“[…] In most towns, the primary artist was simply the cemetery’s own gravedigger, or sometimes a local carpenter, but during the ninenteenth century skull painting was popular enough to sustain a class of artists who made yearly trips to villages to paint skulls. If something more fine than what the local artisans could provide was desired, the skulls would be saved until this professional made his visit. In some cases decorating the skull went beyond painting to include props. In the Eggelsberg charnel there was a woman’s skull to which a skeletal hand draped in black lace was attached, the bony fingers covering the nose and eye sockets. In Emmetten, Switzerland, it was reported that the local custom was to decorate the skulls with ribbons, and affix family emblems or coats of arms. Sometimes a cord would be added, tied around a cheekbone, and knotted whenever prayers were said on behalf of the deceased.”
Paul Koudounaris, The Empire of Death: A Cultural History of Ossuaries and Charnel Houses