Travel tips

Travel health experts advise preparing for a trip four to six weeks before you travel, especially if you need vaccinations.

“Vaccination is just one element of protecting yourself from infectious disease,” says Professor David Hill, National Travel Health Network and Centre (NaTHNaC) director.

UK residents visiting their country of origin should also be vaccinated as any immunity they may have built up previously in their native country will have reduced over time.

Sun Safety Q&A

It's important to protect you and your children's skin in the sun to avoid sunburn and heat exhaustion.

What sun protection factor (SPF) should I use?

Use sunscreen with a sun protection factor (SPF) of at least 15. The higher the SPF, the better. Go for broad-spectrum sunscreens, which protect against harmful UVA and UVB rays. Make sure the product is not past its expiry date. Most sunscreens have a shelf life of two to three years.

What is broad spectrum and the star-rating?

Broad-spectrum products provide protection against the sun’s UVB and UVA rays. The sun protection factor, or SPF, is a measurement of the amount of UVB protection. The higher the number, the greater the protection. In the UK, UVA protection is measured with a star rating. Sunscreens has from 0 to 5 stars. The higher the number of stars, the greater the protection.

How long can I stay in the sun?

Don’t spend any longer in the sun than you would without sunscreen. Sunscreen should not be used as an excuse to stay out in the sun. Instead, it offers protection when exposure is unavoidable. The summer sun is most damaging to your skin in the middle of the day. Spend time in the shade between 11am and 3pm, under umbrellas, trees, canopies or indoors.

Should I reapply sunscreen if I swim?

Water washes off sunscreen and the cooling effect of the water can make you think you're not getting burned. Water also reflects UV rays, increasing your exposure. Even "waterproof" sunscreens should be reapplied after going in the water.

What should I do if I get sunburn?

Painkillers, such as paracetamol or ibuprofen, will ease the pain by helping to reduce inflammation caused by sunburn. Sponge sore skin with cool water, then apply soothing after sun or calamine lotion. If you feel unwell or the skin swells badly or blisters, seek medical help. Stay out of the sun until all signs of redness have gone.

Are children more at risk of sunburn?

Young skin is delicate and very easily damaged by the sun. Use at least a factor 15 sunscreen and choose a broad-spectrum brand that has a four- or five-star rating. Apply it to areas not protected by clothing, such as the face, ears, feet and backs of hands. Choose sunscreens that are formulated for children and babies' skin, as these are less likely to irritate their skin.

My child has eczema. What sunscreen should I use?

Some sunscreens may aggravate eczema. Check the label for any ingredients that you know your child is allergic to. Test any new sunscreen on a small area before applying it to the whole body. Put on your child’s emollient and steroids first then put the sun protection cream on 30 minutes later. Remember to put more sun protection cream on regularly throughout the day and especially after swimming.

What are the symptoms of heat exhaustion?

Heat exhaustion occurs when the body cannot lose heat fast enough. If it's not treated quickly, it can lead to heat stroke, which is a much more dangerous condition. Signs of heat exhaustion include faintness, dizziness, palpitations, nausea, headaches, low blood pressure, tiredness, confusion, loss of appetite and hallucinations.

What should I do if someone has signs of heat exhaustion?

Get them to rest in a cool place, ideally a room with air conditioning. Give them plenty of water. Avoid alcohol or caffeine as this can increase levels of dehydration. Cool their skin with cold water. Use a shower or cold bath to cool them down or, if this is not possible, wet flannels and face cloths in water and apply to their skin. Loosen any unnecessary clothing and make sure that the person gets plenty of ventilation. Monitor their condition closely.

Should I cover up my mole when I’m in the sun?

If you have lots of moles or freckles, you're more likely to develop skin cancer, so you need to take extra care. Avoid getting caught out by sunburn. Use shade, clothing and sunscreen with an SPF of at least 15 to protect yourself. Keep an eye out for changes to your skin and report these to your doctor without delay. Skin cancer is much easier to treat if it is found early.

