Welcome to this blog post about Annapurna Circuit safety! We're so glad you're taking your trek safety seriously enough to read it. Each section below outlines a key aspect of safety, from how to avoid altitude sickness to what you need to know about drinking water.

If you work through this post carefully and take notes, you can book an Annapurna Circuit trek and feel confident that you'll arrive prepared for a safe and happy adventure!

Altitude sickness

Altitude sickness is an illness that develops when your body reacts badly to the thin air associated with high elevation. Mild altitude sickness is common and it isn't dangerous, meaning you can push through it. But note that serious altitude sickness is, well, serious – it can even prove fatal.

So this is an important topic!

Altitude sickness is one of the most important Annapurna Circuit safety topics, alongside exposure. It's critical that you understand what it is and how to avoid it.

On the Annapurna Circuit, the highest elevation you reach is on the mountain pass known as Thorung La, which is 5,416 m or 17,769 ft above sea level. This is higher even than Everest Base Camp.

Given that altitude sickness can strike from anywhere around 3,000 m, you can see that there's a very real danger of your body developing altitude sickness on the Annapurna Circuit.

The benefits of altitude meds

The first way to avoid altitude sickness (or at least mitigate the severity of it) is to take altitude meds, for which you require a prescription from your doctor.

Altitude meds like acetazolamide help your body to better adjust to the increased elevation. That said, such medication is by no means a free ticket! You could still develop altitude sickness, even badly. But the meds improve your chances of adjusting speedily and well.

Thorung La victory photo!

Acclimatising properly

The second – and most important – way to avoid developing bad altitude sickness is to ascend in elevation gradually.

As we discuss in How to acclimatise for a trek in Nepal, you want to give your body adequate time to adjust to each big jump in elevation. In this way, you're still going to feel the strain of each elevation gain, but your body should cope.

One of the best ways to do acclimatise (acclimate) properly while doing the Annapurna Circuit is to rest for a couple of extra nights at Manang.

The town of Manang in the Marsyangdi River valley

Manang (3,540 m) is the biggest settlement on the trail and a great place to stop as your body usually needs to take a beat at this elevation. There's also plenty to do and see in and around the town.

There are beautiful day hikes on offer, for instance, to enjoy more of the area than you'd see on the Annapurna Circuit trail. These hikes mean you aren't 'wasting' time, but instead enjoying yourself, while also benefitting from what we refer to as the 'climb high, sleep low' acclimatising (acclimating) strategy.

The Ice Lake is a tough and rewarding day hike you can do from the town of Manang

Please note that while we can give guidelines for how to avoid developing serious altitude sickness on the Annapurna Circuit trek, you should always listen to your body and your trek guide. (We discuss the value of trek guides at the end of this blog post.)

When to abort your trek

If you're really struggling with the altitude at any point on the trek (and it could be lower down than you'd expect, you just never know), then you need to promptly descend in altitude.

What does "really struggling" look like, you ask? Please read How to acclimatise for a trek in Nepal to learn more about the symptoms of altitude sickness, which include headaches, dizziness and nausea.

Yes, it's always going to be gutting to abort your trek, but please take careful note that descending in altitude is the only remedy for altitude sickness – you can't 'shelter in place' and hope to get better that way.

That said, if you only have mild symptoms then it's possible to take an extra day or two to rest before continuing on up the trail.

Further reading on the topic

• What's the elevation gain on the Annapurna Circuit?
• What's the elevation gain on the Nar–Phu and Annapurna Circuit?
• Annapurna Circuit vs Everest Base Camp

Extreme weather conditions

The other major safety concern on the Annapurna Circuit is overexposure to the often harsh elements.

Let's discuss each weather-related danger in turn ...

Staying warm and dry when trekking

Extreme cold, fierce winds, massive downpours – the Annapurna Circuit wouldn't be the famous high-altitude adventure that it is without these elements! But it's only an adventure, and not a horror story, if you come properly equipped. And this means knowing exactly what to pack.

A misty monsoon day on the lower Annapurna Circuit

The lower half of the Annapurna Circuit takes place in a forested temperate zone that's subject to summer monsoonal rains. And if you begin the trek near its traditional start point – which we, like many others, don't do as this section is now paved and you must walk the road alongside cars – then you're trekking in a subtropical zone that experiences the summer rains even more intensely.

Waterproof clothing and quality trekking boots that are waterproof or at least water-resistant are critical when there are downpours to avoid your feet becoming wet, growing cold, and likely blistering.

