The first minutes matter. When an attack sets in, steps taken early often limit how bad it gets. Here is what genuinely helps, what is folklore, and what can make things worse.
What helps
1. Get away from light and noise
This is the most effective step, and the most neglected. Sensitivity to light and sound is not fussiness: it is part of the attack, and every stimulus prolongs the pain. A dark, quiet room with no screen is worth more than any accessory.
2. Apply cold
The practice has been documented since the nineteenth century. A randomised controlled trial published in 2013 in the Hawai'i Journal of Medicine & Public Health measured a significant reduction in pain using a chilled wrap applied at the onset of the attack. We cover that research and its limits in a dedicated article.
In practice: 15 to 20 minutes, on the forehead, temples or neck. Never place ice directly on the skin — always keep a layer of fabric between. Remove it as soon as the sensation becomes unpleasant. Cold does not suit everyone: in the available studies, a few participants had to stop because of intolerance or dizziness.
3. Drink water
Dehydration is a recognised trigger. A glass of water will not stop an attack already under way, but if you have not had anything to drink for hours, that may be part of the problem.
4. Do not stay on your feet pushing through
Worsening with physical effort is a diagnostic criterion for migraine. Carrying on prolongs the attack. Lying down, even for twenty minutes, does more than people expect.
5. Take a painkiller early, if that is your habit
Acute treatments work considerably better taken at the first signs than after two hours of established pain. We recommend no medicine and no dose: that is for your doctor or pharmacist.
Cold or heat?
The question comes up constantly, and the answer depends on the type of headache.
- Migraine → cold, on the forehead, temples or neck
- Tension headache → heat, on the neck and shoulders, where the muscles are tight
- Eye strain → cold on the eyelids, together with a real break from the screen
If in doubt, try it: the sensation will tell you within thirty seconds. What soothes one person can be unbearable to another, and that is normal.
What changes nothing, or makes it worse
- Coffee — ambiguous. It can help occasionally, but regular consumption and above all withdrawal are well-established triggers.
- Toughing it out — waiting for it to pass while carrying on working is the single most counterproductive reflex.
- Painkillers too often — beyond two doses a week on a regular basis, there is a risk of medication-overuse headache, where the treatment sustains the pain. Raise it with your doctor.
- Dark mode on the screen — better than nothing, but a long way from a real screen-free break.
Over time: keep a diary
The most useful step does not happen during the attack. For one month, note the date, time, duration, intensity, what you had eaten and slept, and the context. Personal triggers often emerge after only a few weeks.
It is also the most useful document you can bring to an appointment.
When to seek urgent care
Go to the emergency department or call emergency services if the headache comes on suddenly and peaks in under a minute, if it comes with fever and a stiff neck, with difficulty speaking, seeing or moving, if it follows a blow to the head, or if it is unlike anything you have experienced.
See your doctor, without urgency, if attacks become more frequent or weigh on your daily life. Effective preventive treatments exist.
Where a gel mask fits in
A reusable mask such as ThéraMask™ is a practical way to apply cold or heat without it sliding off, while blocking light. A damp towel from the freezer does the same thing for free, less comfortably.
It is not a treatment. It is a comfort accessory that accompanies rest rather than replacing it — and we would rather put it that way.