top of page

How to avoid and treat cold injuries in hiking

Updated: Dec 26, 2020

There are two types of cold injuries

  1. Central problem - reduction in core temperature, which can be severe and fatal.

  2. Peripheral problems - such as fingers and toes frostbite, chilblains, or trench foot.

What makes cold injuries more likely to occur?

Cold and high winds: Cold injuries are more likely to occur with a combination of cold and high winds. For example, at -1 degrees Celsius, which may not be unusually cold; however, with a wind speed of 35 miles per hour, the actual temperature can reduce to -5 degrees Celsius.

Wind Chill Factor: the wind chill chart gives a brief idea of how temperature and wind speed related to each other.

Wind chill chart

The wind speed is calculated at an average height of 5 feet ( typical height of adult face) and assumes no impact from the sun.

Wet and exhausted - further intensify the effect of the cold and high wind. Also, hikers who previously suffer from frostbite are more prone to injury by the cold.

Other factors, such as dehydration, lack of food, physical type, and psychological factors, including depression, anxiety, and poor leadership can contribute to cold injuries.

Prevention of cold injuries

Dressing tips for cold weather hiking

  • Multiple layers - can trap heat and insulate the body more efficiently than one thick layer.

  • Wearing layers of clothing can allow you to adapt to change in weather and exertion amount.

  • Do not wear so many clothes that cause you to sweat as that causes dehydration and wet clothing. Wet garments tend to lose heat retentiveness.

  • Pack extra layers for an outdoor trip to put on during rest.

  • Base layer; wear a thin and synthetic layer. The thickness should be thin enough to transmit moisture away from the skin but do not absorb moisture from the outside. Choose materials that remain dry and wick away sweat.

  • Insulating layer; keep you warm by retaining body heat; fleece is an effective insulating material.

  • Shell layer; Shields you from winds and rain. Choose breathable materials such as Gore-Tex.

  • Keep the head warm - 30% of body heat is lost to the surrounding from the head's surface area. It is essential to give special attention and keep the head warm.

  • Cover body parts furthest away from large muscles and deep organs, e.g., fingers, toes, noses, ears, and cheeks.

  • Wear well fit shoes and gloves - if they are too tight, the chance of forming frostbite is higher.

  • Spare pair of dry socks- wet feet are more prone to frostbite.

  • Do not go outside with inadequate clothing.

More tips to prevent cold injuries

  • Making expressions and exercising facial muscles to keep them warm.

  • Do not touch cold metal with bare hands.

  • Avoid tired and exhausted conditions.

  • Wear sunglasses in the snow area.

dressing tips for cold weather hiking

Symptoms and treatments of different cold injuries

Cold injuries can be challenging to detect, especially by the victim, as cold decreases pain sensation. Watch out for symptoms such as pins and needles or tingling sensation in the limbs. Pale skin can also be signs of cold injuries.

The general treatment of cold injuries includes placing the affected part in a warm area to improve circulation. DO NOT attempt to warm the injured body part by direct heat or rubbing.


Chilblain is a condition that is caused by exposing skin to low temperature for a long time. The blood vessels under the skin surface will constrict and lead to itchy, purpled-red swelling conditions. The symptoms usually start in the distal body parts such as toes or fingers.

Treatments: warmed the affected part will allow the symptoms to go away. E.g., wear gloves if symptoms develop in fingers.

Trench / immersion foot

Trench foot is a medical condition caused by prolonged exposure of the feet to wet, damp, unsanitary, and cold surroundings. In the early onset stage, the feet turn pale with little detectable pulse. The feet then become red, swollen, painful, and with a strong pulse in the later stage.

Treatments: In the early stage, when the feet are wet and cold, warm them gently. When the feet become red and swollen in the later stage, allow them to cool gently. DO NOT apply ice and rub them. The best treatment for trench foot is prevention, keep the socks dry and prepare spare socks.


Frostbite is caused by direct exposure to cold and wind. Due to the anesthetic effect of cold, frostbite may be missed by victims in the early stage. Frostbite usually affects the body parts that have the least protection. E.g., hands, feet, nose, and ears.

Blanching of the skin, pins and needles, numbness are the signs of frostbite followed by the formation of blisters and cell death. The white, cold, and hard skin in the early stage of frostbite can become red and swollen in the later stage. Frostbite can be dangerous if the blood vessels are affected, which can cause the death of tissue.

Treatments: Remove the injured person from the cold area, take off wet clothing, and put on dry and clean one for the affected part. Take action to warm the skin by blowing through cupped hands or placing your injured hands in the armpit. If frostbite occurs in feet, put your feet inside companion's clothing.

If blisters develop, do not burst it; cover the affected area with clean material or dressing. Deeper frostbite needs rewarming in a warm water bath (40 degrees Celsius) with movement of the affected part until it returns to normal color. Avoid dry heat, as it may result in severe damage.

SEEK MEDICAL HELP for severe and deep frostbite.


Hypothermia occurred when the temperature fell below 37 degrees Celsius. Victims may present symptoms such as drowsiness, lowered heart rate, and breathing. When core temperature drops below 35 degrees Celsius, uncontrollable shivering, clumsiness, coordination, and judgment loss can happen, followed by the inability to shiver, unconscious, and even death.

Hypothermia is a critical condition that requires medical attention.


  • Seek medical help immediately.

  • Remove the victim from cold, wet, and dangerous environments and place him/her in a warm, protected area. E.g., you can place a victim in a sleeping bag with someone in the sleeping bag to warm the surrounding.

  • Remove victims wet and frozen clothes, and put on a dry and clean one.

  • Monitor vital signs and prepare resuscitation if necessary.

  • If the patient is conscious, give him/her a warm and sweet drink.

Snow blindness

The snow and ice crystals intensify the sunlight's reflection, and the intense glare of the sun can cause snow blindness. Symptoms include sensitivity to glare, pinkish vision, and watering eyes. When conditions worsen, symptoms such as loss of vision, sharp pain, and red curtain may happen.

Treatments: Place bandages over the eyes immediately, place the victim in a dark place, use a cool, wet bandage to reduce pain if needed. It takes time for the blindness to recover. The best treatment is to prevent snow blindness by wearing sunglasses.

Information from:

Alexander Stilwell. The Encyclopedia of Survival Techniques. The Lyons Press 2000

Reid, D.C.: Sports Injury Assessment and Rehabilitation. New York, Churchill Livingstone 1992, p.483-484.

Reid, D.C.: Sports Injury Assessment and Rehabilitation. New York, Churchill Livingstone 1992, p.483-484

Please leave us comments and subscribe to our membership. We'd love to hear your feedback and know how we can do better.

66 views0 comments


bottom of page