How to Treat and Prevent Bed Sores (Pressure Injuries) - GoodRx (2024)

Pressure injuries, commonly referred to as bed sores, occur when people don’t (or can’t) move enough. They are areas of skin breakdown that can extend into deep layers of tissue. And many people don’t realize how easily they can develop — or how problematic they can be. Pressure injuries are the third most expensive health condition after cancer and heart disease. We’ll provide some information on how you can prevent pressure injuries, which is especially important if you recently had an injury or illness. We’ll also cover how to identify them in the early stages before they get larger. Because once a pressure injury progresses into later stages, it can be very challenging to heal.

How are bed sores treated?

Pressure injury treatment depends on the depth and size of the injury, and whether it’s wet or infected. Selecting the best treatment begins with knowing the stage of the injury. There are different treatments commonly used at different stages.

There are four stages of pressure injury:

1) Stage 1: The skin is at risk for breaking down but hasn’t yet. It looks pink or deep red, or darker brown (in people with darker skin). The color doesn’t change when you push on it. A padded bandage can help to protect the area.

2) Stage 2: The skin is blistered, or there is a shallow ulcer. Typically, these need to be protected with a special bandage that keeps the area moist and clean. Wound gels and foam dressings may be used.

3) Stage 3: The wound is open, and you can see deeper layers of tissue including fat and/or muscle. These wounds often need dressings that wick away excess moisture. Antibacterial ointments can help to remove dead skin cells.

4) Stage 4: The wound goes all the way to bone. These may need surgery or a wound vacuum device for treatment.

Wound care specialists are experts at knowing exactly what kind of bandages and treatments the different stages of injury need. If you or a loved one is dealing with a pressure injury, it may help to ask your provider about connecting with a wound care team for treatment.

Healing time depends on a lot of things. This includes the size and depth of the wound, whether there’s an infection, the extent of wound care, pressure relief strategies, and the individual’s ability to heal. Stage 1 pressure injuries might take days to heal, while stage 4 may take a year or more.

Good nutrition is an important part of wound healing. Increasing protein intake, staying hydrated, and taking vitamin C and zinc supplements may help speed recovery.

How are bed sores prevented?

Fortunately, there are ways to help prevent pressure injuries for people who are at high risk:

• Relieve the pressure. The most important first step in preventing and treating pressure injuries is to relieve the pressure. The general rule of thumb is to shift weight or turn every 2 hours to prevent pressure from causing damage.

• Perform daily skin checks. Those at risk for pressure injuries should have regular daily skin checks to look for the earliest signs of pressure damage, especially around bony areas. Before an open sore develops, the skin changes color as its blood supply decreases. For lighter skin tones, pinkness or redness remain even if you press on it. For darker skin tones, the color may be deeper brown.

• Invest in special equipment. Specialized air mattresses can offload pressure for people who have to remain in bed. There are many types of bed equipment that can help. These include gel cushions, padded dressings, mobility aids, and lifts that can help people who aren’t moving on their own.

• Maintain good nutrition. A healthy diet, rich in protein, can help to reduce the risk of muscle wasting. And this is important because loss of muscle mass can decrease the space between skin and bone.

What causes bed sores?

Most people don’t realize how much we naturally shift our weight and body position whenever we are sitting or lying down. Without these subtle movements, sustained pressure to certain areas compresses small blood vessels between bones and skin. This reduces the circulation to these areas, which leads to skin breakdown and deep tissue damage.

Pressure can damage any part of your skin. But it’s more common in locations where bones are closest to the skin and there’s less “padding.” The most common areas are the:

• Back of the head

• Shoulders

• Tailbone (sacrum)

• “Sit bones” (ischial tuberosities)

• Elbows

• Heels

Pressure injuries can develop pretty quickly. And the greater the pressure, the faster the damage occurs. It may only take 3 minutes to develop a pressure ulcer (if your skin is pinched between hard surfaces, for example). But more commonly, they occur over hours or days.

Who gets bed sores?

Anyone can get a pressure injury. They don’t just affect people who use wheelchairs or those who are in the hospital or a nursing home. In fact, “bed sore” is a misleading term because they don’t always happen in bed. You can get a sore from sitting too long, sleeping on the ground, or having something hard (such as plastic or metal) pressing on the skin.

But even though they can happen to anyone, people in certain situations are at particularly high risk:

• Immobilization: Pressure injuries most commonly occur when you can’t easily move your body. This can be because you’re weak, paralyzed, immobilized, unconscious, or not fully awake or aware of your surroundings. Under normal circumstances, the body sends tiny “discomfort” signals to the brain to change position. During the day we shift in our seats or get up to walk, and at night we turn in our sleep. So if you can’t respond to these signals, you’re at risk for developing pressure injuries.

• Nerve damage: Having reduced skin sensation makes you less aware of signals that would usually trigger the urge to move or shift positions. Peripheral neuropathy from diabetes is a very common condition that puts you at risk for pressure injuries. People who have a brain or spinal injury may also have reduced sensation in certain parts of the body.

• Malnourishment: Being underweight can be a risk factor for pressure injuries. This is because there’s less padding between bones and skin. And if sores develop, it’s harder for the body to heal itself if there isn’t enough protein or vitamins to repair the skin.

• Environmental factors: A few characteristics about your surroundings can also increase risk. For example, moist environments soften the skin and make it more vulnerable to pressure injuries. This means that people with bladder or bowel incontinence may be at higher risk for skin breakdown and infection. Friction on the skin can also contribute to tissue damage. This can happen when skin slides across a bed, slideboard, sheet, or clothing.

Bottom line

Pressure injuries can be difficult to live with and treat. But the good news is that you can avoid them by knowing the risk factors and a few prevention strategies. If you can’t move and shift on your own, the first step is to be aware of when bony areas on your body are in contact with a bed, chair, or other object. From there, you — and the people who care for you — can develop a padding and shifting system to help alleviate any pressure. Even with these strategies, daily skin checks are helpful to identify areas that show signs of increased pressure.