Hell’s itch is an intense itching sensation that can occur after a sunburn, distinct from the typical mild itch associated with healing skin. It is often described as a deep, throbbing, or burning itch, likened to fire ants or hot needles. This discomfort often arises 24 to 72 hours following significant sun exposure, particularly on areas like the back and shoulders. While not life-threatening, it can be distressing and disrupt sleep and daily activities.
Understanding Hells Itch
Hell’s itch typically manifests after severe sunburn, though the exact reasons why some individuals experience it while others do not are not fully understood. One theory suggests it might be due to damage to nerve endings in the skin, leading to an overreaction in nerve signals as the skin begins to heal. This inflammatory response can trigger sensations beyond a normal sunburn itch.
Beyond the itching, individuals may experience inflammation, swelling, pain, blistering, peeling, numbness, or tingling. The itching can come in waves. Water exposure, like showering or swimming, or certain topical creams, can sometimes trigger or worsen the reaction.
Immediate Relief Strategies
Relief strategies include topical applications, oral medications, and home remedies. Menthol-based creams may offer a cooling sensation, though their effectiveness varies. Hydrocortisone cream (1%) can calm inflammation and reduce itching, but its effect on deep itch may be limited. Fragrance-free aloe vera gel can soothe skin, but might not be sufficient for severe hell’s itch. Avoid thick, greasy lotions or petroleum jelly, as they can trap heat and worsen burning.
Oral medications are a primary relief option. NSAIDs like ibuprofen, naproxen, or aspirin reduce pain and inflammation. Sedating antihistamines like diphenhydramine (Benadryl) can manage itch and promote sleep. Non-drowsy options like cetirizine may also be tried, but diphenhydramine is often preferred for severe itching.
Home-based techniques can provide comfort. Some find temporary relief from hot showers, theorizing intense heat overloads nerve endings. Use caution to prevent burns or irritation. Cool compresses or washcloths can calm skin, but avoid direct ice application to prevent damage. A lukewarm colloidal oatmeal bath may also soothe irritated skin. Staying hydrated is important, as sunburn can lead to fluid loss.
Avoid scratching, which can intensify pain and lead to skin damage or infection. Also avoid tight clothing, salicylic acid products, or numbing creams, as these may cause further irritation.
When to Seek Medical Help
While hell’s itch usually resolves on its own, seek medical attention in certain situations. If itching is unbearable despite home remedies and over-the-counter medications, a doctor can provide stronger prescriptions. Signs of infection, like pus, spreading redness, increased pain, or fever, require immediate medical evaluation. Severe blistering over a large area also requires medical assessment to prevent complications.
Consult a doctor if the affected individual is a young child, as their skin is more delicate and prone to severe reactions. Individuals with underlying health conditions should also seek medical advice for safe treatment. A healthcare provider can assess severity, rule out conditions like sun poisoning, and offer tailored guidance.
Duration and Recovery
Hell’s itch is generally a short-term, intense experience. It typically subsides within 24 to 72 hours, though some report it lasting longer. Symptoms often peak within 48 hours and diminish as skin heals. While the itching resolves, the skin will still be recovering from the sunburn.
Recovery involves skin healing from sun damage, which may include peeling. Gentle skin care is beneficial during this time. Protecting healing skin from further sun exposure prevents recurrence or additional damage. This includes sun-protective clothing, seeking shade, and applying broad-spectrum sunscreen (SPF 30+) to unburned areas outdoors.