High Altitude Is More Than Thin Air: Dry Nose, Split Lips, Sun, Appetite, Sleep
On a big mountain, the small miseries do the slow damage: dryness, cracked lips, sunburn, no appetite, no sleep. None of it replaces altitude-illness checks — all of it has to be managed.
At altitude the air is dry, cold and thin, so the nose dries and bleeds, lips split, skin cracks, UV burns harder and appetite and sleep degrade. Manage each one deliberately: saline spray and humidification, SPF lip balm, SPF 30–50 sunscreen with goggles, small frequent meals. None of this substitutes for recognising AMS, HACE and HAPE.
Altitude illness gets the attention, and it deserves it. But the things that quietly wreck a trip are smaller and more constant: a nose that will not stop bleeding, lips that split when you smile, a sunburn in a whiteout, and four nights of bad sleep.
Dry nose and nosebleeds
- Cold, dry air cracks the nasal lining. Use saline spray or a nasal rinse, and raise humidity in the tent with a damp towel or a water bowl.
- Do not pick, and do not pack tissue hard into the nostril. A little water-based lubricant helps; use sparingly and never share.
- Nosebleed: sit upright, lean slightly forward, pinch the soft part of the nose for 10–15 minutes. Do not tilt your head back — the blood runs into your throat.
- Repeated or heavy bleeding, dizziness, palpitations, or being on anticoagulants: seek medical care.
Lips and skin
- SPF lip balm, reapplied often. Do not lick your lips; it makes them worse.
- A buff or face mask in wind and snow; a thick unscented balm before sleep.
- Cracked, peeling, weeping corners of the mouth: keep clean, do not tear the skin, and see a doctor if it does not heal.
- Skin: not-too-hot showers, gentle soap, moisturiser while skin is still damp. Heels, knuckles and hands crack first — thick cream plus gloves or socks.
- Exposed skin in wind and snow can frostbite. Numbness, white or hard skin means rewarm and seek care. Do not rub with snow.
Sun
- UV rises with altitude — roughly 10% per 1,000 m (3,300 ft) — and snow reflection multiplies it. Cloud does not protect you.
- SPF 30–50, broad spectrum, applied generously before you leave, reapplied every 2 hours and after sweating. Nose, ears, back of the neck, backs of hands and lips get missed.
- On snow and glacier, use goggles with side shields or category-4 lenses. Ordinary sunglasses are not enough. Snow blindness is painful, photophobic and disabling: get out of the light and seek care.
- Sunscreen is not about tanning. It is about burns, snow blindness and long-term skin damage. Sprays miss in wind — use a cream.
Appetite and vitamins
- Loss of appetite at altitude is normal. Eat small and often, bring food you actually like, and use hot drinks. Carbohydrate, protein and some fat — not sugar alone.
- A monotonous long trip can run short on vitamins C, B and D. Food first; a multivitamin only if intake is genuinely poor, and not in large doses.
- There is no reliable evidence that high-dose vitamins prevent altitude illness. They do not replace slow ascent, descent and medical judgement.
- Chronic conditions, pregnancy, children, or existing medication: ask a doctor before adding supplements.
Sleep
- Dryness, coughing, night-time urination and worry all fragment sleep. Fix the dry nose, the cough and the cold first.
- Do not use alcohol or sleeping tablets to force sleep. Sleeping tablets can mask altitude illness and worsen breathing.
- Headache plus nausea plus unsteady walking is altitude illness, not insomnia.
Eyes and contact lenses
- Dry air, wind and UV dry out lenses. Carry glasses as a backup and preservative-free lubricant.
- Snow blindness, eye pain or photophobia: remove the lenses, get out of the light, seek care. Do not keep going in the sun.
Log it daily
Resting heart rate, SpO2, sleep, headache, appetite, gait and consciousness, morning and evening. Read the trend, not a single number. See Daily altitude monitoring.
Red flags
Unsteady walking, confusion, breathlessness at rest, or pink frothy sputum: treat it as HACE or HAPE and descend or call for help now. Do not keep treating it with lip balm and vitamins. See Altitude sickness.