Hell's Itch - featured image

One Hell of a Sunburn: What is Hell's Itch and How to Treat It

As we settle into Fall, many of us are still enjoying the remaining warm weather by spending time outdoors. And while we may be slathering on the SPF 30, sometimes a sunburn sneaks up on us. For most of us, this means a few days of discomfort followed by peeling skin. But for some unlucky people, a sunburn can trigger something worse. Much worse.

Just in time for Halloween, we're taking a look at one of the most frightening things that can happen to your skin. No, this doesn't have anything to do with Hannibal Lector; though we're talking about something so horrifying that it's earned a name that certainly sounds like it came straight out of a horror movie: Hell's itch.

In this article, we're going to look this dermatological demon straight in the eyes to see what causes it, how to identify it, and - most importantly - how to get rid of it! 

The answers might surprise you!


What is Hell's Itch?

Hell's itch is a rare, but extremely painful, complication of too much sun exposure. It gets its name from the fact that it can cause such intense itching and discomfort that it feels like you're in, well, you know.

The name alone hints at how terrifying this condition is, but what exactly is hell's itch? And how do you know if you have it?

Simply put, hell's itch is an extremely intense itching sensation that can occur after a sunburn. From those who have had the misfortune over experiencing hell's itch, it's almost impossible to put into words how intensely itchy and painful it is.

According to Dr. David J. Leffell, MD of Yale Medicine, "It is described as a maddening, uncontrollable itch of the affected skin. Some have described it as deep sandpaper rubbing on the skin or severe pins and needles."

Another common description is that the pain is like "fire ants under the skin".

closeup of a fire ant


The condition usually occurs within 24 to 72 hours of being exposed to the ultraviolet light of the sun's rays, and lasts around 48 hours. Most people experience it on their shoulders and backs, perhaps because these areas are often exposed to the sun.

Luckily, the implications aren't worse than a couple of really uncomfortable days. Even though hell's itch is excruciating, it doesn't pose a serious threat to your health and can be soothed with home remedies.

What Causes Hell's Itch?

While regular sunburns are a very common complaint, it's hard to say exactly how common hell's itch is. Some estimates suggest 5 to 10 percent of the population has experienced it. 

The exact cause of hell's itch is unknown, but the condition is thought to be caused by damage to nerve endings, which can become irritated and inflamed.

According to a doctor writing in the Journal of Travel Medicine, “the true nature of hell’s [itch] is still a conundrum, though it appears to be a brief self-limiting epiphenomenon producing considerable discomfort”.

Basically, when you get a sunburn, you suffer skin damage. This damage causes your body to release histamines and other chemicals to try and repair the damage, resulting in pain and itching. For most people, this process is not pleasant, yet certainly short of unbearable.

But for some people, the damage to nerve endings is so severe that it causes an intense and unbearably painful itch described in a dedicated subReddit as an itch so bad "(that) I thought I was dying the pain was so bad. I remember thinking that it would literally be better for doctors to pull the skin off my back than to leave me with that terrible itch."

How To Treat Hell's Itch

If you're unfortunate enough to have a case of hell's itch, it's a fair assumption that there's little else you care about at the moment other than making it stop.

The good news is that, because hell's itch is not a serious condition, there are a number of things you can do to soothe the itch and get some relief.

However, one of the most surprising things about some of the solutions is how counterintuitive they may seem. As some on the subReddit state, "Everything you do for sunburn, you should do the opposite."

For example, if you've literally burned the skin on your back from exposure to the sun, the last thing you would want to do is expose the skin to extreme heat, such as that of a hot bath or shower. Yet that's exactly what many people with hell's itch report as providing some relief. Just be sure not to have the water so hot as to cause additional burns.

Interestingly, certain traditional sunburn treatments such as aloe vera lotion have little to no effect on hell's itch. In fact, some people report that these treatments make the itch worse.

One product that has shown to be extremely effective at immediately soothing the itch is Dermeleve®.

Dermeleve® is a revolutionary, clinically-proven, steroid-free, over-the-counter product created by Dermatologists. Made with natural ingredients like shea butter, ceramides, and free of dangerous corticosteroids, Dermeleve® provides fast acting and long lasting relief in a topical cream that be be used as often and for as long of a time as desired.

With a single application, many patients feel relief from itch in as little as five minutes, with results lasting up to five hours or more.

Another potential avenue for relief can come from the use of antihistamines like Benadryl, that help to relieve the itch by suppressing histamine production. 

Prevention Tips to Avoid Getting a Sunburn in the First Place

Of course, the best way to deal with hell's itch is to avoid getting a sunburn in the first place.

There are a few things you can do to help minimize your risk:

  • Use sunscreen regularly and generously, especially if you have fair skin. Be sure to reapply every two hours, or more often if you're sweating or swimming.
sunscreen being squeezed into a hand
  • Seek shade whenever possible, especially during the peak hours of 10 a.m. to 4 p.m.
strong sun shining through an umbrella
  • Cover up with clothing, including a wide-brimmed hat, long-sleeved shirt, and pants.
woman on a boat wearing protective clothing
  • Avoid tanning beds.
Tanning beds can be extremely harmful for your skin and should be avoided.
  • Check the UV index for your area and take extra precautions when the index is high.
App showing the UV index

Home Remedies For Treating a Sunburn

If you do find yourself with a sunburn, chances are good it's not quite as bad as hell's itch. Nevertheless, it's still important to take care of your skin and treat the burn properly to minimize discomfort and prevent further damage.

Some home remedies people have found helpful in treating a sunburn include:

  • Applying a cool compress to the affected area. This can be done with a cloth dampened with cool water or even a bag of frozen peas wrapped in a towel.
  • Taking a cool bath or shower.
  • Avoid using soap, which can further dry out your skin. Instead, add colloidal oatmeal or baking soda to the bathwater to help soothe the skin.
  • Gently patting the skin dry rather than rubbing it.
  • Applying a moisturizer to the affected area. Be sure to avoid any products that contain fragrance, which can irritate the skin. Good choices include petroleum jelly, aloe vera, and coconut oil.
  • Wearing loose-fitting, breathable clothing.
  • Stay hydrated by drinking plenty of fluids.

When to See a Doctor About a Sunburn

Most sunburns can be treated at home and will eventually heal on their own. However, there are a few cases where you should see a doctor.

If you have blisters or your skin is peeling, it's important to see a doctor to make sure you don't have a more serious condition such as heat stroke or heat exhaustion.

peeling skin

In addition, if you have a sunburn that covers a large area of your body or is accompanied by other symptoms such as fever, chills, nausea, or dizziness, it's best to seek medical attention.

Finally, if you have a history of skin cancer or are concerned about any changes in your skin, it's always best to err on the side of caution and make an appointment to see a dermatologist.


Wrap Up

Hell's itch is a very real and extremely painful and severe sunburn complication. Luckily, relatively few people will ever experience it.

woman scratching painful itch

By taking precautions to avoid a sunburn in the first place and using an effective treatment like Dermeleve® if you do find yourself with one, you can help ensure that a fun day in the sun doesn't turn into a living nightmare.

After all, there's nothing worse than being one of the unlucky few who find out that hell truly is a place on earth.