Heading towards the warming light of a glorious sunrise on summit day

Then, there are the upper reaches of the circuit, where you climb above the tree line.

While daytime temperatures along the upper portion of the Annapurna Circuit don't often drop below freezing point outside of winter, they frequently come close. And when you reach Thorung La – the highest point on the route – all bets are off. Temperatures often plummet below freezing (as shown in the graph below), and snow is common.

So during the day, it's vital that you have the right clobber to keep you warm, head to toe. We discuss this topic in detail in How to dress for a high-altitude trek in the Himalayas, but here are some of the key items to pack to stay safely snug while trekking:

• Properly insulated trekking boots (more on these in a moment)
• A poncho or rain jacket
• Waterproof trousers or overpants
• A backpack rain cover
• A winter jacket
• Thermal inner wear
• Woollen or similarly cosy socks
• Winter gloves
• A beanie or balaclava

Our client Hala tackles a section of the circuit in rain

Staying warm at night

Your Annapurna Circuit accommodation is pretty comfortable as far as high-altitude trekking is concerned. You have the option of staying in lodges, for instance, which have fire-heated common rooms.

But you sleep in small rooms of usually two to four beds that only have single-pane windows. So while you're overnighting indoors, don't expect the walls to offer you much protection from the elements beyond blocking the wind.

If you leave your water bottle next to your bed, for instance, you'll very likely waken to some frozen water.

Only the common room of a teahouse is heated – bedrooms aren't

Night-time temperatures can regularly drop below freezing point in the teahouse bedrooms of the upper section of the Annapurna Circuit.

Some items to pack to ensure you stay cosy during the night on the Annapurna Circuit trek are:

• A snug-fitting winter sleeping bag with a hood
• Thermals, including woollen socks
• A warm hat (since much heat is lost through the head)
• A hot water bottle or hand warmer

Independent mountain lodges in Nepal are called teahouses

The best seasons for the Annapurna Circuit

As we discuss in When is the best time to hike the Annapurna Circuit?, you probably want to avoid the summer monsoon season to avoid being regularly drenched when trekking along the start of the trail.

Spring and autumn offer the best trekking conditions in the Annapurna mountains

You might also want to avoid the middle of winter to reduce the dangers that come with big deposits of snow high up in the mountains.

Occasionally Thorung La – the highest point on the Annapurna Circuit – is closed off by authorities after a heavy dump of the white stuff. When this happens trekkers must hunker down where they are or turn back. Disappointing indeed when you've travelled so far to be there!

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The trail

The trail you trek along the Annapurna Circuit varies greatly.

If you start low down in the subtropical zone, where the route has its traditional start, then you'll walk alongside vehicles on tarred roads and jeep tracks. In the temperate zone, the roads end and you're now on footpaths for the rest of the way.

En route to Thorung La in snow and mist

Throughout the temperate and alpine zones you can expect to tackle steep inclines and declines, protruding roots, uneven stone steps, narrow contour paths, scree, (loose) rocks, snow, perhaps ice, plenty of switchbacks, traditional wooden footbridges, and more. Be sure to give your ankles a thankful pat each night for all they do for you.

You encounter scree, sloped paths, bridges and much more on the trail

Of course the trail can be treacherous in places, especially when you add rain, snow or ice. So please be sure to bring quality trekking boots. We discuss what these look like in The best hiking boots for trekking in Nepal, but here are a few key points:

• You should have already hiked about 100 km in them.
• They must have deep lugs for traction.
• Proper toe caps are important to protect your digits.
• They should be waterproof or at least water-resistant.

Your hiking boots should be well worn-in before you start trekking

Also be sure to pack quality hiking socks, including some winter hiking socks.

Remember that the Annapurnas are part of the Himalayas, so frostbite is all too possible if you don't come armed with warm and waterproof clothing and boots!

You might also like to consider packing gaiters, as these help to keep snow, stones and other unwelcomes out of your boots. Trekking poles are also a vital bit of equipment as they help to assure you don't take a tumble if a footfall is a fail!

You can find a full list of what to bring in Your complete Annapurna Circuit packing list.

Light snowfall on the Annapurna Circuit

Finally, crampons generally aren't necessary, even when there's a little snow near the summit. That said, check the weather forecast before heading out. And if you do decide to tackle the Annapurna Circuit in winter, then crampons are a really good idea.

Food and water

Right, another important Annapurna Circuit safety topic is food and water.

Food safety on the Annapurna Circuit

The higher up you climb on the trail, the further away you are from any roads. This means all food has been portered in. And that could mean animal products have gone unrefrigerated for longer than is safe.

