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Bedsores (decubitus ulcers)

Medically reviewed by Last updated on Jul 28, 2023.

What is a bedsore (decubitus ulcer)?

Harvard Health Publishing

Bedsores, also called pressure ulcers or decubitus ulcers, are areas of broken skin that can develop in people who:

Bedsores are common in people in hospitals and nursing homes and in people being cared for at home. Bedsores form where the weight of the person's body presses the skin against the firm surface of the bed.

In people confined to bed, bedsores are most common over the hip, spine, lower back, tailbone, shoulder blades, elbows and heels. In people who use a wheelchair, bedsores tend to occur on the buttocks and bottoms of the feet.

This pressure temporarily cuts off the skin's blood supply. This injures skin cells. Unless the pressure is relieved and blood flows to the skin again, the skin soon begins to show signs of injury.

The pressure that causes bedsores does not have to be very intense. Normally, our skin is protected from being injured by pressure because we move frequently, even when asleep.

Where bedsores occur

Bedsores (decubitus ulcers)

At first, there may be only a patch of redness. If this red patch is not protected from additional pressure, the redness can form blisters or open sores (ulcers). In severe cases, damage may extend through the skin and create a deep crater that exposes muscle or bone.

Muscle is even more prone to severe injury from pressure than skin. A bedsore can involve several layers of damaged tissue.

Although pressure on the skin is the main cause of bedsores, other factors often contribute to the problem. These include:

Bedsores can lead to severe medical complications, including bone and blood infections.

Symptoms of a bedsore

Bedsores are classified into stages, depending on the severity of skin damage:

Because broken skin can allow bacteria to enter, bedsores are extremely vulnerable to infection. This is especially true if the sore is contaminated by urine or feces. Signs of infection in a bedsore can include:

Diagnosing a bedsore

A doctor or nurse can diagnose a bedsore by examining the skin. Testing is usually unnecessary unless there are symptoms of infection.

If a person with bedsores develops an infection, a doctor may order tests to find out if the infection has moved into the soft tissues, into bones, into the bloodstream or to another site. Tests may include blood tests, a laboratory examination of tissue or secretions from the bedsore, and an x-ray, a magnetic resonance imaging scan (MRI scan) or a bone scan to look for evidence of a bone infection called osteomyelitis.

If you care for a family member who is in a bed or wheelchair, your doctor or home care nurse can teach you how to identify the earliest signs of bedsores. You'll learn which areas of skin are particularly vulnerable and what to look for. When you find signs of skin damage, you can take steps to prevent areas of redness from becoming full-blown ulcers.

Expected duration of a bedsore

Many factors influence how long a bedsore lasts, including the severity of the sore and the type of treatment, as well as the person's age, overall health, nutrition and ability to move. For example, there is a good chance that a Stage II bedsore will heal within one to six weeks in a relatively healthy older person who eats well and is able to move. Stage III and Stage IV ulcers can take longer than six months to heal. Some never heal. Bedsores can be an ongoing problem in chronically ill people who have multiple risk factors, such as incontinence, the inability to move and circulatory problems.

Preventing a bedsore

Bedsores can still form even if a patient is receiving excellent medical care or household care — they are not necessarily a sign of neglected needs. To help prevent bedsores in a person who is confined to a bed or chair, the plan of care includes these strategies:

Treating a bedsore

If you care for someone with bedsores, your doctor or home care nurse may ask you to help with the treatment by following preventive steps that should stop further damage to vulnerable skin and increase the chances of healing.

Additional treatments, usually done by health care professionals, depend on the stage of the bedsore. First, areas of unbroken skin near the bedsore are covered with a protective film or a lubricant to protect them from injury. Next, special dressings are applied to the injured area to promote healing or to help remove small areas of dead tissue. If necessary, larger areas of dead tissue may be trimmed away surgically or dissolved with a special medication. Deep craters may need skin grafting and other forms of reconstructive surgery.

If the person's skin shows any signs of possible infection, the doctor may prescribe antibiotics, which may be applied as an ointment, taken as a pill or given intravenously (into a vein).

When to call a professional

If you find a suspicious area of redness or blistering on a person you are caring for, contact the person's nurse or doctor promptly.


In many cases, the outlook for bedsores is good. Simple bedside treatments can heal most stage II bedsores within a few weeks. If conservative methods fail to heal a stage III or stage IV bedsore, reconstructive surgery often can repair the damaged area.

Additional info

National Institute of Arthritis and Musculoskeletal and Skin Diseases

National Institute on Aging

American Academy of Dermatology

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.