Hiesho, or cold sensation, predominantly affects females, presenting significant health concerns. Despite its prevalence, screening methods remain controversial, often relying on subjective assessments. Quantitative approaches are urgently needed. This study investigates foot skin temperature recovery rate after cooling test as a novel biomarker for Hiesho. 62 young females participated, undergoing a cooling test followed by foot temperature measurements. Participants completed the Terasawa Hiesho Questionnaire. Biomarker analysis involves receiver operating characteristic (ROC) curve and statistical tests. Thirty-one participants were classified with Hiesho. Significant temperature recovery rate differences were found between Hiesho and no-Hiesho groups, particularly at specific foot points and time intervals. The ROC curve identified optimal biomarkers, with the highest diagnostic performance observed in temperature recovery rate at the medial metatarsal 15 minutes after cooling test. A temperature recovery rate of ≤ 44.68% was suggested as a screening criterion. The study highlights significant temperature recovery rate differences between Hiesho and healthy individuals, supporting its potential as a biomarker. Physiological mechanisms underlying 1 Hiesho, including hormonal influences and genetic factors, were discussed. Foot skin temperature recovery rate post-cooling test shows promise as a biomarker for Hiesho screening in young females. Despite limitations, its potential warrants further investigation, offering a quantitative approach to Hiesho assessment.