Bed Sore Stages: What Each Stage Looks Like and How to Prevent Them at Home

Updated November 2026

A bed sore (pressure injury, pressure ulcer or decubitus ulcer) is damage to skin and the tissue under it from pressure that cuts off blood flow (Mayo Clinic). Nurses grade bed sores in stages, from Stage 1 (red, unbroken skin) to Stage 4 (deep wounds that reach muscle or bone). Most can be prevented: shift position often, keep skin clean and dry, and pad the bony spots.

Where bed sores form

Mayo Clinic lists these common spots:

• In bed: the back or sides of the head, shoulder blades, hips, lower back and tailbone, heels, ankles, and the skin behind the knees.
• In a wheelchair: the tailbone and buttocks, shoulder blades and spine, and the backs of the arms and legs where they rest on the chair.

The stages of bed sores

Stage names follow the National Pressure Injury Advisory Panel (NPIAP), the system US nurses use.

Stage	What you see	What to do
Stage 1	Unbroken skin with a red patch that doesn't fade when pressed. It may feel warmer, cooler, firmer or more painful than the skin around it. On darker skin the redness may be hard to see.	Take all pressure off the spot. If it hasn't improved in 24 to 48 hours, call the person's nurse or doctor.
Stage 2	A shallow open sore, pink or red and moist, or a blister filled with clear fluid. Only the top layers of skin are broken.	Call the nurse or doctor. They choose the dressing; it is often a foam or other moist dressing.
Stage 3	A deeper wound that goes through the skin into the fat below.	Needs a nurse or doctor.
Stage 4	A deep wound with muscle, tendon or bone showing or close to the surface.	Needs a nurse or doctor.
Unstageable	The base is covered by yellow, tan or black dead tissue, so its depth can't be seen.	Needs a nurse or doctor. Don't try to remove it.
Deep tissue injury	Skin that stays deep red, maroon or purple, or a blood-filled blister. Pain or a change in skin temperature often comes first.	Call the nurse or doctor. It can open up into a deeper wound.

Get care right away for fever, foul-smelling drainage, or warmth and swelling around a sore. These can be signs of infection (Mayo Clinic).

Who is most at risk

Mayo Clinic lists these risk factors:

• not being able to change position on your own;
• incontinence;
• reduced feeling, so the person doesn't notice discomfort;
• poor eating or drinking;
• conditions that affect blood flow, such as diabetes;
• being over 70.

How to prevent bed sores at home

1. Change position often. Mayo Clinic advises changing position about every two hours. A Minnesota hospital patient guide says every one to two hours in bed. People sitting in a chair should shift their weight often, about every 15 minutes if they can.
2. