The Violin/Viola Hickey: Mark of Greatness or Neck Callus?
I received an inquiry a few days ago about the dreaded violin/viola hickey. What is it, why does it hurt, and why does it get puffy and gross? Ah, human skin...so mystifying.
Much like a callus on your fingers from pizzicato, your hickey is most likely a neck callus, or an area of hyperpigmentation and lichenification (color change and texture change). You may remember my post from a few months ago giving the genesis of a callus but if you need a refresher, skin responds to mechanical stress by thickening, which is called hyperkeratosis. . (Bone responds to mechanical stress by growing). In addition, that hickey may be along the Sternocleidomastoid, much like the top arrow in the image below, or you may have a few sights of irritation. This depends on a few factors:
1) The material of your chinrest itself. Wood, hypoallergenic plastic, etc.
2) The material of your chinrest plate, AKA. the metal thing on the bottom. Some are silver, brass, or nickel, all which may irritate your skin, just as an earring post might.
3) Your setup. Depending on where you hold the instrument, different locations contact the violin/viola.
4) What you wear- fabric barriers may prevent the callus from forming along the collarbone/sternum.
5) Your skin. Everyone has different sensitivities, whether to dryness, oiliness, irritation, etc. A violin/viola hickey may be dry and scaly for some, acne prone for some, and non existent for others.
Great picture from Allthingsstrings.com demonstrating a few of the different places where the hickey can manifest, depending on your skin and setup. Some folks just have irritation at the top arrow, others only along the collarbone. It depends on your shoulder rest, chin rest, skin, and setup, for starters, as well as the weather, how much you sweat when you play, and how often you clean the chinrest.
For most people, the hickey isn't a bother, doesn't cause pain, and isn't red/sore/itchy. However, a combination of sweaty weather, shaving (men!), creams/oils/lotions, etc., can irritate the skin. The first stage of irritation is redness, irritation, itchiness, etc., and a subsequent stage might be a blistering, a filling of pus/liquid, or a cystic quality. Most folks can self-medicate at the first stage, but the second stage may demand a lancing from a dermatologist (AKA. gotta get that pus out of there!). This means that your hickey is infected, which may required extra attention. *Side note: freshman year of college, my hickey did get infected and I lanced it myself...Gross and not recommended, but it did go away.*
Prevention tactics:
1) Cover chinrest with a cloth (and wash it every once in a while!), or try a stradpad which stays adhered to the instrument.
2) Clean your chinrest, preferably with an alcohol based wipe, solution, or clean face wipe.
I used a stradpad for many years, although I eventually disliked the sonic dampening effect it had on my instrument. For some people, it's not a bother.
3) Look into a hypoallergenic chinrest or chinrest plate. I changed to a plastic chinrest a few years ago, which has helped.
Topical tactics:
1) Wash the afflicted area(s) just as you would your face. The skin of your neck is actually much thinner than much of your facial skin and more delicate.
2) Try non-aggressive cleaners and gentle topical treatments to prevent infection, inflammation, etc: aloe vera, tea tree oil (or cleanser), eucalyptus, or witch hazel are all nice. Depending on whether you are prone to oily or dry skin, you could decide to apply a topical moisturizer if the skin is scaly and dry(for me, that would probably make things worse).
3) Warm a damp face towel and place on the hickey if it starts to bother you or show signs of inflammation. In the case that your hickey starts to get infected, clean it regularly, avoid shaving near it, and cover it with a bandage.
Here's a good article from Chamber Music Today, giving additional thoughts on the matter.
Remember as always that I'm not a dermatologist, so seek medical assistance should your skin become infected, painful, or pus filled. Hope that helps!