Hell's Itch: A Self‐Case Report

ABSTRACT Hell's itch is a severely distressing dermatological condition characterized by the onset of incessant itching and intolerable pain 2–3 days post‐sunburn. It is underdiagnosed and underreported, and no definitive management framework has yet been developed. The objective of this self‐case report is to contribute to the limited body of published literature on Hell's itch by documenting and analysing a first‐hand experience of the condition, as well as to propose a definitive treatment plan. The report describes the first‐hand experience of Hell's itch by a 21‐year‐old male medical student, including symptom progression, treatment strategies and responses to said strategies. A comprehensive review of all the available published literature on Hell's itch was conducted to compare findings and treatment strategies, thus culminating in the proposal of a definitive management plan for future sufferers of the condition. A mild sunburn evolved into incessant itching and intolerable pain 2–3 days later, after the trigger of a hot shower. Effective relief of symptoms was achieved by immediate medical treatment with a combination of NSAIDs, analgesics, corticosteroids and antihistamines. Although published literature on Hell's itch is limited, commonalities were identified in the trigger of symptoms by showering, the symptoms themselves and effective treatment by NSAIDs and antihistamines. Healthcare workers should be aware of Hell's itch and consider the diagnosis strongly in patients presenting with severe post‐sunburn pain and itching—the proposed treatment model should be considered in the management of sufferers. Patients should be advised to avoid hot showers after any degree of sunburn. Further research is required to improve the understanding of the prevalence, pathophysiology, causes and effective treatments for Hell's itch.