Hot weather is reported to exacerbate fiddlers neck, as are tiredness, playing emotional music, and playing in smaller groups where individual stress is higher. Type I hypersensitivity reactions may also be involved, particularly to rosewood and ebony in the chinrest and tailpiece, as well as to varnish of the instrument body when chinrests are not used and to rosin deposits on the instrument and on chin cloths. Nickel or other metal allergies are common causes if the chin rest has a metal clip that comes into constant contact with the skin. Rosin exposure in particular may lead to abietic acid dermatitis. Diagnosis
Differential diagnoses
The differential diagnoses of fiddlers neck include branchial cleft cyst, disease of the salivary glands, tumors of the parotid gland, psoriasis, lichen planus, contact dermatitis, herpes simplex and similar infections, and insect bites and stings especially from fleas. Treatment
Treatment for fiddlers neck is unnecessary if it is painless and shows minimal swelling, particularly since minor cases are taken as a mark of pride. But fiddlers neck may lead to worse disorders. The primary methods of treatment involve adjustments to playing of the instrument:
good hygiene for the affected area and for the instrument
use of a clean cotton cloth that is changed frequently
use of a comfortable pad to absorb sweat and reduce friction between the instrument and skin
use of a shoulder rest to reduce pressure below the jaw
a suitable chin rest, especially one carved or molded for the individual
covering or changing potentially allergenic materials on the instrument.
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