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Skin Care & Pressure Sore Prevention

Protecting fragile skin and preventing bedsores

Why Skin Care Matters

Aging skin is vulnerable

Prevention Is Everything

Pressure sores (also called bedsores or pressure ulcers) are easier to prevent than to treat. Once developed, they can take months to heal, cause serious infections, and even be life-threatening. With proper care, most pressure sores are completely preventable.

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Why Aging Skin Is Vulnerable

Thinner: Skin loses fat layer and becomes more fragile
Drier: Produces less oil; more prone to cracking
Less elastic: Tears and bruises easily
Slower healing: Takes longer to repair damage
Reduced sensation: May not feel pain from pressure
Poor circulation: Less blood flow to extremities

High-Risk Areas for Pressure Sores

Check these spots daily on anyone who sits or lies for long periods:

Lying on back: Back of head, shoulder blades, elbows, lower back (sacrum), heels
Lying on side: Ears, shoulders, hips, knees, ankles
Sitting: Tailbone, buttocks, back of thighs, heels
Any area: Where bones press against skin, especially reddened areas

Stages of Pressure Sores

Stage 1

Skin is intact but red and doesn't blanch (turn white) when pressed. May feel warm, firm, or painful. Reversible with immediate action.

Stage 2

Partial skin loss. May look like a blister, abrasion, or shallow crater. Painful. Needs wound care.

Stage 3

Full-thickness skin loss. Deep crater may expose fat tissue. Risk of infection. Medical attention required.

Stage 4

Extensive damage through muscle and down to bone. Very serious. High infection risk. Requires aggressive treatment.

When to Call the Doctor

Any Stage 2 or higher pressure sore
Redness that doesn't fade after 30 minutes of pressure relief
Signs of infection: increasing pain, warmth, swelling, pus, fever, odor
Wound that isn't improving or is getting larger

Prevention Strategies

Protecting the skin every day

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Repositioning (The Most Important Step)

In bed: Turn every 2 hours (at minimum). Alternate: back, left side, right side.
In wheelchair/chair: Shift weight every 15-30 minutes. Stand briefly if possible.
Use pillows: Between knees, under calves (to float heels), behind back
30-degree tilt: When side-lying, use 30° angle rather than directly on hip
Avoid dragging: Lift, don't slide, when repositioning (use draw sheet)
Set reminders: Use phone alarms for repositioning schedule

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Pressure-Relieving Surfaces

Specialty mattresses: Foam, air, or alternating pressure mattresses reduce pressure points
Mattress overlays: Egg crate foam or gel pads (affordable option)
Wheelchair cushions: Gel or air cushions for those who sit extensively
Heel protectors: Booties that float heels off the bed
Medicare may cover: Pressure-reducing mattresses with doctor's order

Daily Skin Care Routine

Inspect skin daily: Check all high-risk areas, look for redness
Keep skin clean and dry: Gentle cleansing, pat dry (don't rub)
Moisturize dry skin: Apply lotion to prevent cracking (not between toes)
Change wet/soiled clothing promptly: Moisture increases skin breakdown
Use barrier cream: Protect areas exposed to urine/stool
Avoid harsh soaps: Use mild, pH-balanced cleansers

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Nutrition & Hydration

Healthy skin needs proper nutrition:

Protein: Essential for skin repair. Eggs, meat, fish, beans, dairy.
Vitamin C: Helps wound healing. Citrus, strawberries, peppers.
Zinc: Supports skin integrity. Meat, shellfish, legumes.
Hydration: Dehydrated skin is more fragile. Encourage fluids.
Calories: Underweight individuals are higher risk.

Avoid These Skin Mistakes

Don't massage red areas: Causes more damage to fragile tissue
Don't use donut cushions: They reduce blood flow to center
Don't let them sit on wrinkled sheets: Causes shear injury
Don't leave in wet incontinence products: Change immediately
Don't ignore early warning signs: Stage 1 can become Stage 4