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Identifying the 4 Stages of Bed Sores

Identifying the 4 Stages of Bed Sores
Kevin Cleary

Key Takeaways: 

  1. Our skin is the largest organ in our body and, if not cared for, can cause serious issues.
  2. Bedsores are also known as pressure injuries or pressure ulcers and are common in those who are bedridden.
  3. Constant pressure on an area restricts blood flow and can cause bedsores or pressure ulcers. 
  4. Effective management of bedsores relies on identifying the stage each sore is experiencing.
  5. Proactive measures and treatments are effective before pressure sores develop, and HPFY has what you need.


For those who are confined to a wheelchair or bedridden, the risk of bedsores or pressure ulcers is very real. Approximately 2.5 million Americans get bedsores or pressure ulcers every year. These wounds develop mainly from pressure, moisture, and shearing and are progressive in nature. Bedsores are a type of injury where the skin and underlying tissue break down under constant pressure for a certain period of time. This causes ischemia, cessation of nutrition, and oxygen supply to tissues, causing tissue necrosis. Often, this is caused by skin smooshed between a bone and the surface, such as your mattress or wheelchair. The earlier the treatment intervention, the higher the risk of healing. Later stages of bedsores can lead to negative outcomes, including death. 

Symptoms of Bed Sores

Obviously, the best way to treat bedsores is to avoid them, but it’s also important to recognize the symptoms of pressure ulcers before they get dangerous. Daily skin checks around the heel, ankle, hips, or tailbone can identify bedsores before they advance to a stage that can cause skin breakdown and infection. Symptoms of bedsores include:

  • Changes in skin color/texture
  • Swelling
  • Sore areas
  • Skin that feels cooler or warmer to the touch
  • Pus draining

Pressure ulcers can be classified into four stages depending on their depth and severity. Skin damage can range from inflamed or unbroken skin to a deep injury involving muscle and bone. Caregivers or loved ones should pay attention to bony areas such as shoulder blades/spine, tail bones, heels, and ankles since these are the most common areas where bedridden or those with wheelchairs experience bedsores or pressure sores. 

The 4 Stages of Bed Sores

According to an article by Cleveland Clinic, Those who are older, are bedridden or spend long periods of time in wheelchairs are the most susceptible to bedsores or pressure ulcers. When these injuries appear, it’s important to identify which stage they are in so appropriate treatment can be given. Caused by friction, moisture, or shearing, the four stages of bedsores are:

  • Stage I Pressure Ulcer: This stage of wound development is characterized by skin that looks red or pink but has no open wound. Your skin may be tender to the touch and can even be warmer, cooler, softer, or firmer. Your doctor may refer to this stage as a pressure injury.
  • Stage II Pressure Ulcer: At this stage, you may notice a shallow wound with a pink or red base. Skin loss, abrasions, and blisters can also appear at this stage. This tour can be painful and the skin around it may be discolored.
  • Stage III Pressure Ulcer: At this stage, you may notice full-thickness skin loss and the fat layers beneath the skin may be revealed. Since the damage extends below the skin, the pressure sore may look more like a crater.
  • Stage IV Pressure Ulcer: This is the most severe pressure wound you can experience. Extensive damage below the skin can affect muscles, bones, tendons, and ligaments. At this point, the risk of infection is high, and significant tissue death is a real possibility.

Our Best Products That Help Prevent Bed Sores


When to Seek Medical Attention

As you can imagine, being proactive with any bedsore or skin injury is best. As they say, “An ounce of prevention is worth a pound of cure.” For Stage I & II wounds, you or a caregiver at home may be able to treat them at home, but for Stage III & IV wounds, a wound specialist is your best bet. If you notice changes in skin color, skin tenderness, any sign of infection, or skin temperature change, alert your physician ASAP to avoid wound progression. 



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HPFY Kevin Cleary

Kevin Cleary

Kevin Cleary has been a Health Products For You contributor for many years and has a degree in marketing. His health and wellness journey has a very personal meaning and has guided him in his content writing for HPFY.

In 2006, ...

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