A violinist’s musical technique depends on close physical contact between the violin and their own skin. As a violinist, your skin health is vital in supporting your music performance because of the critical positioning of your hold. A skin condition which affects the way you hold your violin may be devastating for your performance. Sadly, violinists and violists, like other string players, are at risk of specific skin conditions, in particular violinist’s dermatitis.
The area which is particularly vulnerable is around the neck (and especially so for violists because of the increased friction and pressure from the larger, heavier instrument). The spectrum of symptoms ranges from mild irritation to skin which is very sore and infected with lesions and cysts.* Other areas which may be affected include fingers and hands.
Skin, not only the outer surface layer but also two additional layers underneath, is in fact the largest organ of your body. Your skin health depends not only on skin care routines on the outside but on nourishment on the inside.
*When skin is broken, there is a risk of infection. It is important to keep skin clean and protected (with a dressing if appropriate).
Violinist’s Dermatitis
Violinist’s dermatitis is a type of contact dermatitis, a common condition which affects the general population. Skin becomes dry itchy and may become blistered, cracked and discoloured.
The inflammatory condition is caused when the skin is exposed to an irritant (irritant contact dermatitis) or an allergen (allergic contact dermatitis).
While an irritant causes a nonspecific response by the body, an allergen causes a hypersensitivity response when the immune system is activated. An allergy is diagnosed by medical testing.
An increased risk for violinist’s dermatitis is an emotional factor (such as stress or anxiety) which may combine with a genetic predisposition for skin conditions.
Skin care on the outside
A first step in skin care on the outside is to avoid (or minimise) contact with the irritant or allergen. Violinists come into contact with a number of substances known to cause dermatitis but there may be alternatives.
Rosin is a solid form of resin applied to the bow. Rosin is normally made from pine trees. D’Addario Clarity, Stohr or Geisel hypoallergenic rosins are alternative options.
Exotic woods are used for chin rests. Commonly these are ebony and rosewood but there may also be a cross sensitivity with other woods. An alternative is boxwood.
Nickel is used in the metal parts of a violin, including strings and chin rest fittings. A cotton cover over the chin rest or plastic fittings may be helpful. The composition of strings is vital for the quality of sound. Thomastik-Infeld continues to work towards finding alternatives to nickel with titanium alloys.
The acid-alkaline balance of the skin is vital to skin health, best when it is more acid than alkaline (in the range pH from 4.1 to 5.8, varying in different parts of the body). Upsetting this balance, when skin becomes more alkaline, may aggravate contact dermatitis.
An acid environment supports another vital aspect of skin health: your skin microbiome. The communities of microorganisms living on the skin have essential roles in skin health. In the same way as the microbiome in the gut is supported by its microbiome, your skin is supported by its own microbiome.
To maintain a healthy skin pH and support the skin’s microbiome, avoid harsh cleansing routines, in particular soap, which is typically alkaline. Choose gentle cleansers, toners and moisturisers appropriate for your skin.
To soothe irritated skin bathe your skin in a prepared wash for about 20 minutes. Hands can be bathed by soaking in a bowl. Or your neck can be bathed by applying cotton wool soaked in the wash, with a towel wrapped a towel around your shoulders. Oatmeal or Dead Sea salts are options for a soothing wash.
Oatmeal. Grind 3 tablespoons of gluten free organic oats in a grinder until fine. Add this powder to a cup of warm water. Stir well.
Dead Sea salt. Add 2 tablespoons of Dead Sea salt (such as Sea Magik) to a cup of warm water. Stir well.
Skin care on the inside
Skin care on the inside depends on hydration. All body cells depend on water, which needs to be regularly topped up.
Hydration. The minimum recommendation for daily water intake is about 8 glasses. This needs to be increased during intense activity (such as a music performance) or high environmental temperature. Some drinks (such as alcohol or a lot of coffee) are dehydrating.
Skin care on the inside depends on key nutrients. These include anti-inflammatory vitamin C, Omega-3 and polyphenols. Collagen is also a primary building block for your skin.
Polyphenols. Many fruits and vegetables contain polyphenols, such as red grapes, cherries, blueberries, plums, apples, spinach, broccoli, carrots, ginger and turmeric.
Vitamin C. A wide variety of fruits and vegetables (such as red peppers, green peppers, blackcurrants, strawberries, pineapple and citrus fruits*) contain vitamin C, best when they are seasonal and fresh.
Omega-3. The best food source of Omega-3 is oily fish (salmon, sardines, anchovies, herrings, mackerel, trout). Other (less rich) sources of Omega-3 are chia seeds, flaxseeds and walnuts.
Collagen Bone broth is a rich source of collagen. A bone broth powder (such as Planet Paleo or Designs for Health) is a convenient option.
A meat-free option is tremella (snow fungus) mushrooms, which stimulate the body’s production of collagen. Follow preparation instructions for the dried mushrooms and add to soups or stir fries.
*Note that citrus fruits are associated with allergies. If you are susceptible, choose non-citrus vitamin C options.
Skin care on the inside also depends on a healthy gut microbiome. You can support the friendly microbes in your microbiome with your prebiotic food choices.
Prebiotics. These are foods which are rich in plant fibres and some fats. Choose a variety of prebiotic foods for diversity in your microbiome.
Prebiotic foods:
Vegetables (especially artichokes, asparagus, leafy greens, onions, legumes)
Fruits (especially bananas and berries)
Whole grains (oats, barley and wheat*)
Nuts (almonds, walnuts)
Seeds (flaxseeds)
Garlic
*Note that wheat and barley contain gluten, which is highly linked with allergies. Oats also contain similar proteins, which may affect some people. These foods are not suitable for everyone.
Although violinist’s dermatitis may be dismissed as an occupational hazard or considered as evidence of dedication, it is vital that violinists do not ignore the earliest signs. Following a skin care routine on the outside and on the inside may be helpful, not only to reduce existing symptoms but also to prevent further symptoms.
Please note: You should consult your doctor if your symptoms of dermatitis are severe or persistent.
References
(Accessed: April 2024)
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Crépy, M. (2015) Skin diseases in musicians. Available at: https://link.springer.com/content/pdf/10.1684/ejd.2015.2559
Byrd, A., Belkaid, Y & Segre, J. (2018) The human skin microbiome. Available at: https://www.nature.com/articles/nrmicro.2017.157#:~:text=Our skin is home to,products1,2,3.
De Pessemmier, B., Grine, L. Debaere, M. et al (2021) Gut-Skin Axis: Current Knowledge of the Interrelationship Between Microbial Dysbiosis and Skin Conditions. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916842/
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Katta, R. (2022) Allergic contact dermatitis why does it happen and how do you treat it. Available at: https://www.doctorkatta.com/post/allergic-contact-dermatitis-why-does-it-happen-and-how-do-you-treat-it
Katta, R. (2022) Prebiotics. Available at: https://www.skinanddiet.com/prebiotics
Kiecka, A., Macura B. & Szczepanik, M. (2023) Modulation of allergic contact dermatitis via gut microbiota modified by diet, vitamins, prebiotics, probiotics and antibiotics. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060339/
Kodumudi, V. & Feng, H. (2022) Contact dermatitis and nutrition. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0738081X21002194
Parks, M., Perez-Sanchez, A Tamil, D. et al (2021) Diet and Skin Barrier: the Role of Dietary Interventions on Skin Barrier Function. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875671/
Skotnicki S. (2021) Skin pH, cleansers and the skin. Available at: https://thesecretlifeofskin.com/2021/11/04/skin-ph-skin-microbiome/
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