Sun Protection and Heat Illness on Sri Lanka's East Coast

Arugam Bay sits at about six degrees north of the equator. The sun here is more intense than most visitors are used to, including people who think of themselves as good in the heat. Between November and April, daytime temperatures regularly hit 32 to 35°C with humidity around eighty percent, and the UV index sits at “extreme” for most of the daylight hours. Sun and heat illness is one of the most common reasons travelers come to see us — and one of the most preventable.

Sunburn

Sunburn is more than a cosmetic problem. Severe sunburn damages skin cells, causes inflammation, increases lifetime skin cancer risk, and in the short term can leave you blistered, feverish, and unable to surf for days.

Prevention is simple in theory:

• Broad-spectrum sunscreen, SPF 30 minimum, ideally 50. Apply twenty minutes before going out. Reapply every two hours, and after every surf session.
• Reef-friendly sunscreen is increasingly important in Sri Lanka’s surf areas. Look for formulations free of oxybenzone and octinoxate.
• Cover up where you can. Long-sleeved rash vests, surf hats, lightweight cotton shirts when not in the water.
• Avoid peak sun, 11am to 3pm, especially for the first few days of your trip while your skin acclimatises.
• Pay attention to overcast days. UV gets through cloud. You can burn badly on a grey day.

If you do get burned, cool the skin with cool (not cold) showers or compresses, apply aloe vera gel, and stay out of the sun completely for a day or two. Severe burns with blistering, fever, or large affected areas should be seen by a doctor.

Heat exhaustion

Heat exhaustion happens when your body’s cooling system is overwhelmed. Symptoms develop over hours of exertion in the heat:

• Heavy sweating
• Weakness, fatigue
• Headache
• Nausea, sometimes vomiting
• Dizziness, especially on standing
• A fast, thready pulse
• Pale, clammy skin
• Body temperature still in the normal range or slightly elevated, but you feel awful

Treatment is to get out of the heat, into shade or air conditioning, lie down with feet elevated, sip cool fluids (water, electrolyte drink, or ORS), and cool the skin with damp cloths or a fan. Most people recover in thirty to ninety minutes.

If you don’t improve, or if symptoms worsen, come and see us. We may give an IV drip to restore fluids faster than oral rehydration can.

Heat stroke

Heat stroke is heat exhaustion’s dangerous cousin. The body’s temperature regulation has failed completely, core temperature climbs above 40°C, and the brain starts to be affected. Symptoms:

• Very high body temperature
• Hot, dry skin (sweating may have stopped)
• Confusion, slurred speech, agitation, sometimes seizures
• Rapid breathing, racing heart
• Loss of consciousness in severe cases

This is a true medical emergency. Call 1990 for an ambulance, or call us. While waiting:

• Move the person into shade or air conditioning
• Strip excess clothing
• Cool aggressively — wet cloths, ice packs to the neck, armpits, and groin, fan air across the body
• Do not give large amounts of cold water by mouth if they’re confused (risk of aspiration)

Special note for surfers

Long sessions in the water hide how much fluid you’re losing. The water is warm, you’re not aware of sweating, but you’re losing fluid to evaporation, exercise, and sun. Drink a full bottle of water before paddling out, and rehydrate immediately when you come in. ORS sachets are cheap and worth carrying in your beach bag.

The other underestimated risk for surfers is sun exposure to the face from reflected light off the water. A wide-brim surf hat or a rash vest with a hood makes a real difference over a multi-week trip.

This article is general health information and not a substitute for medical advice. Heat stroke is an emergency — call 1990 or come in immediately.