‘Fire ants under my skin’: I was struck down by hell’s itch, the searing pain of the summer

Last week, I found myself standing half naked on the sidewalk outside a CVS in Brooklyn frantically attempting to apply daubs of aloe vera gel and hydrocortisone to the bit of my back between the shoulder blades all while dramatically squirming in pain. Passers byenjoying ice-cream in the oppressive heat glanced at me before quickly looking away – and rightly so. I looked insane, but I had read online that these gels would relieve my pain. I slathered on half a tube and waited for cool relief.

Instead I was struck with only further agony: it felt like I was being stabbed by the sharp point of a thousand compasses while lemon juice and itching powder was rubbed into the wounds.

Two days earlier, I had gone to the beach armed with my usual two bottles of sunscreen lotion. After a swim, I did my best to reapply, but I couldn’t quite reach a few spots and – generous soul that I am – I didn’t want to force my friends to negotiate the forests of my back hair. It was already 3pm, I told myself – it would probably be fine.

My skin stung slightly when I took a shower later, but I’ve had sunburn before and it’s always been fine. Then, 48 hours after the initial burn, something changed. I was working out in my bedroom when I started to get the most intensely painful itch I’ve ever experienced. I contorted and twisted my body while it spread like a volcano erupting under my skin.

My first instinct was to reach for Sudocrem – a toothpaste-thick antiseptic cream which is good for burns and that I already had on hand. But that made things worse – like I had reached for a bandage and somehow come back with a blowtorch.

I ran a freezing cold shower and started contorting my body to get the stream of cold water to whack the mole of each new itch. In that moment, I finally truly understood the meaning of the verb “writhe”. But as soon as I got out again the barbed pain returned worse than before. My next stop was the pharmacy for aloe and hydrocortisone, the trip that resulted in me becoming the kind of man that parents pull their children away from.

When I got back home I went straight back to an ice cold shower. Holding my phone out of the water as I did so, I managed a Google search for “something irritated sunburn crazy” which lead me to a solution: a subreddit dedicated to “acute, unimaginable, itching that occurs in short, intense waves … 2-3 days after a reasonably mild (non-blistering) sun burn” also known as “hell’s itch”.

There, every few hours someone was posting symptoms just like mine. But reading them was not much comfort.

“I feel as if there are fire ants crawling underneath my skin and they are pissed off … this is the worst pain I’ve ever had, and that includes breaking my collarbone.”

“Currently dealing with hell’s itch at work. I’m a concrete pump operator and I literally wanna cover myself up with concrete and die. I think it would be way better than dealing with this.”

“I WANT THE SWEET RELIEF OF DEATH PLEASE MAKE THIS SHIT STOP I HATE EVERYTHING AND EVERYONE. I WANT TO FUCKING SCRATCH MY SKIN WHIT RUSTY FORKS AND TEAR IT O MY CORPSE AND BURN IT.”

What exactly is causing all this discomfort? Though there has been little research into the phenomenon, the Cleveland Clinic describes hell’s itch as “this deep, painful, almost throbbing, itch that happens one to three days after a sunburn, often on the upper back and shoulders”. It probably affects only “a small percentage of people” and “may be due to damage in the nerve endings at the site of your burn, triggering an overreaction”.

References in medical journals tend to cite Reddit posts or other online accounts. One doctor writes in the Journal of Travel Medicine that the “the true nature of hell’s [itch] is still a conundrum, though it appears to be a brief self-limiting epiphenomenon producing considerable discomfort”.

Beyond helping to restore my sanity by assuring me that I was not imagining my pain, the hell’s itch subreddit provided me with the best crowdsourced advice for dealing with the condition.

“Don’t apply aloe or anything topical” was one of the first things I saw. “Everything you do for sunburn you should do the opposite” said another. This advice came a little too late for me, but I’m happy to pass it on.

Instead, the subreddit provides recommended treatments in a pinned post: the most common are maximum dosages of an antihistamine like Benadryl, ibuprofen and unspeakably hot baths or showers. (Users also recommend peppermint oil as the only effective topical treatment, but I wasn’t about to make another madman trip to the pharmacy.)

Those remedies are broadly endorsed on the board, but others are fiercely disputed. Some hell’s itch veterans swear by covering themselves in vinegar soaked rags, or scratching the “burn” off until the entire layer of skin has gone. (The subreddit is also full of users who tried those remedies, only to complain that they made things worse.)

I kept things simple with the Benadryl and hot water – lowering my back into a bath that was too hot to put my legs in – and they eventually provided some relief.

The day was brutal but by the time I woke up the next morning, everything was back to normal. Since then I’ve spent a lot of time on the Wirecutter page for best sunscreens – but I think this might be the end of my tops off summer.