The term “Devil’s Itch,” also known as “Hell’s Itch,” describes an intense, painful form of itching that can occur following a severe sunburn. This sensation is far beyond the mild flakiness or irritation associated with a typical burn. Those who have experienced it often describe the feeling as if fire ants are crawling or stinging beneath the skin. This severe reaction is a relatively rare but distressing consequence of sun damage.
Recognizing the Symptoms
The onset of this phenomenon is distinctive, usually appearing about 48 to 72 hours after significant sun exposure, when the initial pain of the burn begins to subside. Instead of the expected mild itchiness that accompanies skin peeling, the sensation transforms into a deep, unrelenting torment. People frequently describe a burning, stinging, or crawling feeling that seems to originate deep within the dermis.
This irritation is often accompanied by an urge to scratch, which offers no true relief and can even make the sensation worse. The experience is debilitating and can interfere with sleep and daily activities for the few days it lasts, contrasting sharply with a common sunburn itch that responds to simple moisturizing.
The Biological Cause
The underlying mechanism of Devil’s Itch centers on damage to the superficial nerve endings in the skin caused by ultraviolet (UV) radiation. Severe sunburn compromises the protective barrier of the skin, and the UV rays penetrate deep enough to irritate or damage the cutaneous nerve fibers, particularly the nociceptors and C-fibers responsible for transmitting pain and itch signals. Research shows that both UVA and UVB exposure can reduce the density of these free nerve endings.
This damage leads to a state of hypersensitivity, where the nerves become confused and misfire, sending an overwhelming signal to the brain. The pain signal is misinterpreted as a deep itch, a condition categorized as a form of neuropathic pruritus. When a person attempts to scratch, the mechanical action further stimulates these hyper-sensitized nerve endings. This is why scratching provides only momentary distraction before the feeling returns, often amplified.
Effective Relief and Treatment
Immediate relief often involves a combination of strategies aimed at calming both the inflammation and the hyperactive nerves. Taking an oral non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen or naproxen is recommended to reduce the underlying inflammation and pain caused by the sunburn. This internal reduction of swelling can help minimize the pressure and irritation on the compromised nerve endings.
Pairing the NSAID with an oral antihistamine, specifically one containing diphenhydramine, is often helpful because of its sedative properties. While it may not directly stop the neuropathic itch, the drowsiness can provide much-needed rest and break the cycle of discomfort. It is also effective to apply a cold compress or a cold, wet towel directly to the affected area, as the cool temperature provides a temporary numbing effect on the irritated nerves.
It is important to avoid applying heavy lotions, petroleum jelly, or thick aloe vera gels that contain added fragrances or alcohol, as these can trap heat within the skin and exacerbate the burning sensation. Similarly, most topical anesthetics, such as lidocaine creams, should be avoided unless advised by a healthcare professional, as they can irritate the sensitive skin.