March 17, 2022

What the Heck Is Hell’s Itch?

A dermatologist explains this agonizing type of sunburn

Close-up shot of sunburnt skin, peeling on the shoulder to expose raw skin.

Sunburns are common and so is the mild itching and pain that can accompany them. But for certain people, a healing sunburn can turn into a temporarily unrelenting nightmare that’s appropriately nicknamed “hell’s itch.” Though it may seem like a comical name, the symptoms it causes are anything but funny.

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What is hell’s itch?

So, what the heck is it? “Hell’s itch is this deep, painful, almost throbbing, itch that happens one to three days after a sunburn, often on the upper back and shoulders,” says dermatologist Melissa Piliang, MD.

People have described their experiences as feeling “like fire ants are biting you under your skin,” “wanting to rip your skin off” or “an uncontrollable itch that, when scratched, causes stabbing pain.” The symptoms seem to come in waves and typically relent within 48 hours.

Hell’s itch appears to only affect a small percentage of people. “Anyone who has a sunburn could get it, but it seems to be more common in fair-skinned people and people who have been at higher altitudes where the sun is more intense, like in the mountains,” Dr. Piliang says.

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It’s unclear exactly why hell’s itch happens, but it may be due to damage in the nerve endings at the site of your burn, triggering an overreaction. It seems to happen more often with severe sunburns.

Home remedies to help soothe hell’s itch

Most cases of hell’s itch can be treated at home, but “if you have blisters over a large area of your body, fever, chills, dizziness or confusion, you should see a doctor,” Dr. Piliang advises.

She suggests these at-home remedies to relieve your symptoms:

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  • Use ibuprofen, aspirin or naproxen for pain and inflammation.
  • Take an antihistamine like diphenhydramine (Benadryl®) or fexofenadine (Allegra®) to reduce itching.
  • Wet a towel or washcloth in cool water and place it on your burn to help pain and itching. Repeat as desired.
  • Apply 1% hydrocortisone cream for itching. Avoid ointments, as these seal in heat.
  • Try soaking in an oatmeal bath to soothe itchy skin.
  • Keep yourself well hydrated, as sunburns leach fluid from the rest of your body. Water is best, but an electrolyte-replenishing sports drink may be helpful, too.
  • “Be really careful not to scratch the itch because it doesn’t relieve it at all and often makes it worse,” notes Dr. Piliang. “You can also create tears in your skin that can be a portal of entry for bacteria and could lead to infection.”

How to prevent it

If you develop hell’s itch once, you can get it again simply because it’s a risk for anyone with a sunburn. The only way to prevent it is to avoid getting a sunburn. Here are Dr. Piliang’s sunscreen tips:

  • Use a broad-spectrum sunscreen with an SPF of at least 30 whenever you’re outdoors for any length of time. “Broad-spectrum means it protects against UVA and UVB rays,” explains Dr. Piliang.
  • Look for water-resistant sunscreens. “This means it’s less likely to come off if it gets wet in water or from sweating,” she says. Water-resistant doesn’t mean waterproof; you still need to reapply as the label directs.
  • Whether you use a cream, gel, spray, stick or lotion is up to you. “Whichever one you’ll use is the right choice,” says Dr. Piliang.
  • Look into sun-protective clothing. “It can protect even better than sunscreen because you don’t have to reapply it,” she says. Keep in mind that you’ll still need sunscreen on exposed areas of skin.
  • Get in the habit of putting sunscreen on every day. This can be as simple as a light moisturizer with added SPF applied to your face, the backs of your hands and your chest, places that are regularly exposed to sun.
    Use it in the winter, too, because ultraviolet light is still plentiful, plus you can be exposed to small amounts indoors as well.
    Not only does using a daily broad-spectrum SPF moisturizer protect you from sun damage, but it may also have the added benefit of making you look younger by reversing some existing sun damage according to one study, says Dr. Piliang.
  • Don’t let cloudy days fool you. “Clouds aren’t great ultraviolet light filters,” notes Dr. Piliang. “I’ve seen people with terrible blistering sunburns that they got on a cloudy day.”

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