How to Spot Pressure Sores, Stop Them, and Support Better Skin Health
- damienhwright
- Jul 28
- 4 min read
Pressure sores – also known as pressure ulcers or bedsores – are injuries to the skin and underlying tissue, usually caused by prolonged pressure on one area. Though they’re common in people with limited mobility, they are not an inevitable part of ageing or illness. In fact, most pressure ulcers can be prevented.
Whether you’re a family carer, a professional support worker, or a medical professional, knowing how to spot the signs early and act quickly can prevent unnecessary pain, infection, and even hospital admission.
We bring together best practice guidance and prevention strategies, using the tried-and-tested SSKIN framework.
What Are Pressure Sores?
A pressure sore is damage that happens to the skin and deeper tissue due to continuous pressure, shear (skin moving in one direction and bone in another), or friction.
These injuries most often develop:
On bony parts of the body (heels, hips, lower back, elbows, shoulder blades)
In people who are immobile, use wheelchairs or remain in bed for long periods
Where skin is weakened by moisture, poor nutrition, or chronic illness
Pressure ulcers can range in severity:
Stage 1 – Red or discoloured skin that doesn’t fade when pressed
Stage 2 – Partial skin loss, blisters, or shallow open wounds
Stage 3 – Full-thickness skin loss with damage to tissue underneath
Stage 4 – Deep tissue damage, exposing muscle, bone or tendons
Early signs include:
Skin that’s red, blue, or purple
Areas that feel warmer, cooler, firmer, or softer than the surrounding skin
Localised swelling or pain
Blistering or shiny skin
Who Is Most at Risk?
Anyone can develop a pressure sore, but some people are more vulnerable than others, including those who:
Are unable to change position easily (due to illness, injury, or disability)
Have lost sensation (such as spinal cord injury or diabetes)
Experience incontinence or excessive sweating
Are underweight, overweight or malnourished
Have fragile, aged, or dry skin
Use medical equipment that presses against the skin (e.g. oxygen masks, tubes)
Pressure ulcers can develop in just a few hours, especially if the skin is already compromised. That’s why daily checks and preventative action are vital.
Preventing Pressure Sores: The SSKIN Approach
Healthcare teams use the SSKIN bundle as a structured, holistic approach to pressure ulcer prevention. It can also be adapted for home care settings. Here’s how it works:
🩺 S – Skin Inspection
Look early. Look often.
Check the skin at least once a day – more often if someone is immobile or at high risk. Pay close attention to pressure points and places where skin is in contact with clothing, bedding, or medical devices.
What to look for:
Redness or darker skin (especially on darker skin tones – look for areas that feel warm, hard, or look shiny)
Skin that doesn’t return to normal colour after gentle pressure
Pain or complaints of discomfort
Blisters, cracks, or dry patches
Use a mirror or get help to check hard-to-see areas like the buttocks or heels.
🛏️ S – Surface
Supportive surfaces make all the difference.
Beds, mattresses, and chairs should be tailored to the individual’s needs. Special pressure-relieving cushions, overlays, and mattresses reduce the impact of prolonged pressure.
Good practice includes:
Using a high-spec foam or alternating pressure mattress (speak to a nurse or OT)
Checking the integrity of cushions and covers
Keeping sheets dry and crease-free
Ensuring clothing isn’t digging into the skin
🚶♀️ K – Keep Moving
Movement is medicine.
Encourage regular position changes – ideally every 2 hours for someone in bed and every 15–30 minutes for someone in a wheelchair. Even small shifts in position help improve blood flow and reduce risk.
Supportive movement strategies:
Use slide sheets and hoists to reduce friction
Support people to sit upright with good posture
Encourage gentle leg and arm movements, even if in bed
Record turning schedules to ensure consistency
🚽 I – Incontinence & Moisture Management
Moist skin breaks down faster.
Incontinence, sweating, and wound drainage can weaken the skin. Keep skin clean and dry using a routine that’s respectful and effective.
Tips include:
Use absorbent pads or incontinence briefs only as needed – not as a substitute for toileting
Clean with gentle, pH-balanced cleansers (avoid harsh soaps)
Pat, don’t rub, the skin dry
Apply barrier creams if needed
If incontinence is persistent, discuss bladder/bowel management options with a nurse or GP.
🍽️ N – Nutrition & Hydration
Good skin starts from within.
The body needs protein, vitamins, and hydration to maintain healthy skin and repair damage. Malnutrition is a hidden but major risk factor.
Support better nutrition by:
Encouraging small, frequent meals with protein-rich foods
Offering a variety of foods and fluids throughout the day
Monitoring for unplanned weight loss
Consulting a dietitian or GP if appetite is poor or there are swallowing concerns
Equipment and Support
If you're concerned about the risk of pressure sores, speak to a district nurse, GP, or occupational therapist.
They can:
Assess the person’s skin and risk level
Provide or recommend specialist equipment such as medical-grade mattresses and pressure relief cushions
Create a personalised care plan
Arrange training for carers
In the NHS, most pressure-relieving equipment can be loaned free of charge following an assessment.
Seek professional help if you notice:
Persistent redness or discolouration
Any breaks in the skin
Signs of infection (heat, swelling, pus, smell, fever)
Increased pain or deterioration
Untreated pressure sores can lead to serious complications, including infections, sepsis, or slow-healing wounds, which can significantly impact quality of life.
Pressure sores are preventable, and preventing them is far easier than treating them. By following the SSKIN framework, carers and professionals alike can help safeguard comfort, dignity, and health.
Think of it as a daily checklist:
Skin: Look and feel
Surface: Sit and lie right
Keep moving: Shift the pressure
Incontinence: Keep skin clean and dry
Nutrition: Fuel for healing
Together, we can protect vulnerable skin and the people we care for.
Further Reading and Support