[1] The main cause is a type-I hypersensitivity reaction to products containing abietic acid, such as the rosin/colophony, which is commonly used as a friction-increasing agent.

Ballet and flamenco dancers sometimes rub their shoes in powdered rosin to reduce slippage before going on stage.

Gymnasts, baseball pitchers and ten pin bowlers use rosin to improve grip.

[3] Cutaneous disorders in musicians include frictional injury ("fiddler's neck"), hyperhidrosis, acne mechanica and vascular compromise.

Other agents of irritant and allergic contact dermatitis may be rosewood, Makassar ebony, cocobolo wood, African blackwood, nickel, reed, propolis (bee glue), chromium and paraphenylenediamine.