Pressure
Constant pressure limits blood flow, starving tissue of oxygen and nutrients.
Home Pressure wounds
How Bed Sores Start and Why They Worsen
Bed sores (pressure injuries) develop when constant pressure limits blood flow to skin and deeper tissue. The earlier you spot changes, the more likely you can prevent serious damage.
Start here
Early pressure damage can be subtle and easy to miss.
Best protection
Relieve pressure early + keep skin dry + reduce friction.
What Causes Bed Sores
Bed sores form when pressure reduces blood flow for too long. Even moderate pressure can cause injury if it lasts long enough. Over time, tissue damage and breakdown occur—often over bony areas.
Immobility
When a person can’t shift position, pressure stays in one spot and damage begins below the surface.
Friction
Sliding down in bed or dragging skin across sheets weakens the skin’s protective barrier.
Moisture
Sweat or incontinence softens skin, making it easier to tear and break down.
Early Signs of Pressure Wounds
Early pressure wounds often look mild because the skin may still be intact. Catching these signs early can prevent serious damage.
Skin changes to watch for
- Redness in lighter skin tones
- Purple, blue, or darkened areas in darker skin tones
- Skin that does not turn white when pressed (non-blanchable)
- Shiny or tight-looking skin
Temperature & texture changes
- Warmer or cooler than nearby skin
- Firm or spongy feel
- Mild swelling
Tip: Don’t rely on pain alone. Early bed sores may not hurt much, especially when sensation is reduced.
Caregiver note:
When to get help
Daily skin checks beat “waiting to see if it hurts.”
Why Bed Sores Don’t Heal Easily
Pressure wounds heal differently than simple cuts. Pressure often continues even after a wound forms, and damage under the skin can be much larger than it appears.
Blood flow loss affects tissue quickly
Cells become stressed, waste builds up, and repair slows or stops when oxygen delivery drops.
Deep tissue damage can happen first
Muscle needs more oxygen than skin. Damage can progress under intact skin before it opens.
Moisture + friction accelerates breakdown
Softened skin tears more easily and loses its protective barrier.
Nutrition & illness slow healing
Poor circulation, low protein intake, dehydration, chronic illness, and reduced immunity make repair harder.
Why Bed Sores Worsen Over Time
| Factor | Early Stage | Advanced Stage |
|---|---|---|
| Blood flow | Reduced but present | Severely limited |
| Skin surface | Intact | Open or ulcerated |
| Tissue damage | Shallow | Deep, involving muscle or bone |
| Infection risk | Low | High |
| Healing difficulty | Often reversible | Complex and prolonged |
What Patients and Families Can Do Daily
Simple daily habits prevent many serious pressure wounds and protect overall health.
1
Reposition regularly
Changing position restores blood flow and reduces pressure points. Even small shifts help.
2
Use support surfaces
Pressure-relieving mattresses/cushions distribute weight more evenly and reduce strain.
3
Keep skin clean & dry
Moisture makes skin fragile. Manage sweat/incontinence quickly and gently.
4
Check skin daily
Look for discoloration, temperature change, swelling, and texture changes over bony areas.
5
Support nutrition & hydration
Healing needs energy + protein + fluids. Malnutrition and dehydration slow recovery.
6
Reduce friction
Avoid sliding down in bed. Use proper positioning and transfer techniques when possible.
When to Get Help
Medical evaluation is important when any of the following occur:
- Skin discoloration does not improve
- Blisters or open wounds appear
- Drainage or odor develops
- Pain, swelling, or fever occurs
- Healing stalls or worsens
Concerned about pressure wounds?
Get clear guidance on pressure wounds and when medical care is needed.