A bottle of sunscreen and a sun hat sit on a sandy beach.

Summer is officially underway and it is time to get outside and enjoy the warm weather. Alongside sunshine and bike rides, come a series of common questions about how to stay safe and healthy: How much water should I be drinking? How do I protect myself from bug bites? Do I need to be wearing sunscreen?

We reached out to a couple of physicians at Unity Health to find out how to stay protected while enjoying the outdoors this summer.    

Keeping Cool

Over the past few years, Toronto has seen more extreme weather events, including heat waves. Even on a typical summer day, it is important to know how to prevent heat illnesses and dehydration.

Dr. Jessica He, a physician with the St. Joseph’s Academic Urban Family Health Team, shared her insights on how to stay cool and safe.

Dr. Jessica He is a family physician at the St. Joseph’s Academic Urban Family Health Team.

What are heat illnesses?

Heat illnesses range from mild to severe, He explains. For mild cases, known as heat syncope, you begin to feel dizzy or like you are about to faint. The next level is heat exhaustion where you begin to feel nauseous, weak or lightheaded, and you may even vomit. The final level is heat stroke where you feel lethargic, confused and delirious—which are all signs of a heat emergency. “Early recognition makes a huge difference, because there are things that you can do to intervene before it progresses all the way to heat stroke,” says He. 

What can I do to protect myself from heat stroke?

“The first thing is to know yourself and whether you’re someone who is more at risk for getting heat stroke,” says He. This often includes children and elderly people. You will also be more at risk if you are doing strenuous activities outdoors, don’t drink many fluids or are on medications that influence your ability to sweat or urinate, she notes.

If you begin to feel symptoms of heat stroke, He recommends that you move to a shaded area or, if possible, an air-conditioned building. If you begin to feel dizzy or lightheaded while standing, sit or lie down – it can help to put your feet up to facilitate blood flow. He also suggests drinking water or an electrolyte drink to restore the lack of fluid in your body. 

How much water should I be drinking in the summer months?

Contrary to popular belief, He states that we do not need to drink eight glasses of water a day. “Most people have regulatory mechanisms that will increase your thirst drive if you are dehydrated, so it’s important to listen to that,” she says. Unless you have a health issue that requires you to follow different rules, He encourages people to simply drink when they are thirsty and keep water nearby.

Sun Safety

While it’s great to spend time in the sun, it’s important to know how to protect yourself. In another conversation with He, she shared how using a sunscreen that has the right sun protection level (SPF) for you can protect you from sun-related injuries like sunburns and even skin cancer.

Who should wear sunscreen? Is it necessary to wear it if you have a darker skin tone? 

He notes that skin tone does play a factor in how much you are at risk for sun-related skin damage, with lighter skin tones being more at risk and darker tones being less at risk. However, she points out that it is beneficial for everyone to wear sunscreen. “Being at lesser risk doesn’t mean being at no risk,” she says.

What level of SPF do you need for your specific skin tone?

“Generally, the SPF that we recommend is 30 and above,” says He.

Re-application is also key. “Even if SPF 60 may provide more sun protection than SPF 30, if you don’t reapply it as much, then you’re probably getting better protection from an SPF 30 that reminds you to apply more often,” she says.

How many times should I re-apply sunscreen?

Every two hours, especially if you will be outside or in the water frequently, He recommends. According to He, this is most important during peak hours of sunlight between 10 a.m. and 4 p.m. “Sunscreen is beneficial, but only as long as it’s actually on your body,” she says.

Can my medication influence my sensitivity to the sun?

He states that two common ingredients that can make skin more sensitive to the sun or heat are doxycycline and topical retinoid. They are often included in medications for severe acne or hyper-pigmentation. If using them, she notes that you should stay aware of your exposure to the sun and ensure you purchase a sunscreen that gives you enough protection.  

Bugs and Ticks

Due to warmer temperatures, the tick population in Ontario is increasing. We learned more from He on how to stay protected from these tiny parasites, as well as other bugs when we spend more time outdoors in the summer.

When should I look for ticks on my body?

He encourages checking for ticks during and after spending time outdoors or going on a hike. After 24 hours have passed from the time you were first exposed to a tick, you are more at risk of contracting Lyme disease, so she emphasizes that it is important to check your skin frequently.

How can I distinguish a tick bite from a mosquito bite?

Mosquito bites are typically small and localized, and will not become bigger than five centimeters, describes He. Tick bites, on the other hand, usually result in a rash or skin discoloration that can expand around the bite, she explains.

How can we protect ourselves from tick and mosquito bites?

A few tips He shares for avoiding tick and mosquito bites are to, first, wear long sleeves and pants when you know you will be outdoors for long periods, and second, use a bug repellant. “Ticks can also be prevented by sticking to the center of hiking trails, as they tend to live in bushes and shrubs,” she adds.

To avoid mosquitos, try not to be outside in the early morning or late evening when they tend to be active.

How do I treat a mosquito or tick bite?

“Generally, your body will be good at resolving mosquito bites, so it’s mainly about symptom management,” says He. “You can use an over the counter itch cream to help.”  

He also advises that you see your family doctor within three days of a tick bite appearing. The doctor may be able to offer an antibiotic to prevent Lyme disease. Beyond that, she says to monitor yourself for the next 30 days to see if symptoms of Lyme disease emerge, which present a flu-like illness. “If that happens, there are antibiotics that we can give for that as well,” she notes.

Cycling Safe

In the summer months, people often use bicycles and other kinds of active transportation. However, biking accidents can be some of the most devastating.

We spoke to Dr. Sahil Gupta, an emergency physician at St. Michael’s Hospital, about how to stay safe on the roads.

Dr. Sahil Gupta is an emergency physician at St. Michael’s Hospital.

What are some of the most common injuries you treat related to bike safety?

In a downtown area, many of the injuries that Gupta and his team see are cycling-related injuries, such as head trauma, concussions or major brain injuries, as well as orthopedic injuries to the bone or soft tissue. He notes that these injuries can take weeks or months to heal, while others can be lifelong.

How can we protect ourselves from road related injuries?

Protective gear such as helmets and knee and elbow pads are the primary way to protect yourself from road related injuries, Gupta shares. He also states that the built environment plays a role in injury prevention. “Infrastructure that separates cyclists or pedestrians from cars and traffic calming measures can reduce the number of injuries,” he says.

If you could create a bike safety kit, what would you include?

In addition to protective gear like helmets, Gupta recommends making sure your brakes are in good working order and using a bike with thicker tires in the city. Thicker tires have more grip and do not fall as easily into uneven road surfaces like pavement cracks or streetcar tracks, he explains.  

By: Kaela Tenn