Discover the vital key to protective skincare for violinists

The intense contact between a violinist’s skin and violin for music performance is nurtured by skin care on the outside and on the inside. The positioning of the violin or viola against the skin is critical for playing and your skin has an important role in supporting your music performance. Your skin is not only the visible outer layer but, as the largest organ of your body, also comprises two layers underneath, supported by beneficial nutrients in your food as well as your skincare routines.

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Violinist’s dermatitis

Whether your first reaction to signs of violinist’s dermatitis was to accept it as an occupational hazard or evidence of your dedication to practice, this skin condition, while it may not considered very serious, has the alarmingly serious potential to affect your music performance. 

Violinists and violists, like other string players, are at risk of specific skin conditions. The neck or jawline is a vulnerable location, where a distinctive condition known as “fiddler’s neck” or “violin hickey” may develop. This is an area of dermatitis, which may become sore and infected, with acne-like lesions and cysts. The condition is more likely with the larger and heavier viola, with friction and pressure contributing to its development. While there is a wide spectrum of skin changes in this condition, violinists and violists also experience regular contact dermatitis, affecting fingers and hands, as well as the neck.

As emotional factors may trigger a genetic disposition for a skin problem, stress or anxiety in a musician’s life increases the risk of developing a skin condition

When skin is broken, there is a risk of infection. It is important to keep skin clean and protected (with a dressing if appropriate).

If your symptoms of dermatitis are severe or persistent, you should consult your doctor.


Contact dermatitis 

Contact dermatitis is a common inflammatory skin condition affecting the general population, characterised by dry, itchy skin which may become blistered, cracked and discoloured. The condition is caused by skin coming into contact with an irritant (irritant contact dermatitis) or with an allergen (allergic contact dermatitis). Irritant contact dermatitis is more common. A diagnosis of allergic contact dermatitis is confirmed by medical testing. An allergy is the body’s hypersensitivity response when the immune system is activated, distinct from the body’s nonspecific response to an irritant.

For both types of contact dermatitis, a first step in treatment is avoiding contact with the substance causing the dermatitis. Violinists and violists are at particular risk of contact dermatitis, around the neck and on fingers and hands, because they are exposed to a number of substances known to cause dermatitis, either as irritants or allergens.

Rosin (also known as colophony), is a solid form of resin normally made from pine trees, applied to the bow. D’Addario Clarity, Stohr or Geipel hypoallergenic rosins are alternative options. (Rosin is also used in some cosmetics and adhesives.)

Nickel is used in various metal parts of a violin, including strings and chin rest fittings. A cotton cover on the chin rest may help. While the composition of strings is vital for the quality of sound, Thomastik-Infeld continues to work towards finding solutions with titanium alloys as an alternative to nickel. 

Exotic woods, in particular rosewood and ebony, are used for chin rests. Cross sensitivity may also occur with other woods. An alternative wood for chin rests is boxtree wood.


Skin health 

Scientifically identified, the normal range for skin pH is 4.1 to 5.8, varying in different parts of the body. Healthy skin is more acidic than alkaline. Upsetting this acid-alkaline balance, when skin becomes more alkaline, may aggravate contact dermatitis.

An acid environment supports another vital aspect of skin health. The community of microorganisms living on the skin have essential roles in skin health, in the same way as the microbiome in the gut has important roles in health, skin is supported by its own microbiome. 

Skincare on the outside:

To maintain a healthy skin pH, avoid harsh cleansing routines (such as 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. Dip your hands in a bowl of water. For your neck, wrap a towel around your shoulders and apply cotton wool soaked in the wash. Make a wash with oatmeal or dead sea salts.

  • Oatmeal: Grind three tablespoons of gluten-free organic oats in a grinder until fine. Add this powder to a cup of warm water and stir well.
  • Dead sea salt: Add two tablespoons of dead sea salt (such as Westlab, Soakin or Sea Magik) to a cup of warm water. Stir well.

Skincare on the inside:

Your skin is an integral part of your body and not merely a superficial covering for your body. Your health on the inside supports the health of the layers of your skin. Key to the health of your skin is also a healthy gut microbiome, the vast community of microbes living inside you. 

The health of your microbiome depends on your food choices which feed the beneficial microbes, to overwhelm any harmful microbes. You can support these friendly microbes to flourish with prebiotic food choices...

Prebiotics

Prebiotics are the foods that encourage the growth of beneficial microbes. They are foods rich in plant fibres also containing helpful nutrients such as polyphenols and some fats. A wide variety of prebiotic foods is needed to support beneficial wide diversity in your microbiome. 

These are only a few of the many 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 contain similar proteins which may affect some people. These foods are not suitable for everyone.

Healthy skin also depends on hydration and nutrients from your food. All body cells need to be hydrated. Two key nutrients for skin health are vitamin C and Omega-3. Collagen is a primary building block for your skin.

Hydration

Your body depends on water being replenished regularly to hydrate all body cells. The eight glasses of water minimum recommendation needs to be increased during intense activity (such as music practice or performance) or high environmental temperature. Some drinks (such as alcohol or a lot of coffee) are dehydrating. Drinking water little and often is the best way to stay hydrated.

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 in place of making bone broth from scratch. Tremella (snow fungus) mushrooms stimulate the body’s production of collagen. Follow the preparation instructions for the dried mushrooms and add them to soups or stir-fries.

*Note that citrus fruits are associated with allergies. If you are susceptible, choose non-citrus vitamin C options.


Personalised nutrition for musicians

Skincare on the outside and inside helps not only to reduce symptoms of existing conditions but also to prevent the development of skin problems. All body systems interact and there is a strong link between gut health and skin health. A holistic approach considers all interacting areas of health.

Gut health, digestive health and a balanced microbiome are foundational for the health of other body systems such as your immune system and your skin.

Working with me starts with a free online well-being review. Why not book your discovery call to find out how a programme could help you?


References

  • Cherney, K. (2022) About Skin pH and Why It Matters. Available at: https://www.healthline.com/health/whats-so-important-about-skin-ph#skin-p-h (Accessed: 20.4.2024)
  • Crépy, M. (2015) Skin diseases in musicians. Available at: https://link.springer.com/content/pdf/10.1684/ejd.2015.2559.pdf (Accessed 20.4.2024)
  • 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. (Accessed 21.4.2024)
  • 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/ (Accessed 20.4.2024)
  • Gambichler, T., Boss, S., Freitag, M. (2004) Contact dermatitis and other skin conditions in instrumental musicians. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC416484/ (Accessed 20.4.2024)
  • 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 (Accessed 20.4.2024)
  • Katta, R. (2022) Prebiotics. Available at: https://www.skinanddiet.com/prebiotics (Accessed 21.4.2024)
  • 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/ (Accessed 21.4.2024)
  • Kodumudi, V. & Feng, H. (2022) Contact dermatitis and nutrition. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0738081X21002194 (Accessed 20.4.2024)
  • 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/ (Accessed 21.4.2024)
  • Skotnicki S. (2021) Skin pH, cleansers and the skin. Available at: https://thesecretlifeofskin.com/2021/11/04/skin-ph-skin-microbiome/ (Accessed 20.4.2024)
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The views expressed in this article are those of the author. All articles published on Nutritionist Resource are reviewed by our editorial team.

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Bristol BS9 & BS2
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Written by Jane Hickey, DipNT mBANT rCNHC
location_on Bristol BS9 & BS2

Jane, a registered Nutritional Therapist, specialises in the health and wellbeing of musicians with one to one programmes to support conditions associated with music performance.

Jane is also available for talks to groups and has a special interest in supporting music students learn the importance of self care.

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