We just lived through what was likely the hottest month ever recorded on Earth, according to a shared July announcement by the World Meteorological Organization and Copernicus, the European Union’s climate monitoring program. And as the planet heats up, the health burden isn’t shared equally. 

Factors such as which country someone lives in, how much money they have, what they do for work, their age and whether they live with any health conditions all play a role in the impact.

In terms of your underlying health, a range of conditions, involving everything from the skin to the heart, can be aggravated by high temperatures. This means people with a health condition should be given extra care in times of extreme heat.

As always, you should consult your doctor or call 911 if you’re in distress or are having a hard time breathing. Also, it’s helpful to know the symptoms of heatstroke or whether it’s heat exhaustion, which typically occurs before heatstroke begins.

It’s also important to note that some health conditions (cardiovascular disease, for example) are more common in older adults, who may already be at higher risk of heat illness. And taking certain medications can also influence your body’s response to the heat and raise the risk of heat illness. 

Read more: Electrolytes: Tips to Stay Hydrated Throughout the Day

Respiratory conditions 

People with health conditions that affect the lungs or airway, like asthma or chronic obstructive pulmonary disease, or COPD, are more affected by the heat. If you have a respiratory condition, pay attention to air quality alerts in your area and limit your time outside on the hottest days.

What to do: If you have asthma or use an inhaler, you may want to carry your inhaler with you at all times, as explained by Penn Medicine, and check in with your doctor if you notice your symptoms worsening. Make note of the inhaler’s instructions for storage, and definitely don’t leave it in your hot car.

As laid out by Temple Health, you may also want to plan your day around the hottest periods of time. For example, if you need to run errands, try going out in the morning or later in the evening. 

Skin conditions 

Weather at both ends of the spectrum can cause symptoms to flare up for people with eczema and rosacea. High heat is associated with dehydration, sweating and more sunlight — all of which can trigger a flare up of a skin condition. Also, people prone to acne may notice more breakouts in the summer, thanks to all that sweat and the bacteria that’s in it.

What to do: If you have eczema, follow these tips for the summer months from the American Academy of Dermatology Association:

• To keep skin hydrated (and reduce the likelihood of a flare-up): limit showers to one per day, in lukewarm water, and try to keep to under 10 minutes. If you do something that made you sweat and requires another shower, try to make it a cool one.
• Use fragrance-free soaps, shampoos and even laundry detergent, if you can. The sweat can make someone sensitive to fragrance or dyes even more sensitive. (Plus, don’t overdo it on soap in general.)
• Wear loose clothing. 

If you’re prone to acne, take extra care to shower or rinse off after exercise or sweating in the heat, as the bacteria and sweat buildup can make everyone more susceptible to pimples. 

If you have a skin condition, pay extra close attention to the ingredients in your sunscreen. The National Eczema Association recommends mineral-based ingredients. 

Diabetes

About 11% of people in the US have diabetes, and people with both Type 1 and Type 2 diabetes feel the heat more than others, according to the US Centers for Disease Control and Prevention. Diabetes can cause complications that interfere with how your sweat glands work, and therefore how well your body is able to cool itself. Diabetes can also dehydrate you (dehydration is a very common symptom of diabetes, and not one to overlook), worsening an already-common issue during the summer months. Additionally, high temperatures can change how your body uses insulin, according to the CDC. 

What to do: Avoid getting sunburned as much as you can, as sunburn can raise your blood sugar, according to the CDC. To do this, wear sunscreen, a big hat and even some protective yet cool loose-fitting clothing, if you can. The CDC also recommends not going barefoot, even on the beach. 

To keep yourself hydrated, try to avoid or limit alcohol or caffeine on the really hot days. If you use insulin, make sure to store it as directed and away from extreme temperatures (PDF), as that can cause it to lose effectiveness. 

One more note: Diabetes is super common. If you aren’t diagnosed but are concerned you may have diabetes and haven’t checked your blood sugar, now’s the time to make that appointment. 

Read more: 6 Foods to Keep You Hydrated During a Heat Wave

Heart disease and high blood pressure 

Being hot can put extra strain on your heart (PDF), which can be an issue if you’re living with cardiovascular disease. Also, people with high blood pressure are more likely to have heat-related illness or experience heatstroke. What’s more, some common medications people take for their heart or blood pressure can affect the body’s response to heat, including beta blockers and diuretics. 

What to do: Try to limit things that excite your body or raise your blood pressure, like drinking caffeine or doing anything strenuous when it’s hot outside, according to the Mississippi State Department of Health. And as always, stay hydrated. 

You may also take advantage of the fruits of summertime, like fresh garden vegetables, to add to your nutrition and create a more heart-healthy diet. 

Like with diabetes, use these hot months as an excuse to get your blood pressure checked or managed. High blood pressure is extremely common — about half of US adults have it. 

Pregnancy 

High heat, as well as pollution, can affect a pregnancy and increase the risk of early delivery, low birthweight and other not-ideal outcomes. This is in addition to making a pregnancy way less comfortable.

What to do: If you’re pregnant, take the steps you normally would to keep yourself and your internal body temperature cool, like staying indoors as much as possible on hot days and making sure you stay hydrated. To keep your nutrition intake up in the heat, try eating small, cool meals (like bowls of fruit or hearty salads), as BabyCenter suggests. 

Autoimmune diseases 

Health conditions that start at the immune system may flare up for people during the summer months. According to the Global Autoimmune Institute, high temperatures, UV light and humidity can trigger an immune response. Lupus, multiple sclerosis (MS), rheumatoid arthritis and more may all be exacerbated by the heat, whether the effects are in the joints (as with arthritis) or neurological (as with MS).

What to do: The National Multiple Sclerosis Society recommends doing all the things you’re probably already doing to stay cool, like staying in an air conditioned space (the society also notes that your AC cost may be tax deductible, if your health care provider writes a prescription for it to minimize symptoms). But it also recommends doing some pre- and post-cooling if you’ll be exercising, by gradually adding cool water to tepid bath water. In general, as the Global Autoimmune Institute says, be mindful of sudden changes in temperature, which may also cause problems (i.e. going from a very cold air conditioned room to a 90-something degree sunny day). Allow your body time to ease into it.

If you have an autoimmune condition that affects the skin, like psoriasis, and warm weather makes it worse instead of better, you may help prevent a flare-up by following the skin care tips for people with eczema, like using gentle soaps and limiting warm showers.

Mental health conditions 

Extreme heat and climate change affect mental health in many ways, and many mental health conditions are more likely to occur in people with other health conditions, or who are affected by factors that make them more vulnerable to high heat, like poverty. According to the American Psychiatric Association, extreme heat can make people feel more irritable and can worsen symptoms of depression. Some people are more explicitly affected by heat, like those with schizophrenia who have more problems regulating their body temperature. Also, psychotropic medications people may be taking for mood or behavior can increase the risk the heat-related illness.

Heat can also impact sleep quality, which is directly linked to the state of your mental health. 

What to do: If you have symptoms of anxiety or depression, are feeling hopeless, or experiencing other unpleasant feelings, reach out for help. Check out these online therapy services, or these tips for making friends with whom you may find a sense of community. 

For everyone, be sure to reach out to your neighbor and check in during heat waves, whether they have a physical condition that makes them more susceptible to heat, or a mental hardship. Sometimes the symptoms of heat exhaustion, or the more serious heatstroke, can sneak up on a person.