Devil’s Itch, or Hell’s Itch, is a severe, delayed reaction to intense sunburn. This condition, medically termed Pruritus Solaris, often begins one to three days after initial sun exposure, long after the typical pain of a sunburn has peaked. The following strategies outline how to manage this acute discomfort using home remedies and medical interventions.
Identifying the Cause of the Intense Itching
Devil’s Itch is a hypersensitive, neuropathic response triggered by severe ultraviolet (UV) damage to the skin’s nerve endings. The intense UV radiation damages the sensory nerves in the skin. As the skin begins to repair, these damaged nerves misfire, sending signals of profound, unrelenting itch and pain to the brain.
This condition differs from the mild, superficial flaking itch of normal healing sunburn. It is a deep, painful, and often throbbing sensation, commonly described as feeling like fire ants biting underneath the skin. Symptoms tend to come in waves and can persist for up to 48 hours, often affecting the upper back and shoulders.
Immediate Non-Medical Relief Measures
The immediate goal is to soothe agitated nerves and reduce inflammation without further irritating the compromised skin barrier. Applying a cool, wet compress or washcloth to the affected area provides temporary relief by calming localized heat and irritation. Use a cool compress, not ice directly, as extreme cold can potentially damage the skin or trigger further irritation.
A lukewarm bath infused with colloidal oatmeal or baking soda can soothe the skin due to their anti-inflammatory properties. Some sufferers report temporary relief from a hot shower, which may override the itch signal, but this relief is often fleeting and can lead to a rebound in itching. Apply pure aloe vera gel without added alcohol, fragrances, or numbing agents, which can sometimes exacerbate the itch.
Crucially, avoid scratching, as this intensifies the neuropathic response and can lead to skin tears and infection. Do not apply heavy or greasy lotions, oils, or petroleum jelly, which trap heat in the damaged skin and make the burning sensation worse. Topical creams that work for normal itch, such as those containing lidocaine or benzocaine, may also worsen Devil’s Itch for some individuals.
Pharmacological and Prescription Solutions
Managing pain and inflammation is a primary step. Over-the-counter (OTC) Nonsteroidal Anti-inflammatory Drugs (NSAIDs) like ibuprofen or naproxen can help reduce both by addressing the systemic inflammatory response caused by the sunburn. Take these medications according to package directions to manage symptoms during the 24 to 48-hour peak of the condition.
Oral antihistamines are a common first-line treatment, particularly sedating types like diphenhydramine (Benadryl). Although Devil’s Itch is not purely histamine-driven, the sedating effect helps sufferers sleep through the most severe nocturnal itching. Non-sedating antihistamines may offer some anti-inflammatory benefit, but the sedating options are often more effective for this intense discomfort.
For severe and unresponsive cases, a healthcare provider may prescribe medications that target nerve pain directly. The anticonvulsant gabapentin has been shown to be effective for various types of neuropathic pruritus, including this nerve-related itch. Prescription-strength topical corticosteroids may also be used to calm extreme localized inflammation, though they are not a direct antipruritic for nerve-related itch.
Strategies to Prevent Future Occurrences
The only definitive method to prevent Devil’s Itch is to avoid the severe sunburn that triggers it, as the condition is a direct consequence of intense UV overexposure. Robust sun protection is non-negotiable for those who have experienced this condition. Apply a broad-spectrum sunscreen with a Sun Protection Factor (SPF) of 30 or higher liberally to all exposed skin.
Reapply sunscreen at least every two hours, and immediately after swimming or excessive sweating. Seeking shade, especially during peak sun hours between 10 a.m. and 4 p.m., significantly reduces UV exposure. Wearing protective clothing, such as wide-brimmed hats and tightly woven fabrics with a high Ultraviolet Protection Factor (UPF), provides a physical barrier.