Clinical
Holiday help pharmacy-style
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Whether it’s sunburn, insect bites, stings or digestive problems, patients need plenty of guidance. But what advice should independent pharmacists provide? Victoria Goldman explains…
According to ABTA’s Holiday Habits 2023-24 report, 64 percent of UK holidaymakers are predicted to travel abroad over the next 12 months, while 58 percent are planning a holiday in the UK.
In March 2024, the UK Health Security Agency (UKHSA) revealed that travel-associated mosquito-borne infections such as dengue and malaria are returning to pre-pandemic levels, highlighting the need for long-haul travellers to take necessary health precautions.
Ideally holidaymakers should consult their pharmacist four to six weeks before their trip, for individual advice, travel vaccines and malaria prophylaxis. Even if customers aren’t travelling long-haul, or are staying in the UK, they should still gather holiday health essentials in advance, including suitable medicines and first aid equipment.
“It’s best to be prepared, and pharmacists should ensure customers have adequate supplies,” says Kenny Chan, Numark lead information services pharmacist. “It’s also important to be aware of restrictions regarding controlled drugs, and airline regulations regarding liquid medication. Pharmacy teams should familiarise themselves with restricted medications so they can provide advice and support before customers travel.”
Sunburn and sun protection
In July 2023, Cancer Research UK revealed that melanoma skin cancer cases in the UK have reached an all-time high, mainly linked to too much sun exposure. The charity’s latest analysis shows 17,500 cases are diagnosed each year, and projections reveal that these high numbers could continue to increase by around 50 percent over the next 20 years.
“For pharmacy teams providing tips on sun safety, a key focus should be sunscreen,” says Kenny Chan. “Customers should use an SPF suitable for their skin type, and pharmacists should have a range of products and formats (creams, sprays and gels) to protect skin from both UVA and UVB rays. This should include specialty products, including waterproof, suitable for sensitive skin and formulated for children.”
Cancer Research UK recommends using sunscreen with at least SPF30 (UVB protection) and 4 or 5 stars (for UVA protection). Sunscreen should be applied regularly and generously throughout the day.
However, the charity warns: “Skin damage and sunburn can still happen when wearing sunscreen, even one with a high SPF and star rating. Using sunscreen doesn’t mean you should stay out in the sun for longer.”
Therefore, pharmacy customers should also be advised to stay in the shade as much as possible, especially between 11am and 3pm in the UK, when the sun is strongest, and wear clothing that covers the shoulders, a wide-brimmed hat and UV-protection sunglasses.
Babies under six months should be kept out of direct sunlight completely, as sunscreen isn’t suitable for their age group. “Older babies and children should be covered up with suitable clothing and stay in the shade where possible,” says Kenny Chan.
“Sunscreen should be applied to areas not protected by clothing, such as the face, ears, feet and backs of hands.”
Insect bites and stings
Mosquito bites are common in most parts of the world, even in the UK. Pharmacy customers can protect themselves from insect bites by wearing insect repellent and covering exposed skin with long sleeves and long trousers. In countries with high mosquito populations, tourists should sleep under a treated bed net if air conditioning isn’t available.
Pharmacy customers may need to take anti-malaria medicines if they are travelling to a malaria high-risk zone.
Most insect bites and stings heal well without any medical treatment. However, sometimes these can become infected, causing redness, pain, tenderness and swelling.
“Use a locally applied antihistamine cream (such as Anthisan), bought over the counter, to soothe and cool and reduce the itch,” says Dr Marion Sloan, Sheffield GP. “Draw a biro line round the red margin of the bite to see if the inflammation is spreading. If it’s clearly spreading, prompt treatment with antibiotics is appropriate.”
Infected insect bites in people aged one year and over can now be treated by community pharmacists under the Pharmacy First scheme in England, so it’s important to raise awareness of this service over the coming months. “Pharmacists can advertise the services available through Pharmacy First in the branch, through information boards, posters and displays,” says Kenny Chan. “They should also work with local GP practices where possible to ensure a smooth referral process for the services offered.”
Digestion remedies
Many people experience digestive problems on holiday, from heartburn and indigestion to constipation or diarrhoea. This may be caused by eating and drinking contaminated food or water or may be due to being out of routine or not being used to local cuisine.
Pharmacy customers should be advised to pack suitable medicines for digestive problems, especially if they are already prone to specific symptoms. Readymade sachets or tablets are more portable than bottles of liquid.
“Pharmacy customers should be advised to take care with water and ice,” says Dr Sloan, “and have bottled or cooled boiled water instead. They should pack electrolyte fluid replacement sachets, such as Dioralyte, as these can help to maintain body fluid volumes, especially if there is considerable liquid stool loss.
“They should seek medical advice if they pass blood. Before travelling to certain destinations, they may need some vaccinations, e.g. hepatitis A and typhoid.”
First aid kits
A first aid kit should be an essential for all holidaymakers, as buying products abroad may be difficult or expensive. Even UK travel may require basic first aid supplies for quick and easy wound management.
A standard holiday kit usually includes plasters, wound-cleansing wipes, antiseptic cream, bite cream, bandages, dressings, scissors and tweezers, along with an eye wash, pain relief, antihistamine tablets, anti-diarrhoeal tablets and oral rehydration.
While an off-the-shelf kit may be suitable for most adults, others may need a tailormade kit to suit their destination, type of holiday, existing medical conditions or age of the travellers (e.g. children).
“As with most aspects of pharmacy, it’s important to have conversations with customers to ensure that we meet their individual needs,” says Kenny Chan. “Checklists and standard questions – such as finding out where they’re going and if they have any existing conditions – can be helpful as a tool to suggest the appropriate products.”