Headaches in the Heat: Dehydration Headaches, Migraines, and When to Worry in Arugam Bay

A pounding head is one of the most common complaints we see at the clinic, and by far the most common reason is the simplest: heat, sun, and not enough water. Arugam Bay asks a lot of a body that isn’t used to it — long hours outdoors, salt water, broken sleep, late nights, and a climate that dehydrates you faster than most travelers expect. Most headaches here settle with rest and fluids. A few are a sign of something that needs a clinic visit, so it’s worth knowing the difference.

The most common cause: dehydration and heat

If you’ve spent the day surfing, on a scooter, or wandering around without much shade, and a dull, tight headache builds through the afternoon, dehydration is the first suspect. It’s often described as a band of pressure around the head or behind the eyes, and it usually comes with some combination of:

• Dry mouth and dark yellow urine
• Fatigue or feeling foggy
• Dizziness on standing
• Mild nausea

This kind of headache responds well to simple measures, and it usually improves within an hour or two:

• Get out of the sun and into shade or air conditioning
• Drink water steadily, not in one big gulp — oral rehydration salts (ORS) work faster than water alone if you’ve been sweating heavily
• Eat something. Skipped meals plus heat is a very common combination behind these headaches
• Rest lying down for twenty to thirty minutes if you can

If the headache doesn’t ease after rest and fluids, or comes with confusion, a very high body temperature, or you’ve stopped sweating despite the heat, that’s closer to heat exhaustion or heatstroke territory — come in, or call 1990. We cover the fuller picture of heat illness in our sun protection guide.

Migraines away from home

If you get migraines normally, travel is a near-perfect trigger environment: bright glare off sand and water, dehydration, irregular meals, disrupted sleep, alcohol, and unfamiliar food all stack up. A migraine usually feels different from a heat headache — often one-sided, throbbing, worse with light or movement, sometimes with nausea or visual disturbance (shimmering lines or blind spots) beforehand.

If you already know your triggers and usual medication, bring it with you and use it early — migraines are easier to head off in the first thirty minutes than once they’re established. If you’ve run out, we stock common migraine and pain medications and can advise on what’s safe to combine. A first-ever migraine-type headache in your life, especially past your forties, is worth having checked rather than assumed.

Tension headaches from the trip itself

Long tuk-tuk or bus rides on winding roads, hours hunched over a phone, an unfamiliar pillow, sunburned shoulders and neck, or the muscular strain of paddling and popping up on a surfboard for the first time in a while can all produce an ordinary tension headache — a dull, tight ache, often across the forehead or back of the head and neck. Stretching, hydration, a break from screens, and simple paracetamol usually settle these within a day.

Other things worth considering

• Hangover. Alcohol dehydrates you and disturbs sleep, and the resulting headache is genuine dehydration on top of whatever else alcohol does to you. Water before bed and in the morning helps more than most remedies.
• Caffeine withdrawal. If your usual three cups of coffee a day has dropped to one guesthouse coffee, the withdrawal headache is real and resolves once you’re back on a normal amount, or within a couple of days if you cut it out.
• Sinus congestion from air conditioning, dust, or a cold can cause pressure and pain around the forehead, cheeks, and eyes.
• Fever-related headache. A headache alongside a new fever, especially a high one, needs to be taken seriously in Sri Lanka — dengue in particular often starts with a severe headache, frequently behind the eyes, alongside fever and body aches. See our dengue guide if that pattern fits, and note that ibuprofen and aspirin should be avoided until dengue is ruled out, in case of bleeding risk. Paracetamol is the safer choice for pain and fever until you’ve been checked.

Paracetamol dosing

For most ordinary headaches, paracetamol (acetaminophen) is the first-line option: up to 1 gram (two 500mg tablets) every six hours for an adult, to a maximum of 4 grams in 24 hours. Ibuprofen is generally fine for a simple tension or heat headache once dengue or another fever illness has been ruled out, but avoid it if there’s any chance of dengue, or if you have a history of stomach ulcers or kidney problems.

When it’s more than “just a headache”

Walk in straight away, or call 1990 for a free ambulance, if a headache comes with any of the following:

• The worst headache of your life, especially if it comes on suddenly like a thunderclap
• Fever, stiff neck, a rash, or sensitivity to light together with the headache
• Weakness, numbness, slurred speech, confusion, or trouble walking
• Vision loss, double vision, or a headache that started after a head injury (a wipeout, a scooter fall)
• Repeated vomiting that won’t let you keep fluids down
• A headache that keeps getting worse over hours rather than settling with rest and water

These combinations point toward things like meningitis, a bleed, dengue with warning signs, or a head injury needing urgent assessment, not an ordinary headache, and they’re worth acting on quickly rather than waiting it out.

Come and see us

If a headache isn’t settling with rest, shade, and fluids, or you’re not sure which kind you’re dealing with, walk in any time. We’re a 24/7 clinic, we can check your blood pressure and hydration, run a dengue test if there’s any fever involved, and set up an IV drip on the spot if you need rehydrating properly. We also facilitate insurance claims and provide itemised English receipts if you need to claim on your travel insurance.

Related reading

• Dehydration in the Tropics: Oral Rehydration Salts and When You Need an IV Drip
• Sun Protection and Heat Stroke: Staying Safe in the Arugam Bay Sun
• Fever in the Tropics: When It’s Serious and When It Isn’t

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This article is general health information and not a substitute for medical advice. If a headache comes with any warning sign above, walk in immediately or call 1990 for emergency transport.