Whether you're on holiday or at home, you can protect yourself by following Cancer Research UK's SunSmart messages:

  • Spend time in the shade between 11am and 3pm.
  • Make sure you never burn.
  • Aim to cover up with a T-shirt, hat and sunglasses.
  • Remember to take extra care with children.
  • Then use factor 15+ sunscreen.

Travel Sickness

Travel sickness is a general term for an unpleasant combination of symptoms, such as dizziness, nausea and vomiting, that can occur when you are travelling.

Travel sickness is also known as motion sickness, seasickness, car sickness or air sickness.

Initial symptoms of motion sickness may include:

  • pale skin
  • cold sweat
  • dizziness
  • an increase in saliva
  • vomiting

Some people also experience additional symptoms, such as:

  • rapid, shallow breathing
  • headaches
  • drowsiness
  • extreme tiredness

In most cases, the symptoms of travel sickness will start to improve as your body adapts to the conditions causing the problem.

For example, if you have motion sickness on a cruise ship, your symptoms may improve after a couple of days. However, some people do not adapt and have symptoms until they leave the environment that is causing them.

Anyone can get travel sickness, but some are more vulnerable than others. Women often experience motion sickness, particularly during periods or pregnancy. People who often get migraines may also be more likely to experience motion sickness and to have a migraine at the same time.

Travel sickness is also more common in children aged 3 to 12. After this age, most teenagers grow out of the condition.

When to seek medical advice

It's only necessary to seek medical advice about travel sickness if your symptoms continue after you stop travelling. Your GP will be able to rule out other possible causes of your symptoms, such as a viral infection of your inner ear (labyrinthitis).

What causes travel sickness?

Travel sickness is usually associated with travelling in a car, ship, plane or train. Travel sickness is thought to occur when there's a conflict between what your eyes see and what your inner ears, which help with balance, sense.

Your brain holds details about where you are and how you're moving. It constantly updates this with information from your eyes and vestibular system. The vestibular system is a network of nerves, channels and fluids in your inner ear, which gives your brain a sense of motion and balance.

If there's a mismatch of information between these two systems, your brain can't update your current status and the resulting confusion will lead to symptoms of motion sickness, such as nausea and vomiting. For example, you can get travel sickness when travelling by car because your eyes tell your brain that you're travelling at more than 30 miles an hour, but your vestibular system tells your brain that you're sitting still.

Treating motion sickness

Mild symptoms of motion sickness can usually be improved using techniques, such as fixing your eyes on the horizon or distracting yourself by listening to music.

Other self care techniques you could try include:

  • Keep still - if possible, choose a cabin or seat in the middle of a boat or plane, because this is where you'll experience the least movement. Use a pillow or headrest to help keep your head as still as possible.
  • Look at a stable object - for example, the horizon. Reading or playing games may make your symptoms worse. Closing your eyes may help relieve symptoms.
  • Fresh air - open windows or move to the top deck of a ship to avoid getting too hot and to get a good supply of fresh air.
  • Relax - by listening to music while focusing on your breathing or carrying out a mental activity, such as counting backwards from 100.
  • Stay calm - keep calm about the journey. You're more likely to get motion sickness if you worry about it.

It's also a good idea to avoid eating a large meal or drinking alcohol before travelling. You should keep well hydrated throughout your journey by drinking water.

Medication

More severe travel sickness can be treated with medication. It is usually better to take medication for travel sickness before your journey to prevent symptoms developing.

Hyoscine

Hyoscine, also known as scopolamine, is widely used to treat travel sickness. It is thought to work by blocking some of the nerve signals sent from the vestibular system.

Hyoscine is available over the counter from pharmacists. To be effective, you will need to take hyoscine before you travel. If you are about to go on a long journey, such as a sea journey, hyoscine patches can be applied to your skin every three days.

Common side effects of hyoscine include drowsiness, blurred vision and dizziness. As hyoscine can cause drowsiness, avoid taking it if you're planning to drive.

