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Categories > Skin and Scalp Care > Treating skin problems

Pressure sores: Prevention and relief
Signs of a pressure sore
How to prevent a pressure sore

The four stages of a pressure sore
The four stages of a pressure sore

Doctors determine the stage of a pressure sore by looking at the degree of tissue damage:

  1. The top two layers of the skin—the epidermis and dermis—are affected first.
  2. The skin breaks slightly. Damage extends down into fat tissue.
  3. The ulcer becomes a deep crater. Damage spreads down into the muscle.
  4. Nearby soft tissue, bones and joints may be destroyed.

An alert for people with diabetes
An alert for people with diabetes

When diabetes causes nerve damage, feet may lose feeling and pressure sores can go undetected. Some people who suffer from diabetes have bone fractures that can change their foot’s shape, causing unrelieved pressure on some areas, leading to foot ulcers. If you have diabetes, examine your feet daily, keep regularly scheduled checkups and talk to your doctor about foot care and proper footwear.

If you or someone you care for is forced to remain in one position for a lengthy time, you may have to cope with pressure sores. These areas of irritated skin and the underlying tissue beneath them—also called bedsores, pressure ulcers or decubitus ulcers—develop when blood can’t circulate to the affected area of the body. As tissue begins to die, the skin may discolor. In time, tissue damage can extend down into the muscle or bone and become infected.

While some pressure sores can be prevented by taking certain precautions, they can be hard for some people to avoid. Individuals confined to bed rest or who spend long hours in wheelchairs may develop sores because movement is difficult or impossible. Moisture from bladder and bowel accidents can further weaken the skin and cause skin breaks. Some people who have lost feeling in certain parts of the body may not know when a pressure sore is developing.

Signs of a pressure sore

A red area remaining on the skin after pressure has been applied can indicate that a sore is developing. People with darker skin may see their skin become light, dry or ashy. Skin may also feel warm to the touch.

Pressure sores most commonly develop on the tailbone, the base of the buttocks, the heels and other bony areas of the feet. Because these places can be difficult to see, a pressure sore can go unnoticed until pain develops. Embarrassment or lack of knowledge about the seriousness of pressure sores may prevent some people from seeing their doctors, but it’s crucial to get a sore treated as soon as it develops.

How to prevent a pressure sore

Fortunately, most pressure sores are preventable. Take these steps to avoid them:

  • Change position often. Move or ask someone to help you move frequently—at least once an hour—so pressure doesn’t build up on one spot.
  • Check your skin at least twice a day for redness or skin damage. Use a mirror to see certain areas—but don’t be embarrassed to ask a loved one or caregiver for help.
  • Cushion yourself. Support your body with pillows, foam wedges or a special mattress to relieve pressure.
  • Pad your bony areas. Let your weight rest on fleshy areas instead.
  • Sit upright in chairs and wheelchairs so you have more freedom of movement.
  • Keep skin dry and clean. Change out of moist or wet clothes. Relieve your bladder as necessary.
  • Eat a nutritious diet. Foods rich in vitamins and minerals, plus adequate protein, help your skin stay strong and healthy.
  • Drink water to help your skin stay moist and supple.
  • Don’t smoke or abuse alcohol. Both can cause skin damage.

If you already have a pressure sore:

  • Tell your doctor right away. He or she can check for infection or treat the sore before it becomes infected.
  • Keep pressure off the affected area.
  • Keep the pressure sore clean. Use a saltwater solution to rinse away dead tissue and extra fluid on the sore.
  • Bandage your pressure sore. Change your bandage as your doctor directs.
  • Ask your doctor about dressings that dissolve dead tissue, which can cause infection or lengthen healing time.
  • Consider taking a pain reliever before changing bandages. A pain reliever taken 30 to 60 minutes before removing the bandage can ease pain.