Hell’s Itch: The post-sunburn condition that sent me to hell and back

I like to think I have a high pain tolerance. I’ve been bitten by insects, had broken bones, and have spilled hot oil on myself, but nothing I’ve experienced (as yet) is as painful as the Hell’s Itch.

A few weeks ago I visited CanCon, a board game convention in Canberra. On the final day, the city gave me a parting gift – the reddish-pink hue of a sunburn. I only spent half an hour in the sun walking to and from the car, so it was mild. I’ve been burned plenty of times – it's nothing a bit of aloe vera can’t fix, I naively thought. 

Between 24 and 48 hours after my sunburn, my back started to itch and tingle, which wasn’t unusual considering I’d been frequently lathering on aloe vera. As soon as my fingers met the skin, the whole surface of my back was plagued by an itch that was so strong, so painful, that I could do nothing but fall to the floor. It felt like a hoard of fire ants were feasting on the skin of my back, ripping out little chunks of skin with knives along the way. 

After a minute or so, the itch became agonizing, causing me to writhe around like a contortionist. The worst part was, I just had to tolerate the pain until it passed. If I dared scratch it, that increased the pain tenfold. All I could do was hold my partner’s hand and cry while my whole body convulsed from the torturous itch. 

After the emotional and physical pain of what I’d just experienced, I went to decompress by taking a bath. Not hot or cold, just warm. This was possibly the worst thing I could have done. What I didn’t know, was that if you have the Hell’s Itch, pouring water of any temperature is likely to trigger or exacerbate the pain. As soon as I stepped into the bath, it started over again. All I could do was scream and cry out for my partner as that same tortuous pain overwhelmed me.

I frantically Googled something along the lines of ‘sunburn itches and hurts really bad’, which led me down the rabbit hole that is the Hell’s Itch. There is an entire subreddit dedicated to remedies, experiences, and full-fledged guides on what to do if you’re unlucky enough to experience the Hell’s Itch.

Detailed as an ‘acute, unimaginable itching that occurs in short intense waves after a reasonably mild sunburn’, the Hell’s Itch matched every symptom I was experiencing. Even though it's not a good idea to diagnose yourself based on a Reddit thread, I felt comfort in knowing the unimaginable pain and muscle spasms I was experiencing had a name.

Surprisingly, it's estimated only 5-10% of the population have experienced the Hell’s Itch. Because of this, it's sparsely discussed in scientific literature and the medical field as a whole. As of 2023, there have been only 3 published studies on the Hell’s Itch. While I’d doubt anybody in the Hell’s Itch subreddit was a doctor or had any real medical credentials, they all had one thing in common. They’d experienced the same pain I did and knew how to minimise the pain. Some veterans had even experienced the itch upwards of five times.

Commonly recommended treatments include: 

• Refraining from showers or baths (though scalding hot showers can provide temporary relief)
• No aloe vera or lotions
• Drinking lots of water
• Taking antihistamines and ibuprofen for inflammation and pain relief
• Peppermint oil can provide a numbing sensation for temporary relief

After trying out various treatments based on what worked for other users, I felt relief from the intense waves of the maddening itch thanks to a maximum dose of ibuprofen and lying on a bag of frozen peas. After a whole day of battling with this infernal demon who was using my back as a barbeque, prodding my back with a meat fork, I was finally able to get a few hours of sleep.

It's now been 6 days since I’ve had a full wave of pain, and I feel well-equipped to write about how important sun safety is. Sure, I’ve seen those ads that were plastered all over our TVs during the early 2000s about how bad tanning is. I know how common skin cancer is in Australia, and how important it is to wear and reapply sunscreen on a hot day. But the possibility that I could get sunburnt and have to deal with the Hell’s Itch again makes my skin crawl and makes me petrified beyond reason. I’m honestly willing to swim in sunscreen if I have to. 

You might be like other people I’ve talked to about the Hell’s Itch and doubt how severe it truly is. You might be thinking ‘Okay, I’m sure it hurt, but it probably wasn’t that bad. It just sounds like a nasty sunburn’, and that's okay. Unless you’ve lived through it, it can seem unbelievable.

Australia has one of the highest rates of skin cancer in the world. Not only that but due to our proximity to the equator, we have some of the highest recorded UV levels. UK summers are generally tame, and sit at around 6-8 on the UV index, while Australian summers frequently reach between 10-14. 

Exposure to UV doesn't just increase your risk of skin cancer, it can also speed up the ageing process and cause lifelong damage to your eyes, with different conditions like cataracts and macular degeneration. All it takes is ten minutes of exposure to the sun’s UV rays to cause burns to your skin and leave you with an increased risk of skin cancer, and if you’re particularly unlucky, the Hell’s Itch. 

The minimal research that has been conducted on the Hell’s Itch suggests the cause is exposure to high levels of UV, which causes inflammation and damage to the skin. While it might present the same as a sunburn, the feeling is starkly different. 

It's evident in the subreddit that some people who experience the Hell’s Itch, do not learn their lesson, but I cannot overstate how important proper sun safety is. Take it as a cautionary tale from your fellow Safe Wizard, that this is pain like I have never experienced. Even if you’re just going for a quick dip in the pool, wear a coverup or put sunscreen on any exposed areas, and follow slip, slop, slap like your life depends on it.