Allergic reactions treatment in Phuket
Unfamiliar food, unfamiliar insects, unfamiliar medication, and a language barrier around ingredients. Allergic reaction treatment in Phuket covers everything from a rash after dinner to the one emergency where minutes genuinely decide the outcome.
Telling a rash from an emergency
A mild reaction is itching, hives, a localised rash, a runny nose or watering eyes. Uncomfortable, not dangerous, and treated with antihistamines.
A severe reaction involves the airway or the circulation, and that is a different category entirely.
The dividing question is simple: is there any difficulty breathing, any swelling of the mouth or throat, or any faintness. Any one of those and the answer is adrenaline now.
Anaphylaxis, and what to do
Swelling of lips, tongue or throat. A tight chest, wheeze or noisy breathing. Widespread hives with faintness, collapse or a sense of impending doom. Vomiting alongside any of that.
Adrenaline into the outer thigh immediately — through clothing if necessary — then 1669. Do not wait to see whether it improves first.
Lie the person flat with legs raised, or sitting up if breathing is the problem. Never stand them up, because that alone can cause collapse — see emergency medical care.
Why a second dose matters
A single injection is often not enough. If there is no improvement within five minutes, a second dose goes in.
Reactions can also return hours after apparently settling, which is why anyone who has needed adrenaline is observed rather than sent back to a hotel.
Anyone who used a pen needs seeing regardless of how well they now feel, and needs a replacement pen before doing anything else.
Food, and the language problem
Peanuts and other nuts, shellfish, fish, sesame, soy and egg account for most of it, and several of those are in a great deal of Thai cooking.
Fish sauce is in almost everything savoury. Peanut appears in sauces where it is not obvious. Shrimp paste is a base ingredient rather than a garnish.
A written allergy card in Thai is genuinely worth carrying, and is far more reliable than a conversation across a language gap in a busy kitchen — see medical certificates.
The seafood confusion
Two entirely different things get called a seafood allergy here. One is a genuine immune reaction. The other is scombroid poisoning, from histamine in fish that was not kept cold enough.
Scombroid produces flushing, headache, palpitations and a rash within an hour of eating, often with a peppery taste to the fish. It responds to antihistamines and it is not an allergy.
Several people at the same table falling ill points strongly at the fish rather than at anybody’s immune system — see food poisoning treatment.
Stings and bites
Insect stings are a common trigger, and a large local swelling is not the same as a systemic reaction.
Jellyfish stings occasionally produce reactions beyond the sting itself — see jellyfish sting treatment.
Anyone with a known sting allergy should carry two adrenaline pens rather than one, and should tell whoever they are travelling with where they are.
Medication reactions
Antibiotics, particularly penicillins, and anti-inflammatories are the common culprits. Reactions can appear days into a course rather than immediately.
A rash appearing on a course of antibiotics needs assessing rather than ignoring, because a few of them are the start of something serious.
Tell any doctor here what you react to before anything is prescribed, and be specific about what happened — see prescription refills.
Treatment beyond adrenaline
Antihistamines for the histamine effects, steroids to reduce the later phase, and fluid where blood pressure has dropped.
Nebulised treatment where there is wheeze, and oxygen where saturation is low.
Observation for several hours afterwards, because of the delayed second phase — see IV drips.
Afterwards, the useful question is what actually caused it, and that is often harder to answer than people expect. A meal contains a dozen candidates and the obvious suspect is not always the right one. Where it matters, referral for proper allergy testing at home is more reliable than guesswork, and in the meantime avoiding everything plausible is the safer course.
Children
Reactions in children can escalate faster and are easier to underestimate because a distressed child is hard to assess.
Paediatric adrenaline pens are dosed by weight, and any child who has needed one gets seen and observed.
Nurseries, kids clubs and hotel restaurants need telling clearly and in writing, not mentioned in passing — see paediatric care.
Getting and carrying pens
Anyone with a history of anaphylaxis should be carrying two in-date pens, kept out of a hot car and not left in a hotel safe.
Heat degrades adrenaline, and a pen that has spent a week on a balcony is not a pen you should be relying on.
Replacements are available here, and a letter for carrying them through onward borders is issued alongside.
Whoever you are travelling with should know how to use one. In a genuine reaction the person holding the pen is frequently in no state to work out which end goes where, and reading the instructions for the first time during an emergency is not a plan.
Where to be seen
Bang Tao, Kata and Patong, at any hour. A doctor can also come to you with adrenaline, steroids, antihistamines and oxygen — see doctor hotel visits.
For anything involving breathing or collapse, ring 1669 first and treat while waiting.
Severe reactions are admitted rather than observed at a clinic, and that transfer is arranged — see hospital transfer.
Frequently asked questions
When is a reaction an emergency?
Any breathing difficulty, any swelling of mouth or throat, or any faintness. Adrenaline into the outer thigh immediately, then 1669.
Should I wait to see if the pen works?
No — give it at the first sign. If there is no improvement in five minutes, give a second dose.
I used my pen and feel fine now.
You still need seeing. Reactions can return hours later, and you need observation plus a replacement pen.
Which Thai ingredients catch people out?
Fish sauce is in almost everything savoury, peanut hides in sauces, and shrimp paste is a base rather than a garnish.
Is a card written in Thai worth having?
Very much so. It is far more reliable than explaining across a language gap in a busy kitchen.
Everyone at the table got a rash after the fish.
That is more likely scombroid — histamine in fish kept too warm. It responds to antihistamines and is not an allergy.
Can I get replacement adrenaline pens?
Yes, along with a letter for carrying them through onward borders. Keep them out of the heat, which degrades adrenaline.
A rash appeared on day four of antibiotics.
Get it assessed rather than ignoring it. Most are harmless but a few are the beginning of something serious.
Three clinics, none of which close
English-speaking doctors, on duty 24 hours a day. Phuket is bigger than visitors expect and the traffic is worse than the map suggests, so Takecare Medical Clinic works from three separate buildings rather than one: Bang Tao on the north-west coast, Kata in the south, and Patong between them. Each is open every hour of every day, takes people without an appointment, and asks nothing about residency or referrals.
Beyond the island, Takecare Medical Clinic is one of the Takecare Clinic group‘s clinics working across Phuket, Krabi and Chon Buri. That matters mainly for what happens afterwards: move on mid-treatment and the next clinic already holds the notes, so a handover is a call between colleagues rather than a folder you carry through an airport.
Getting seen, and how to choose a branch
There is somebody on the end of +66 81 718 9080 or WhatsApp 24 hours, every day. Say what has gone wrong and the reply will be honest about which of three things you are dealing with: come in now, this will keep until the morning, or skip us entirely and go where there is a surgeon. No appointment exists to be made, and there is no hour at which asking is a nuisance.
Pick whichever branch is nearest rather than whichever sounds largest — they run the same hours and carry the same equipment. Patong suits the west-coast beaches and Bangla Road, Kata covers Karon and the south, and Bang Tao serves Layan, Surin and Cherngtalay. Cannot get out to a clinic? Ask for a doctor hotel visit instead and somebody comes to your room. And if what you need turns out to be beyond any clinic, referral and hospital transfer is arranged from the same conversation. You are made stable before anybody moves you, a colleague rings ahead so the team on the other end knows what is arriving, and the transport is organised for you rather than handed over as one more thing to sort out.