Travel tips from Dr Handford: Managing simple medical conditions on holiday
Common medical problems can arise at any time, but some are more likely when you are on holiday. What could be dealt with very easily by a pharmacist or GP at home, can be more difficult to manage when you are in an unfamiliar country, or when there is a language barrier. Here I will give you some advice about how to approach some simple medical conditions.
Prevention is always better than cure! Use an insect repellent regularly, but especially at dawn and dusk as these are the most common times to be bitten. Long sleeves and long trousers can be helpful if you are in a particularly troublesome spot. Plug-in repellent devices are also available and can be helpful at night, but make sure you have the right adaptor plug with you for the country you are visiting. Mosquito nets can be bought very cheaply, and can be invaluable in some destinations.
- What to do
If you get bitten, using an icepack or cold compress can help reduce itch and swelling. An antihistamine cream can reduce redness and itch at the site too. If you have multiple bites, taking an antihistamine tablet by mouth may be useful too. Check with your GP if you are on other medicines to make sure this would be safe. Taking this kind of medication works best if you do it early, so if you have a few bites, or you know you are prone to reacting to them, make sure to act promptly. It is advisable to take a non-sedating antihistamine in the daytime.
Very itchy bites should settle with some steroid cream, which can be bought over the counter in any chemist. Hydrocortisone 1% should be adequate. Use a tiny amount, twice a day for a week, just over the bite itself.
- Not improving…
If despite these measures, the skin around the bite gets more red, tender, or swollen, and especially if you start feeling unwell- with a temperature, nausea or lethargy, seek medical attention as soon as possible. Infections can spread in the skin sometimes and would need antibiotic treatment from a doctor.
Sunburn can ruin a great holiday. Damage to the skin can cause serious problems, including skin cancers, later in life. It is so important to prevent sunburn.
Sunburn is exactly what it says it is- a BURN. Painful, unsightly, damaging, and totally preventable. Avoiding it in the first place is by far the best bet. The sun is at its hottest between 11am and 3pm, so try to avoid spending time in the direct sun during these hours. Be especially careful when swimming or in windy environments, as you may not be aware of the sun's strength. Snow can also reflect the sun's rays and cause sunburn despite cold weather.
Keeping covered up is sensible, but even some thin fabrics will let the sun through. Always wear suncream, at least factor 30 in children, and preferably for everyone. This WILL need to be reapplied every hour or two, and even more often if you are swimming. A hat is also vital to prevent overheating and to protect the face.
- Vulnerable groups
Young skin is especially vulnerable to UV damage, and sunburn as a child is thought to be especially dangerous in terms of developing skin cancers in adult life. Be generous and rigorous with the application of sun cream. SPF 50 is ideal, and aim to apply it at least 2 hourly. Hats and t shirts are essential, and try to stay in the shade rather than the direct sunlight.
Some medical conditions can make the skin more sensitive to UV light, and more prone to burning. Pregnancy makes the skin more sensitive to the sun too. Also, if you take regular medication check with your GP if any of it increases your chance of getting sunburnt.
- What to do if you get burnt
Treating sunburn is aimed at cooling the skin down and easing pain. Stay in a cool environment, and apply a damp flannel or towel to the burnt skin. Drink plenty of water to rehydrate the skin. Using aloe vera gel or an aftersun moisturiser can be soothing.
If you develop skin blistering, or feel dizzy or sick, you must see a doctor. Similarly, if a child or baby gets sunburnt, please see a doctor for advice.
Heat rash, or prickly heat, usually appears after you have sweated more than usual- often a few days after overheating. It can occur anywhere on the body, but is common around the neck, chest, thighs and face.
Small red bumps appear and can be really itchy and irritating. The rash might sting and the skin underneath it can appear slightly swollen. Usually, you do not feel unwell with this- if you have other symptoms, it is best to see a doctor to rule out other causes of the rash.
- Vulnerable groups
Children and babies are especially susceptible to heat rash, so try to prevent them overheating in the first place. Also, people who are overweight or less mobile are more likely to suffer with it.
Preventing heat rash centres around avoiding overheating, and minimising sweating. Dressing appropriately for the environment and avoiding too much direct sun is important. Keep cool in air conditioning or by taking a swim. Drink plenty of water to avoid dehydration.
Heat rash will disappear on its own in a few days. The symptoms can be eased by staying cool, wearing loose fitting cotton clothing, and keeping the skin moisturised.
If this isn't controlling things adequately, antihistamine tablets may help, but check that they don't interact with any other medication you may be taking. Using a steroid cream like hydrocortisone 1% (available from the chemist) can ease the irritation in very sore areas, but use it sparingly only twice a day, and for no longer than a week. Simple calamine lotion can also be soothing, and can be very useful for children.
Cystitis, or bladder irritation, is more common in women but can occur in anyone. The main symptoms are pain or burning on passing urine, and urinating more often than is usual.
Staying well hydrated is the best way to prevent cystitis. Drinking plenty of water, particularly in hot environments, is the easiest way to stop getting this troublesome condition. Cranberry juice is also good for preventing cystitis.
If you are prone to cystitis, it may be advisable to take some potassium citrate granules with you, just in case. These are available from any chemist, and when mixed with water and drunk, can ease bladder irritation symptoms. Drinking plenty of water can also ease discomfort on passing urine.
If these simple measures don't work, and the discomfort on passing urine continues, it may be that you have a urinary infection. This usually needs antibiotic treatment, often just for three days. It is best to see a doctor if things don't improve quickly with the above measures. Also, if you are feeling unwell with these symptoms- for example feeling sick, having a temperature, or any aches and pains, then you need to see a doctor for stronger treatment.
Always consult your own doctor before travelling
These travel tips are intended to provide general information and do not replace a visit to your doctor. If you are planning a holiday you should consult your doctor to ensure that you are fit to travel and discuss any specific health requirements you may have.
About Dr Ruth Handford
Dr Ruth Handford is a GP with over 10 years' experience of working in both hospital and primary care. She is particularly interested in caring for the elderly in the community, child health, and family planning. Ruth lives and works in a rural community, and is kept very busy by her job and young family.
Important Information: These travel tips are intended to provide general information and do not replace a visit to your doctor. If you are planning a holiday you should consult your doctor to ensure that you are fit to travel and discuss any specific health requirements you may have.
Travel Insurance for Medical Conditions
The Foreign and Commonwealth Office recommend that you have travel insurance in place every time you travel abroad. Make sure that your travel insurance covers any medical conditions you may have.
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