Hyoscine should be used with caution in children, the elderly and if you have certain conditions such as epilepsy or a history of kidney, liver or heart problems.

Antihistamines

Antihistamines are used to treat the symptoms of allergies, but can also help to control nausea and vomiting. Antihistamines are less effective at treating travel sickness than hyoscine, but they may cause fewer side effects.

These are usually taken as tablets one or two hours before your journey. If it is a long journey, you may need to take a dose every eight hours. Like hyoscine, some antihistamines can cause drowsiness. Your pharmacist can advise you.

Complementary therapies

Several complementary therapies have been suggested for travel sickness, although the evidence for their effectiveness is mixed.

Ginger

Ginger supplements, or other giner products including ginger biscuits or ginger tea, may help prevent the symptoms of travel sickness. Ginger is sometimes used to treat other types of nausea, such as morning sickness during pregnancy.

Although there's little scientific evidence to support the use of ginger to treat travel sickness, it has a long history of being used as a remedy for nausea and vomiting.

Before taking ginger supplements, check with your GP that they will not affect any other medication you are taking.

Acupressure bands

Acupressure bands are stretchy bands that are worn around your wrists. They apply pressure to a particular point on the inside of your wrist between the two tendons on your inner arm.

Some complementary therapists claim that using an acupressure band can help to treat travel sickness. Although acupressure bands don't cause any adverse side effects, there's little scientific evidence to show they're an effective treatment for travel sickness.

Food and Water Abroad

Many illnesses, including travellers’ diarrhoea, hepatitis A, typhoid and cholera are contracted through contaminated food and water.

Travellers’ diarrhoea is the most common illness contracted abroad, affecting 20-60% of overseas travellers.

In countries where sanitation is poor, you can reduce your risk of such diseases by following these basic guidelines.

Drinking water abroad

In countries with poor sanitation, don't drink tap water or use it to brush your teeth unless it has been treated. For information about sanitation levels in the country you are travelling to, visit the National Travel Health Network and Centre (NATHNAC).

Filtered, bottled, boiled or chemically treated water should be used. Bottled fizzy drinks with an intact seal are usually safe, as are boiled water and hot drinks made with boiled water. Ice in drinks should be avoided.

The most reliable way to purify water is by boiling it, but this is not always possible.

Chemical disinfectants, such as iodine and chlorine, will usually kill bacteria and viruses and can easily be obtained from larger chemists or specialist travel shops.

However, some parasites are not reliably killed with iodine or chlorine preparations. Combining iodine or chlorine with filtration using a specialist filter (bought from a travel shop) should be effective.

Domestic water filters designed for use in the UK are not suitable.

Food abroad

Some developing countries use animal waste as fertiliser. Certain foods, especially those growing close to the ground, are particularly prone to contamination and should be avoided.

Foods to avoid:

  • salads, such as lettuce
  • uncooked fruits and vegetables, unless they have been washed in safe water and peeled by the traveller
  • fresh or cooked food that has been allowed to stand at room temperature in warm environments, or that has been exposed to flies, such as in an open buffet
  • unpasteurised milk, cheese, ice cream and other dairy products
  • raw or undercooked shellfish or seafood
  • food from street traders, unless it is has been recently prepared and is served hot on clean crockery

Food served in good-standard hotels or restaurants may not always be safe as it may have been contaminated during preparation. Try to pick places to eat that have a reputation for serving safe foods.

As a rule, only eat freshly prepared food that is thoroughly cooked and served very hot. Always wash your hands after going to the toilet and before preparing or eating food. Find out more about preventing travellers' diarrhoea.

Travellers' diarrhoea (TD)

Travellers' diarrhoea is the most common illness in people travelling from the UK to developing countries. TD is caused by eating or drinking contaminated food or water. Foods most likely to cause TD are those that have not been thoroughly heated or that have been left out at room temperature.

