More than 430 people were killed and about 7,000 injured when the quake hit near the Iran-Iraq border on Sunday.
The government is scrambling to get aid to the worst-hit area in the mountainous province of Kermanshah, where hundreds of homes were destroyed.
One man told the BBC residents were afraid of returning to the shells of their homes due to strong aftershocks.
Temperatures in Kermanshah province fell close to freezing for the second night in succession.
Ali Gulani, 42, lives in the province's badly-hit town of Qasr-e-Shirin, and told BBC Persian people were burning crates to try to stay warm.
"We are living in a tent and we don't have enough food or water," he said. "You can hear children crying, it's too cold. They are holding on to their parents to warm themselves - it's pretty bad."
Mr Gulani said there were an average of three strong aftershocks an hour, provoking panic.
Close to 200 aftershocks have hit the region since the magnitude-7.3 earthquake on Sunday night. It was one of the strongest on earth this year, as well as the deadliest.
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