Are you experiencing a hand rash that is worse on your fretting hand than on your strumming hand? Are you also prone to other allergies, such as asthma or hay fever? If so there is a possibility that you have an allergy to your guitar strings.

Recently published case reports describe a musician’s dermatitis (skin rash) affecting the hand, which was the result of nickel contact from guitar strings. Here is the description of a typical case:

“A 17-year-old adolescent boy presented with a 1-year history of a rash on the hands, worse on the left. He was atopic [predisposed to allergies]. On clinical examination he had chronic eczematous changes on his palms and fingers, more severe on the left hand. Patch testing revealed a strong reaction to nickel and also to cobalt and chromate. He had played the electric guitar over the previous 5 years and his guitar strings were nickel-coated. He is right-handed and reported that his left hand contacted the strings much more than the right, which held a plectrum. After these findings he decided to change to playing the drums, resulting in resolution of the dermatitis.”

This is another case

“A 38-year-old, right-handed man was referred with a 12-month history of an erythematous, scaly rash on the right thumb (Fig. 1b). He also had a keen interest in playing the electric and acoustic guitar. The position of the rash corresponded directly with the area of skin that made contact with the strings. He had a past history of atopy. His patch testing demonstrated a strong reaction to nickel, cobalt and chromate. His guitar strings also contained nickel. He was unable to obtain nickel-free strings so he has continued to have nickel exposure. His hand dermatitis has been persistent.”

Smith and co-workers (2006) recommend switching to coated strings, since most electric guitar strings contain or are coated with nickel. Guitarists with this problem could try plastic coated (Elixir) or gold (Optimas) strings. However, acoustic guitar strings are made from bronze, brass or silver-plated copper, so similar problems are much less likely. Nickel in the frets or friction between finger and string, however, could still contribute to dermatitis, whatever the strings are made from.

Switching to the drums is the last resort, for incurable cases only.

References

Smith VH, Charles-Holmes R, Bedlow A. Contact dermatitis in guitar players. Clin Exp Dermatol. 2006 Jan;31(1):143-5.

Marshman G, Kennedy CT. Guitar-string dermatitis. Contact Dermatitis. 1992 Feb;26(2):134.

Gambichler T, Boms S, Freitag M. Contact dermatitis and other skin conditions in instrumental musicians. BMC Dermatol. 2004 Apr 16;4:3. Review.