Brass Instrument-Related Dermatitis and Cheilitis: A Cross-Sectional Survey Study of Brass Musicians

Background: Despite known dermatologic risks from sustained mouthpiece contact, the prevalence, clinical presentation, care-seeking patterns, and hygiene practices related to mouthpiece-associated dermatitis and cheilitis in brass musicians remain poorly understood. Objective: To characterize mouthpiece-related dermatitis/cheilitis symptoms, performance impact, care-seeking behavior, and hygiene practices among brass musicians. Methods: Brass musicians aged ≥15 completed an anonymous 18-item survey. Quantitative data were analyzed with descriptive statistics and logistic regression. Open-ended responses underwent thematic analysis. Results: Of 228 respondents, 48.2% (95% confidence interval [CI]: 41.8–54.7) reported any mouthpiece-related symptoms and 28.1% (95% CI 22.6–34.3) reported definite symptoms. The most common symptoms were redness (67.6%), lip swelling (53.7%), and dryness (52.8%), with impacts on performance quality (47.2%) and the need for playing breaks (46.2%). 80.0% of respondents indicated hygiene familiarity, but only 38.1% cleaned their mouthpiece at least weekly. Symptom reporting varied by age ( P = 0.010) and professional level ( P = 0.002), though multivariable estimates were imprecise. Qualitative themes highlighted physical and mental symptoms, mouthpiece materials, and self-management. Conclusions: Mouthpiece-related dermatitis and cheilitis are prevalent among brass musicians, frequently impacting performance, yet care-seeking remains limited and symptoms are often self-managed outside formal health care settings.