You can reduce your risk of TD by following good food and water hygiene practices. If you develop TD, drink regularly to avoid dehydration. In most cases, TD will only last a few days but you may want to pack medications. More severe cases of travellers’ diarrhoea are treated with a short course of antibiotics.

Travel Insurance

By taking out travel insurance and getting a free European Health Insurance Card (EHIC), you can avoid huge medical bills if you have an emergency during your trip.

Healthcare is free at the point of delivery in the UK, but don't assume it's the same abroad. You will often have to pay part, if not all, of your medical bills. If it's serious, the costs could easily be very high.

Having travel insurance and the EHIC can avoid large medical bills, delays in treatment and undue stress in the event of a medical emergency.

The EHIC, which is free of charge, replaces the now obsolete E111 form. It entitles UK residents to free or reduced-cost medical treatment in European Economic Area countries and Switzerland.

Check your policy

The EHIC is not an alternative to travel insurance. It will not cover any private medical healthcare or the cost of things such as mountain rescue in ski resorts, repatriation to the UK or lost or stolen property.

It's important to have both an EHIC and a valid private travel insurance policy. Some insurers now insist you hold an EHIC and many will waive the excess if you have one.

Each country’s healthcare system varies, so your EHIC may not cover all costs or you may be expected to pay for your treatment and then claim a refund using your EHIC or insurance policy.

Travel insurance will cover other medical costs that the EHIC will not, such as paying for your return journey if illness delays you, or covering your personal contributions towards treatment.

You will also normally receive cover for non-medical emergencies, such as replacing possessions or a lost passport.

Your insurance policy will vary according to your destination and insurer, but cover generally starts at just a few pounds and could save you tens of thousands of pounds.

You may not be fully covered if you are doing any hazardous sports, such as climbing or skiing. Check whether your policy covers the activities you'll be doing.

How to beat jet lag

Jet lag refers to disturbed sleep patterns, weakness and disorientation caused by travelling. It happens when your normal body clock is disrupted by travelling through several time zones.

Jet lag is worse when you move from west to east because the body finds it harder to adapt to a shorter day than a longer one.

Travellers who take medication according to a strict timetable (such as insulin or oral contraceptives) should seek medical advice from a health professional before their journey.

Before you travel

Top up your sleep

Make sure you're fully rested before you travel. If you’re flying overnight and you can get a bit of sleep on the flight, it will help you to stay up until night time once you arrive at your destination.

Change your sleep routine

A few days before you travel, start getting up and going to bed earlier (if you're travelling east) or later (if you're travelling west). During the flight, try to eat and sleep according to your destination's local time.

Have a stopover on the way

Including a stopover in your flight will make it easier to adjust to the time change, and you'll be less tired when you arrive. Take advantage of any short airport transits to have a refreshing shower or swim in the terminal, if possible.

During your journey

Keep hydrated

Dehydration can intensify the effects of jet lag, especially after sitting in a dry aeroplane cabin for many hours. Avoid alcoholic and caffeine drinks (such as coffee, tea and cola), which can disturb sleep.

Preparing for sleep

During your flight, try to create the right conditions when preparing for sleep. Eyeshades and earplugs may help you sleep. Regular exercise during the day may also help you sleep, but avoid strenuous exercise immediately before bedtime.

Use remedies with caution

Many airline staff take melatonin, a hormone formed by the body at night or in darkness, to try to fight jet lag. Sleeping medication is not recommended as it doesn't help your body to adjust naturally to a new sleeping pattern.

At your destination

Anchor sleep

Try to get as much sleep in every 24 hours as you normally would. A minimum block of four hours’ sleep during the local night – known as “anchor sleep” – is thought to be necessary to help you adapt to a new time zone. If possible, make up the total sleep time by taking naps during the day.

Natural light

The cycle of light and dark is one of the most important factors in setting the body’s internal clock. Exposure to daylight at the destination will usually help you adapt to the new time zone faster.

