Hell's itch is a rare sunburn reaction that feels like 'fire ants under the skin' - here's how to treat it

• Hell's itch is a rare response to a sunburn that causes uncontrollable itching.
• Though research on hell's itch is limited, it could be caused by chemicals released from a sunburn.
• Hell's itch will resolve on its own, but you can treat it with antihistamines and moisturizers.

Ultraviolet (UV) rays can cause plenty of skin damage and pain if proper precautions aren't taken. As if a painful sunburn isn't bad enough, in rare occasions, it can escalate. This phenomenon is referred to as "hell's itch."

What is hell's itch?

Hell's itch is a rare, extremely uncomfortable response to a sunburn, says dermatologist David J. Leffell, MD, section chief of the Dermatologic Surgery and Cutaneous Oncology Programs at Yale Medicine. It will typically crop up two days after a severe sunburn has occurred, and will last for two or more days.

"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," says Leffell.

The scientific literature has minimal information on the phenomenon of hell's itch. One of the only mentions of it in medical journals is a firsthand account by a medical student that was published in 2018 in the Journal of Travel Medicine. He describes it as the worst pain he's ever felt in his life.

Despite the lack of concrete medical evidence surrounding hell's itch, Leffell believes in the severity of the condition. "Most of the information about hell's itch appears in the non-medical literature but there is little reason to doubt the complaints likened to 'fire ants under the skin'."

What causes hell's itch?

Since there is so little information about this rare condition, doctors do not know what exactly causes hell's itch. But Leffell believes it's related to the tissue injury that sunburn causes.

He says some people might have extreme reactions to the chemicals that the body releases which are related to itch and pain. Additionally, he cites some studies on sunburn that show that a release of chemicals can increase sensitivity to pain.

"Remember, our skin is our largest sensory organ so it is not surprising that if it is badly injured our bodies will express their disapproval by discouraging us from getting a sunburn again," says Leffell.

How to treat hell's itch

Because hell's itch is so poorly understood, there is no cure or treatment for it. "The condition is self-limited but does resolve on its own, so the key is getting through the couple of days of potentially severe discomfort," says Leffell.

You can relieve the discomfort while you wait it out with the following at-home methods, according to Leffell:

• Over the counter nonsteroidal anti-inflammatory medication (NSAIDs) such as ibuprofen or aspirin (aspirin should only be taken in adults, Leffel says)
• Antihistamine medication
• Topical steroid cream
• Gentle moisturizers
• Oatmeal bath in lukewarm water

You should also avoid hot showers and creams with unknown herbal components, Leffell says. This goes for any type of sunburn, but especially for hell's itch.

If the pain is extremely severe and not responding to any of these remedies, contact your doctor to see if they can help relieve your pain and discomfort. They can prescribe stronger medications such as a prescription-strength steroid cream or pain meds, and make sure that nothing else is going on.

Insider's takeaway

Though there is very little research on hell's itch, many anecdotal accounts describe it as a painful, uncontrollable itch following a sunburn. You can try to treat hell's itch with an oatmeal bath, gentle moisturizers, antihistamine medication, and topical steroid cream.