Bedsores: symptoms, treatment, and when to worry
Last updated September 3, 2026.
Bedsores are injuries to skin and the tissue beneath it, caused by sustained pressure, usually over bony areas like the tailbone, hips, heels, and elbows. They develop in people who spend long periods in a bed or chair without shifting position. They range from a red patch that will not fade to deep wounds reaching muscle and bone, and prevention is far easier than cure.
How do they develop?
Pressure squeezes blood out of the skin, and without blood the tissue starts to die, sometimes within hours in vulnerable people. The earliest warning is a patch of red or discolored skin that does not turn white when pressed, or that does not fade after the pressure is removed. Later stages break the skin open. Risk climbs with immobility, poor nutrition and hydration, incontinence keeping skin damp, reduced sensation, and serious illness.
What actually helps?
- Change position on a schedule: reposition regularly, day and night, with a plan from the care team for how often. For someone in a chair, that includes pressure relief lifts.
- Check the skin daily: look over tailbone, hips, heels, ankles, and elbows for non-fading redness, blisters, or breaks. Early catches reverse before the skin breaks.
- Use pressure-relieving equipment: special mattresses, overlays, and cushions spread load. Ask the district nurse or care team what is available.
- Keep skin clean and dry: moisture from sweat or incontinence softens skin and speeds breakdown. Barrier creams and prompt pad changes protect it.
- Feed the repair: healing skin needs protein and calories. Poor intake stalls recovery, so flag appetite problems early.
- Get wounds dressed properly: open sores need professional assessment and the right dressing, reviewed regularly, with pain relief for dressing changes.
When is it an emergency?
A new red patch is urgent-but-routine: relieve the pressure immediately and arrange a same-week review. Emergency signs are infection and deeper damage: spreading redness or warmth around a sore, pus or a bad smell, black or dead tissue, fever, or new confusion in an older person. Those mean same-day assessment, and fever with confusion or rapid deterioration is a 911 call, since infected pressure sores can tip into sepsis. Pymander's escalation routing is built and tested specifically for this class of decision; see the safety architecture working paper.
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Common questions
How quickly can a bedsore develop?
Faster than most people expect. In someone seriously ill or with poor circulation, skin damage can begin within a few hours of unrelieved pressure. That is why repositioning schedules run through the night, and why a red patch that does not fade after pressure relief is treated as the start of a sore, not as nothing.
What are the stages of a pressure ulcer?
Stage 1 is intact skin with non-fading redness or discoloration. Stage 2 is a shallow open wound or blister. Stage 3 reaches into the fat layer, and stage 4 reaches muscle or bone. There are also unstageable sores hidden under dead tissue. The stage guides treatment, and catching things at stage 1, where relief and protection can reverse it, is the whole point of daily skin checks.
Can bedsores heal, and how long does it take?
Early sores can heal in days to weeks once pressure is relieved and skin is protected. Deeper sores take weeks to months and need regular professional dressing, good nutrition, and sometimes specialist input. The variable that most controls healing is whether pressure truly stays off the area, which is why equipment and repositioning matter as much as dressings.
Who is most at risk of pressure ulcers?
Anyone who cannot easily change position: people confined to bed or a chair, those with paralysis or reduced sensation, the seriously ill, and older adults with thin skin. Incontinence, poor nutrition, dehydration, diabetes, and poor circulation all raise the risk further. After surgery or during a hospital stay is a classic window, which is why risk checks happen on admission.
Do special mattresses really help?
Yes. Pressure-relieving mattresses, overlays, and cushions spread body weight and reduce peak pressure over bony points, and they are a standard part of prevention and treatment for at-risk people. They complement repositioning rather than replace it. A district nurse or care team can assess which level of equipment fits the person's risk.
What does an infected bedsore look like?
Warning signs are spreading redness or warmth around the wound, increasing pain, pus or cloudy drainage, a foul smell, black or dead-looking tissue, and fever. In older adults, infection may announce itself as new confusion rather than fever. Infected pressure sores can seed serious bloodstream infection, so these signs mean same-day medical assessment, not a wait for the next scheduled visit.