Short trips

For stays of less than three or four days, it may be better for the traveller to remain on "home time" (that is, timing activities such as sleeping and eating to occur at the times they would have occurred at home) to minimize disruption to the normal sleep-wake cycle although this is not always practical.

Preventing DVT when you travel

If you're travelling on a long-haul flight, there are several ways you can reduce your risk of getting deep vein thrombosis (DVT).

Travel-related deep vein thrombosis was first reported in 1954 in a 54-year-old doctor who developed a blood clot following a 14-hour flight.

The condition was soon dubbed "economy class syndrome" by researchers, who believed that there was a link between DVT and long-haul air travel in cramped conditions.

The actual number of people who get DVT from travelling on long-haul flights is unknown and is difficult to determine, as the condition can be symptomless and may not occur for some time after travel.

However, there is some evidence to suggest that certain groups of people, such as pregnant women or anyone who has had a stroke, are at increased risk of developing DVT on flights of eight hours or more.

DVT high-risk factors:

  • history of DVT or pulmonary embolism
  • cancer
  • stroke
  • heart disease
  • inherited tendency to clot (thrombophilia)
  • recent surgery (pelvic region or legs)
  • obesity
  • pregnancy
  • hormone replacement therapy

If you think you have a risk of developing DVT, see your GP before you travel.

DVT occurs when blood flows too slowly through the veins. The blood forms a clot that blocks up deep veins, usually in the legs.

DVT doesn’t generally have any immediate symptoms, making it difficult to spot. However, typical signs include a swollen or painful calf or thigh, paleness and increased heat around the affected area.

If left untreated, people with DVT are at risk of developing a pulmonary embolism, when part of the blood clot breaks away and travels to the lung, which can be fatal.

Before you travel

If you think you have a high risk of developing DVT, see your GP before you travel.

You may be prescribed blood-thinning drugs to lessen the risk of your blood clotting, or compression stockings (also called flight socks).

Studies have concluded that airline passengers who wear compression stockings during flights of four hours or more can significantly reduce their risk of DVT as well as leg swelling (oedema).

The below-knee stockings apply gentle pressure to the ankle to help blood flow. They come in a variety of sizes and there are also different levels of compression. Class 1 stockings (exerting a pressure of 14-17 mmHg at the ankle) are generally sufficient.

It's vital that compression stockings are measured and worn correctly. Ill-fitting stockings could further increase the risk of DVT.

Flight socks are available from pharmacies, airports and many retail outlets. Take advice on size and proper fitting from a pharmacist or other health professional.

Recovering from DVT

If you have recently had DVT you are probably taking medication, such as warfarin, to prevent the formation of blood clots.

If that's the case then your risk of developing DVT is low and there is no reason why you can't travel, including long-haul.

However, if you're still in the recovery phase, you should get the all-clear from your consultant before travelling. You should also follow the general DVT prevention advice for high-risk travellers listed below.

While you're tavelling

If you are planning a long-distance plane, train or car journey, ensure that you:

  • Wear loose, comfortable clothes.
  • Consider buying flight socks (compression stockings).
  • Store luggage overhead so you have room to stretch out your legs.
  • Do anti-DVT exercises. Raise your heels, keeping your toes on the floor, then bring them down. Do this 10 times. Now raise and lower your toes 10 times. Do it at least every half an hour (you can do it more often if you like).
  • Walk around whenever you can.
  • Drink plenty of water.
  • Don’t drink alcohol or take sleeping pills.

Safer sex on holiday

Unprotected sex on holiday can have the same results as when you're at home – sexually transmitted infections (STIs) or unintended pregnancy. Find out how to protect yourself, and where to go for help if you need it.

Getting symptoms - or not

If you have had unprotected sex, remember that not everybody who gets an STI has symptoms. For example, most people who have chlamydia don't notice any symptoms, and so don't know they have it. Research suggests that 50% of men and 75% of women don't get symptoms at all with chlamydia infection.