Remember how hard it is for the highest teahouses (lodges) to obtain fresh produce

In our opinion, meaty meals during the trek aren't worth the risk of an upset stomach. It's better to go vegetarian for most of the Annapurna Circuit to ensure you stay fit and healthy; remember that every day is more physically demanding than the last.

One little tummy bug can spell the end of your trek. So be cautious to the point of paranoid with regards to what you eat and drink.

A vegetarian breakfast of soup, omelette, veggies and bread

If you really want to try some local meat dishes while in the region, rather indulge in these in Pokhara after the trek.

Water safety on the Annapurna Circuit

To protect yourself from an upset stomach on the Annapurna Circuit, be sure to only drink water you know to be potable (safe to drink).

Try to ensure you only drink hot water that has reached boiling point

You have a few options on the trail when it comes to securing safe drinking water:

1. Buy bottled water at the shops. This is, however, only an option lower on the trail, as there are no shops at the highest elevations. It's also not an environmentally friendly solution.
2. Pack purification tablets or bring a water bottle with a built-in filtration system if you want to use tap water (public water). But note that there won't be running water higher up on the trail.
3. Stock up on boiled water at the teahouses. This is the best and most sustainable option.

A teahouse dining room on the Annapurna Circuit

Finally, here are a few other tips with regards to water safety on the Annapurna Circuit:

• Avoid salads and other foods that might have been washed in unpotable water.
• Wash your fruit with sterilised water.
• Brush your teeth with your drinking water.
• Keep your mouth shut when showering.

Wash your fruit with sterilised water

The sun

As we discuss in tip #8 of 10 tips for trekking the Annapurna Circuit, you need to protect your eyes, lips and skin from the elements. But the elements aren't just the obvious mountain culprits, which are cold, dry air and strong winds – there's also the often fierce rays of the sun to consider.

Come prepared for the sun, not just the cold

So let's talk about how to protect your eyes from the sun while on the Annapurna Circuit, and then we discuss protecting your skin and lips.

How to protect your eyes

The glare can be potent at high altitude, especially if it's bouncing off clean snow.

The unlucky high-altitude trekker can actually develop snow blindness if too much sunlight enters the eyes. Snow blindness makes the eyes red, painful, watery and extra sensitive to any light. But the condition only reveals itself a few hours after overexposure, so you likely won't know what's up till it's too late.

Wrap-around sunglasses are ideal for high-altitude treks

To protect your eyes on the Annapurna Circuit, be sure to bring a pair of full-spectrum sunglasses. We say "full-spectrum" because these are the ones that protect you from both UVB andUVA rays.

Polarised sunglasses are also a really great idea. Polarised – or anti-glare – sunglasses reduce the strain on your eyes and offer a crisp view of the world.

As to shape, wraparound sunglasses are ideal as they prevent the sun's rays from sneaking in at the sides. But also avoid concave sunglasses that hang too far down your cheeks as those can trap heat and steam up.

Wear your sunglasses before the trek to ensure they don't slip down your nose

As with anything you bring on the Annapurna Circuit, we recommend trialling your sunglasses before arriving in Nepal. You want to ensure they're comfortable even after being worn for many hours. You also want to ensure they don't slide down your nose when you become sweaty.

How to protect your skin and lips

In case you took a nap that day in geography class, the sun's rays are stronger at high altitude. This means it's easy to burn on the Annapurna Circuit, even if you aren't feeling hot, or there's cloud cover.

In fact, your skin and lips can take a true beating on the Annapurna Circuit. While this might not strike you as a typical 'safety' concern, we can assure you that you'll be a very unhappy chappy if you neglect to protect them on the trek. So it's critical that you pack the right protective gear.

The sun's rays are more potent at high altitude

The lips are often a weak link in the body armour on high-altitude treks – don't let painfully peeling lips be the memory you carry with you of your Annapurna Circuit trek!

We mention lips specifically because they have a different structure from the skin on the rest of your face, and their skin is also much thinner. So what you pack for your lips should be a separate consideration from what you pack for the rest of your skin.

