Hell’s Itch is an intense form of sunburn pain, often described as an unbearable, deep itching sensation, unlike the superficial itch of a typical sunburn. It presents unusual and severe discomfort.
Understanding Hell’s Itch
Hell’s Itch manifests with characteristic symptoms that go beyond typical sunburn discomfort. Individuals often describe a deep, burning, prickly, or crawling itch that feels as though it is located beneath the skin’s surface. This sensation is frequently compared to “fire ants biting you under your skin” or an “uncontrollable itch that, when scratched, causes stabbing pain.” The intense itching typically appears 24 to 72 hours after significant sun exposure, particularly affecting areas like the back and shoulders that may have received prolonged, unprotected sunlight.
While the precise mechanism behind Hell’s Itch is not fully understood, it is widely believed to be related to nerve damage or an overreaction of nerve endings caused by severe ultraviolet (UV) radiation. The body’s inflammatory response to UV damage, which involves repairing skin cell DNA, may inadvertently trigger these nerve endings, leading to the intense itching signals sent to the brain.
Hell’s Itch is often associated with first-degree or superficial second-degree burns. While anyone with a severe sunburn can experience it, Hell’s Itch affects a small percentage of people, with higher susceptibility in those with fairer skin or exposed to intense sun at higher altitudes. The intense discomfort typically lasts for 24 to 48 hours, though some residual sensitivity or milder itching may linger as the skin continues to heal.
Relieving Hell’s Itch
Managing the immediate discomfort of Hell’s Itch involves several practical steps to soothe the affected skin. Applying cool compresses or taking cool baths or showers can provide temporary relief by helping to reduce skin temperature and ease the itchy sensation. It is important to avoid hot water, as it can exacerbate the irritation and strip moisture from the skin. Wearing loose, breathable clothing also helps minimize friction and further irritation to the sensitive areas.
Over-the-counter options can play a role in symptom management. Oral antihistamines, such as diphenhydramine, may help reduce the itching and can also aid sleep, which is often disrupted by the intense sensations. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, or aspirin can address both pain and inflammation associated with the severe sunburn. For topical relief, pure aloe vera gel (without added fragrances, alcohol, or numbing agents) can be soothing, and 1% hydrocortisone cream may help calm inflammation and reduce itching. Colloidal oatmeal baths are also often recommended for their anti-inflammatory properties and ability to alleviate widespread itching.
Certain products and practices should be avoided, as they can worsen Hell’s Itch. Topical pain relief or numbing creams containing ingredients like lidocaine or benzocaine may cause further irritation or allergic reactions. Scratching, while tempting, offers only momentary relief and can damage the already compromised skin, potentially leading to infection. Greasy lotions, mineral oil, or petroleum jelly can trap heat within the skin, intensifying the discomfort. Direct application of ice should also be avoided, as it can be too cold for the damaged skin and may cause further injury.
Seeking medical attention is advisable if the symptoms become unbearable or are accompanied by other concerning signs. A doctor’s visit is recommended for severe blistering over a large area, fever, chills, nausea, confusion, or signs of infection such as red streaks or pus on the skin. In some severe cases, prescription medications may be necessary to manage the intense pain and itching.
Avoiding Hell’s Itch
Preventing Hell’s Itch hinges on diligent sun protection, as the condition is a direct consequence of severe sunburn. Applying broad-spectrum sunscreen with an SPF of 30 or higher is an important step, ensuring generous application to all exposed skin and reapplication every two hours, or more frequently if swimming or sweating. This helps to block both UVA and UVB rays, which are responsible for skin damage.
Protective clothing, such as long-sleeved shirts, wide-brimmed hats, and UV-protective apparel, offers an additional layer of defense against harmful UV radiation. Seeking shade, especially during peak sun hours between 10 AM and 4 PM, can significantly reduce overall sun exposure. Staying well-hydrated by drinking plenty of water also supports skin health and overall recovery from sun exposure. Individuals who have experienced Hell’s Itch once are often more susceptible to future occurrences, reinforcing the need for strict and consistent sun protection measures to prevent recurrence.