Most people who are infected with HIV experience a short, flu-like illness that occurs two to six weeks after infection. After this, HIV often causes no symptoms for several years.

If you do get symtpoms of an STI, they can include:

  • unusual discharge from the vagina
  • discharge from the penis
  • itching, sores, blisters or lumps on or around the genitals
  • pain when urinating
  • in women, bleeding between periods or after sex

STIs might be more common in some countries, so having unprotected sex could put you at even more risk than it would at home.

Using a condom

By using a condom you can greatly reduce the risk of pregnancy and STIs.

Of course, not everyone has sex on holiday – but if there's a chance it might happen, you should be prepared. Buy a pack of condoms before you go, and make sure they have the CE mark on the packet. This means they have been tested to the high safety standards that are required in Europe. Condoms that don't have the CE mark won't meet these standards.

If you're going to have sex, tell your sexual partner that you need to use a condom. Don't wait for them to bring up the topic, because they might not.

Bear in mind that:

  • condoms can be damaged by oil-based products such as moisturiser, lotion (including sunscreen), baby oil and lipstick
  • heat can also be a problem – so store them in a cool, dry place

For more information on using male and female condoms, see How to use a condom.

Vomiting, diarrhoea and medication

There's a chance you could get a stomach bug when you're on holiday. If you do, remember that vomiting or diarrhoea can make the contraceptive pill less effective – you can find out more at What if I'm on the pill and I'm sick or have diarrhoea?

Some medicines can also make the pill (combined pill and progestogen only pill), contraceptive patch and contraceptive implant less effective. This can put a woman at risk of pregnancy if she has unprotected sex. Most common antibiotics don't affect contraception, but some do, as do some anti-malaria drugs.

Long acting reversible contraception (LARC) methods, such as the injectionintrauterine system (IUS) and intrauterine device (IUD), are not affected by illness or medication. However, the effectiveness of the contraceptive implant may be lowered by certain medicines.

You can find out more in Does the contraceptive pill interact with other medicines? To reduce your risk, if you have sex use a condom to help protect against pregnancy and STIs.

If you use the contraceptive implant, patch or pill and are prescribed medication when you're on holiday, tell the person who is giving you the medicine that you're using the implant, patch or pill. Make sure you use a condom while taking medicines or antibiotics that might affect your contraception, and for 28 days afterwards.

Masterbation and oral sex

Mutual masturbation can be safer sex, according to Dr O’Mahony, as long as fluids are not passed from one person’s genitals to another via the fingers or any other way.

Oral sex (using the mouth on a partner's vagina, penis or anus) is riskier than most people realise. A cold sore on the mouth is caused by the herpes simpex virus. This can transfer to a partner's genitals during oral sex, giving them genital herpes. Gonorrhoea can live in the throat and transfer as well.

A vaccination against hepatitis B (which can be passed on through sex, as well as contaminated needles) is available and can be added to jabs before travelling.

What to do if you're worried

If you're already back home

If you’re worried that you may be pregnant or have an STI, you can get checked at:

  • genitourinary medicine (GUM) or sexual health clinic
  • a community contraception clinic

Do this as soon as possible after you get home.

Tell the GUM clinic staff your travel and sexual history, as that will help them give you the most appropriate tests. Find sexual health clinics near you.

If you think you might be pregnant, you can do a pregnancy test. If you're pregnant and don't want to be, you can talk to a GP or staff at a sexual health or contraception clinic to find out more about your options. In Great Britain, abortion is an option.

FPA has a leaflet called Pregnant and don't know what to do? A guide to your options, which you may find helpful.

If you're still abroad

Check your travel insurance as it may not cover you for tests and treatment for STIs or HIV. In any case, it may be best to wait.

Some countries have a good sexual health service, but others may not. Depending on where you are, the doctor, hospital or clinic may not do all the appropriate tests.

If you test positive for anything, try to contact past partners. Your sexual health clinic can help with this.

 


Last Updated: 01/04/2017 09:00:00