautist's chin" which are quite irritating and sometimes painful enough to send them to the doctor, according to a recently published study.

 
A variety of occupational hazards from music-making were uncovered in a recent survey of symphony orchestra members conducted by Steven Rimmer, MD, of the UCLA Medical Center, and Richard L. Spielvogel, MD, a dermatologist at Hahnemann University in Philadelphia.  They reviewed the latest research on special skin disorders of musicians in the April issue of the Journal of the American Academy of Dermatology.

The most common problem musicians complained of was calluses on the fingertips of string players, followed in relative frequency by “fiddler's neck" and "cellist's chest."

"Fiddler's neck" causes a thickening of skin and redness just below the jaw line on the left side of the neck of violin and viola players.  Scaling, pimples, and occasional cysts may occur, along with clogged pores and inflamed hair follicles.  Researchers believe it is brought about by an increase of pressure and/or friction on the player's neck, sometimes due to a poor grip on the instrument, a badly-fitting chin rest, or the wrong size or weight of the instrument.  Sweating and poor hygiene only make the situation worse.

Aside from medical treatments such as oral tetracycline or erythromycin for the acne-like rash, the condition can be helped by placing a pad on the instrument's chin rest, or even having the chin rest custom-designed by taking a neck impression similar to those dentists use to create the exact shape of the teeth.

One male violinist with "fiddler's neck" and "beard bumps" (pseudofolliculitis) only rid himself on an irritating rash by eliminating shaving entirely and growing a full beard.

"Guitar nipple" was described in the cases of three grammar-school girls who experienced swelling and inflammation of one nipple only.  All were learning to play on full-sized guitars.  Evidently, the girls were pressing the edge of the soundbox against their left or right nipples, depending on whether they played right- or left-handed.  Temporarily discontinuing practice sessions and obtaining the proper size instrument was all that was needed to clear their conditions.

"Cellist's chest" may occur when a musician leans across the body of the instrument while playing, pressing the lower rib cage into the cello.  Symptoms include chest pain, redness, and welling, or even pimples and boils.

The condition called "harpist's fingers" includes not only calluses on fingertips and finger sides, but also painful reddening of the skin surrounding the nail, or even loosening or separation from the nail bed (onycholysis).  The best way to avoid this condition is for beginning players to increase their practice time gradually.

Growing a goatee was suggested to aid men suffering from "flautist's chin."  This condition typically causes pimples or sores and some skin darkening in the middle of a player's chin, as well as pain during playing.  Female flautists may need medication and might also need to be tested for a possible allergic reaction to metals in the flute such as nickel and chromium.

Brass players who are frequently affected by lip and mouth sores, especially herpes, tend to use lip balms for daily protection.  Additionally, musicians may incur allergic reactions to instrument polishes, cleaning solvents, and especially rosin for violin strings.

 The rare woods used to construct certain violins, oboes, and recorders can also cause players to break out.  The culprits could be rosewoods, African blackwood, and several types of ebony.

One of the worst occupational hazards for the musician is excessive sweating (hyperhidrosis).  Cases on record include two performers who sweated so much they caused corrosion to their respective flute and trombone.  Further problems, especially for players of wind instruments, are dry mouth caused by performance anxiety (xerostomia) and excess production of saliva by recorder players in particular.

 
Source: American Academy of Dermatology, news release, April 12, 1990, P. O. Box 3116, Evanston, IL 60204-3116, (708) 869-3954.


Art Hazard News, Volume 13, No. 6, 1990

This article was originally printed for Art Hazard News, © copyright Center for Safety in the Arts 1990. It appears on CAR courtesy of the Health in the Arts Program, University of Illinois at Chicago, who have curated a collection of these articles from their archive which are still relevant to artists today.