Be sure to pack enough sunscreen for the entire trek

The important items to pack to protect your skin and lips when trekking the Annapurna Circuit are:

• Full-spectrum sunscreen with a high SPF factor (we suggest a factor of 40 or more).
• Full-spectrum lip balm with a high SPF factor.
• A sunhat with a wide, wrap-around brim. A neck cord is useful in case a gust of wind tries to steal it. If you only want to wear a sports cap, be sure to add sunscreen to your ears and wear shirts with collars to the protect the back of your neck.
• Long-sleeved shirts to protect your arms.
• A hardworking moisturiser or hydrating serum. You want to moisturise your skin throughout the trek, especially at night, with particular focus on your hands and face (as these are the most exposed parts of your body). Remember that creams offer more moisture than lotions. Also note that hyaluronic acid is one of the star ingredients in a truly hydrating product.
• A snood. If your lips (and even nose) really start to feel the sting of the cold, you'll be super grateful to have a snood to pull up over them. Alternatively, you could pack a balaclava – this a particularly great idea if you intend to trek in winter.

Remember, your skin can burn on overcast days too

Finally, here are a few further tips with regards to looking after your skin and lips on the Annapurna Circuit:

• Cover up as much as possible on particularly sunny or windy days to prevent your skin drying out.
• Moisturise your skin religiously beforeyou even develop an issue. Prevention is better than a cure.
• Dry skin and lips are dehydrated skin and lips, so drink lots of water to nourish them back to plump wellness.
• Try not to lick your lips if they're dry. This will only worsen the situation.
• Don't pick dry or peeling skin or lips, as this will only prolong the healing time.
• If you're prone to dry skin or lips, consider packing an exfoliator and night-time repair mask for either, or both.

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Vaccinations

There aren't any compulsory vaccinations for travelling to Nepal. That said, if you're coming from a region with a known yellow fever issue, you'll have to present your vaccination card for this.

You visit very remote villages on the circuit

Of course, if you want to ensure you're covered against all possible diseases, check to see if you're vaccinated against all of the usual suspects, namely Hepatitis A, typhoid, meningitis, tetanus, polio, mumps and measles.

Finally, considering the Annapurna Circuit takes you into some very remote places, you might also like to ask your GP for advice on vaccinations against rabies, Hepatitis B and Japanese encephalitis.

Travel insurance

It's absolutely vital that you take out comprehensive travel insurance before trotting off on the Annapurna Circuit.

You won't get a permit to trek the Annapurna Circuit without insurance

Please note that the Government of Nepal won't issue you with a trekking permit without proof of travel insurance.

Not only will the Nepali government not let you trek the Annapurna Circuit without travel insurance, most reputable tour operators (us at Follow Alice included) won't take you on as a client without it. The inherent risks of a high-altitude trek make any other course of action just too foolish.

You can learn more on the topic of travel insurance in How much does it cost to trek the Annapurna Circuit cost? This is where we discuss the sort of cover you should purchase.

That said, one particular thing we want to stress here is the importance of obtaining coverage for hiking at high altitude. Normal travel insurance doesn't cover you for this. So please look for a clause that specifically addresses high-altitude hiking.

Be sure to purchase insurance that covers high-altitude trekking

We can recommend World Nomads as a reputable travel insurance company you might like to research. They offer coverage for more than 150 adventure activities, including high-altitude trekking.

Trek guides

As of 2023, trek guides are now compulsory in Nepal.

This is a great thing, in our opinion. We have a few reasons for saying this, a primary one of which is trekker safety. For all except the most seasoned of trekkers, a qualified and experienced trek guide is your biggest shield against disaster.

A qualified trek guide is paramount to your safety

As far as your safety on the Annapurna Circuit goes, your guide is there to:

• Check you have the proper gear before starting the trek.
• Ensure you don't get lost.
• Detect the signs of altitude sickness and respond appropriately (which might mean insisting you descend in altitude).
• Pay close attention to weather updates and decide if it's safe to continue trekking.
• Carry a first aid kit and treat any accidents or illnesses (within a reasonable scope).
• Carry and administer backup oxygen should a client need it.
• Carry a radio and call for assistance if necessary (and possible).

Your trek guide is there to keep a keen eye on the weather forecast

Of course any trek guide you hike with should be properly certified and experienced.

An important qualification for any trek guide is being a certified Wilderness First Responder (WFR). WFRs know how to respond to medical emergencies in the wild, particularly those relating to altitude sickness and accidents like falls.

You also want a guide who has received plenty of on-the-job training, which means working as an assistant guide for a period of time under the tutelage of a more experienced colleague.

All smiles after safely reaching Thorung La!

Please ask after the qualifications of the tour guide who will lead your trek if such info isn't readily available. All reputable tour companies will have this to hand and be happy to share it with you.

We hope this has all been helpful. Whether you trek the Annapurna Circuit with Follow Alice or opt to travel with another tour operator, we wish you a safe and memorable trek in the majestic Annapurna Mountains!