Paradoxical undressing

Q: What is "paradoxical undressing"?

Answer: It is a relatively unknown phenomenon, but 20-50% of hypothermia deaths are associated with paradoxical undressing. In moderate to severe hypothermia, as the person becomes disoriented, they may take off their clothing, which, in turn, increases the rate of heat loss.

Rescuers' usual first thought is - victims of hypothermia have been subjected to a sexual assault.  

Several explanations have been proposed, including cold-induced malfunction of the hypothalamus. Another explanation is that the muscles contracting peripheral blood vessels become exhausted, losing vasomotor tone and relaxation. This leads to a sudden surge of blood to the extremities, fooling the person into feeling overheated.

#hypothermia

References:

1. Krispin A, Zaitsev K, Hiss J. [Death due to hypothermia and paradoxical undressing]. Harefuah. 2011 Mar;150(3):227-9, 305. Hebrew. PMID: 21574352.

2. Pisani F, Nittis M. An unusual case of hypothermia and paradoxical undressing. Forensic Sci Med Pathol. 2021 Jun;17(2):338-342. doi: 10.1007/s12024-020-00315-3. Epub 2020 Oct 14. PMID: 33052559.

3. Wedin B, Vanggaard L, Hirvonen J. "Paradoxical undressing" in fatal hypothermia. J Forensic Sci. 1979 Jul;24(3):543-53. PMID: 541627.