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Summer health webchat

nidirect teamed up with the health professionals from the Department of Health, Social Services and Public Safety and the Public Health Agency to hold a one-hour webchat on 8 July 2010 to answer your questions about summer health matters. Questions and answers from the online session are available below.

Webchat transcript

Welcome to nidirect's webchat about family health in the summer. A team of health professionals will answer your questions.

I am going on holidays to South America and would like to know do I need any injections?

It is very likely that you will need some injections. Exactly what you will need will depend on things like which countries you are going to, where in the countries you are going to, how long you are there for, what injections you have had before etc. All these things need to be worked out on an individual basis.

You may also need to consider other things like tablets against malaria. So it is important that you make an appointment either with your GP surgery or with a specialist travel clinic - preferably at least six weeks before you go - so that all these things can be sorted out with you.

Every year when I go abroad I get bitten by mosquitoes. This year was the worst and on one night out I got approximately 13 bites around each ankle/lower leg. Other people in my group didn't get bitten at all. What makes them bite a particular person and is there any thing I can do or eat before I go to help?

There is nothing you can do before you go, but while you are there you can try and keep as much of your skin covered after dark by wearing long sleeves and trousers with long legs and then spraying any exposed skin with a repellent containing DEET.

You can spray this on your clothes as well to try and keep them away. It might be best to buy this here and take it with you in case you can't get it where you are going. Mosquitoes normally bite after dark, but other insects can bite as well, so if you're not sure if it is mosquitoes you may need to apply the spray during the day as well.

My eight-year old-son comes out in a very bad rash when I put sunscreen on him. I have tried most types at great cost to myself and he reacts to every one. I have sought advice from my GP, who simply said that the Titanium Dioxide is probably what he reacts to and to keep trying other products. I find this most unhelpful, as sunscreens are not cheap and the long-term effect these creams have on my son's skin could be damaging his skin more than the sun itself.

Lots of children and adults get an irritant reaction to sunscreens and a trial and error approach is usually advised. If the rash that your son gets is very bad, it’s worth asking your GP to refer him to a dermatologist who could do a patch test for sunscreens.

If I run out of my medication while on holidays, what can I do?

This would very much depend on what country you were in. In some countries it could be a lot harder replacing it than others, so the obvious answer is make sure that you don't run out. You know how long you are going on holiday for and add on a few more days for emergencies. Remember the recent problems with volcanic ash and how long people were stranded for - and make sure you take plenty with you to cover the worst possible situation.

Both my children have red hair and fair skin. What is the best factor of sun cream to use?

Protection should take the form of shade and clothing in the first instance, with Sun Protection Factor (SPF) 50+ applied as an extra precaution. Sunscreens should be applied regularly, especially after swimming, and they need to be applied liberally to ensure sufficient coverage.  

I enjoy rambling and I wanted to know: what is the likelihood of getting ticks and are there any health implications?

There is a risk of getting ticks depending on where you are rambling, and this risk is present in parts of the UK and Ireland, so it is probably best to take precautions. They are also very widespread in Europe. The main risk from ticks in this country is Lyme disease. The Health Protection Agency and The Royal Parks have recently produced a useful leaflet about the topic which is available at:

I take medication on a regular basis. I am going on holiday to America for two weeks - do I need a GP's letter explaining why I am carrying this volume of medication?

If carrying medicines when travelling to another country, the Foreign and Commonwealth Office recommend that you take a letter from your doctor confirming the need for your medicine.

Further information can be found on the following website at

I tan very easily; does this mean that I don't have to worry about overexposure to the sun?

A tan is really a sign that your skin has already been damaged and tanning easily does not mean that you are not at risk of developing skin cancer.  Intense and prolonged exposure to the sun should be avoided. If this is not possible, then appropriate clothing and sunscreen (SPF 30+) should be used.

Someone told me that once you get over factor 15, there's no difference in the protection you get from sun creams. Is this true?

No sunscreens offer 100 per cent protection from ultraviolet (UV) rays, therefore they should always be used as an accompaniment to shade and protective clothing. SPF 15 provides a 93 per cent reduction in UVB whereas SPF 30 provides 97 per cent reduction. However, experts recommend that SPF 30+ is used for adults to ensure maximum coverage and to allow for sunscreen not being applied as thoroughly as it should be.

My hayfever is playing up. What can I do to make it a bit more bearable?

This is something you should discuss with your GP or with a pharmacist. They will be able to advise you what to take according to your individual circumstances.

My son injured his neck while playing squash last night and went to hospital to get an x-ray this morning. What should he do while he waits for the results and should he attend work?

As we don't have the details of your son's injury, it is best that you seek advice from your GP or one of the doctors who treated him in hospital.

