Sunburn is a common problem, especially as many people bare more skin during the longer days of summer. Past research suggests around one-third of U.S. adults get sunburned in a given year, with the incidence highest among men, whites, young adults and those with higher incomes, according to national surveys.
For many, the skin reddening caused by overexposure to ultraviolet light — from the sun or tanning beds — may be an uncomfortable annoyance. Symptoms can include tender skin, blisters that develop within hours or even days of the sunburn or skin peeling. However, the long-term impact can be more severe. “The damage to skin cells is often permanent, which can have serious long-term effects, including skin cancer and early aging of the skin. By the time the skin starts to become painful and red, the damage has been done,” according to the National Institutes of Health. “Pain is worst between six to 48 hours after sun exposure.”
What’s more, some people experience severe reactions such as fever, chills and nausea — and in certain cases, a seemingly all-consuming, extreme itch from sunburn. What might seem like a comical result of laying out in the sun for too long is anything but for those who have what’s referred to as sunburn itch — or hell’s itch.
Not an official diagnosis, sunburn itch describes an intensely painful itch that a small proportion of people who develop sunburn experience. In online message boards and forums “many sufferers often describe the condition as hell’s itch, devil’s itch, suicide itch, even fire ant itch,” notes says Dr. Sailesh Konda, an assistant clinical professor of dermatology at the University of Florida College of Medicine and director of Mohs surgery and surgical dermatology at UF Health Dermatology in Gainesville. Some say sunburn itch is so bad they want to basically rip their skin off.
This goes well-beyond a mild itch that’s more common with sunburn, and experts say it tends to begin within one to three days of sustaining a sunburn. While it seems to occur more often when the sunburn is severe, it’s still not entirely clear what causes hell’s itch. Mercifully, it doesn’t last forever — usually not longer than 48 hours after the intense, painful itching begins, clinicians say. But during this time period, people have the strong urge to scratch, which experts caution against since it won’t really soothe the itch and can actually exacerbate it.
Soothing the Pain
Because of the long-term risks associated with skin damage from sunburn, if you have any concerns about lasting damage or questions about reducing your risk of skin cancer, experts say it’s important to see a board-certified dermatologist. The specialist can also help advise on treatment for severe sunburn.
For milder burns that can be treated at home, it’s key to understand why sunburn itches. In particular, two components contribute to sunburn itch: inflammation and dryness. Inflammation from ultraviolet radiation can irritate the nerves in the skin and really make you want to scratch that itch. “Which is why, with a lot of inflammatory skin diseases, a lot of them will itch,” explains Dr. Adam Friedman, interim chair of department of dermatology at the George Washington University School of Medicine & Health Sciences. What’s more, the skin’s ability to hold onto moisture is diminished after sustaining a sunburn, which is why the skin can feel kind of tight, even rigid, and that dryness can make you itchy too.
Keeping that in mind, there are a few things that can help relieve sunburn itch and ease the pain. Here’s what experts suggest you can do:
— Use a cool compress, like a washcloth soaked with cold water.
— Apply a moisturizer that’s cream-based to prevent further drying.
— Use a topical steroid like 1% hydrocortisone cream that’s available over the counter.
— Soak the affected area in an oatmeal bath.
— Take a nonsteroidal anti-inflammatory drug, or NSAID, like ibuprofen or aspirin.
— Take an antihistamine, which can decrease inflammation and the associated itching.
— Drink lots of water to stay hydrated.
“We always have patients make sure that if they have had a significant sun exposure to drink plenty of water,” says Dr. Mary Noland, a dermatologist in the University of Virginia Health System. “Because you do lose a lot of fluids through the skin surface, especially when there’s that radiant heat from the burn.”
Submerging the affected area in colloidal oatmeal — which can be purchased at retail pharmacies — may soothe and help relieve itchiness. While research is scant on home remedies and treatment for sunburn itch, approaches like the oatmeal bath are safe, experts say, and seem to be beneficial.
That said, clinicians reiterate, it’s best to see a doctor if you’re unsure about how to treat severe pain following a sunburn to discuss, for example, if stronger medications like prescription steroids are needed — and again for any concerns related to skin damage.
Prevention — or Keeping It From Happening Again
The best approach of all — though it may be too late this time around to stop sunburn itch — is preventing sunburn in the first place.
Make sure to choose a sunscreen wisely if you’re going to be outside and exposed — selecting a product with at least 30 SPF that offers broad spectrum protection. And wear enough of the stuff — most people don’t — following product instructions and liberally reapplying every two hours.
What’s more, experts emphasize, remember that sunscreen is only part of the strategy to protect against harmful UV exposure. It’s not a license to stay out in the sun longer or ignore other rules, like generally wearing sun-protective clothing and trying to limit exposure and find shade between 10 a.m. and 2 p.m., when the sun’s rays are strongest.
If you’ve ever experienced sunburn itch, or even milder symptoms, you may be more motivated to protect yourself from harmful rays in the future. Among other considerations, “obviously the short-term risks are redness, scaling and then peeling of the skin, which are accompanied usually by pain and itching,” Noland says. “Then long-term damage to the skin can increase your risk of skin cancers. So it’s really critical to protect your skin from sunburn.”
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