Can you advise on the best way to avoid and/or treat prickly heat? Keeping out of sun has no effect against the discomfort and rash

If you are prone to prickly heat, it is certainly best to try to prevent an episode. If you are going on holiday, try not to visit countries with hot, humid climates. If you are somewhere hot, try to keep as cool as possible and don’t do anything that is likely to make you sweat. You should also wear loose, light clothing.

Certain lotions, like calamine, can have a cooling or soothing effect on the rash and should ease the discomfort caused by prickly heat. It is important to discuss this issue with your GP if you are unsure of the diagnosis.

I have heard a lot about P20 as a sun block. Please can you inform me if this is an effective sun block as I am a redhead with very sensitive skin? I usually wear Factor 25, reducing to Factor 20 after a week in the sun. I am off to Greece this month for two weeks and I am tempted to purchase P20 as it requires one application. Please can you advise?

If you have sensitive skin and are prone to burning then a sunscreen containing SPF 20 might not be the most suitable for your skin type. The British Association of Dermatologists recommends that if you are very fair you need to regularly apply sunscreen containing SPF 30 at least. You also need to ensure that your sunscreen protects against UVA as well as UVB, so make sure that any product you choose has a UVA rating of four stars or above.  

In addition, you should adopt other skin care precautions such as avoiding the sun during the hottest part of the day, and making use of appropriate clothing and shade to ensure that you don't burn.

Can you explain what UVA and UVB mean in relation to sunscreens?

UVA and UVB are ultraviolet (UV) rays from the sun. UVA can penetrate into the deeper layers of the skin and is believed to play a major part in skin aging and wrinkling. Importantly, recent studies strongly suggest that it may also initiate and make worse the development of skin cancers.

UVB is responsible for burning, tanning, and acceleration of skin aging. It has a very key role in the development of skin cancer.  

People choosing sunscreens need to be sure that they pick one which protects from both UVA and UVB. The sun protection factor (SPF) rating is for UVB while the stars denote the level of UVA protection. A minimum of four stars is recommended.

I am worried about flying on a long distance flight. I have heard about getting cramps/ DVT in my legs, what can I do to avoid this?

Deep Vein Thrombosis (DVT) is a recognised risk of long haul air travel, although it does tend to occur quite rarely. Certain medical conditions, such as cardiac disease, stroke or recent surgery, could put someone at increased risk of developing a DVT. Obesity is also a potential risk factor. It is best to discuss specific medical issues with a health professional before travelling.

However, in general on long journeys it is best to try to get up and walk about at least hourly and exercise calf muscles by rotating your ankles. Drinking plenty of fluids such as water or fruit juices is also helpful, as dehydration is a risk factor for DVT. Avoid alcohol and tea and coffee, as these can dehydrate the body further. Wearing loose clothing is also advised. Certain hosiery products may be beneficial but these should be fitted professionally because if they are too tight, they can make the situation worse.

If you have an EHIC card do you still need travel insurance within Europe?

It is always recommended that travellers purchase comprehensive travel insurance in addition to carrying the European Health Insurance Card (EHIC). The card does not cover all types of treatment, nor does it cover the transfer of patients using an air ambulance or the costs associated with being brought back to Northern Ireland. You should also remember to declare any pre-existing medical conditions you may have to the insurance company, as failure to do so could result in the company refusing to cover the costs of your treatment.

Is there any difference to the amount of alcohol you can drink in the warm weather and will how much you drink have a different effect on you?

No matter what the weather, the recommended level of alcohol consumption remains the same. For people over 18 years of age, it is recommended that men drink no more than three to four units of alcohol a day and no more than 21 units over the course of the week. It is recommended that women drink no more than two to three units of alcohol a day and no more than 14 units over the course of the week.

However, the warm weather makes it more likely we’ll consume more drinks - so it very important to keep an eye on your intake. It also increases the chances of people becoming dehydrated, it more important than ever therefore to alternate each alcoholic drink with a non-alcoholic drink, for example water or a soft drink.

Myself and my husband are due to go to Africa next month. We were aware of needing to take tablets for malaria, which I thought would protect us from the disease. But now we have heard you can get malaria even though you were taking the tablets.

It is very important to make sure you are taking the right type of tablets against malaria, as there are several different types and it is important to have the right ones for the area that you are going to visit. For many malaria tablets it is important to start taking them before you go and to keep taking them after you leave the malaria area - how long for depends on the type of tablet but it can be for up to four weeks.

However no tablets are 100 per cent effective, so it is also very important to take measures to avoid being bitten by the mosquitoes that spread malaria. These include using insect repellants and wearing appropriate clothing. More information on these measures and other advice on malaria can be found at:

If you do become unwell while away or after returning with things like fever or shivering then you seek medical attention. But don't let worrying about this spoil your holiday. If you follow the advice, your risk of getting malaria is low.

The webchat session is now closed. Thank you for your participation.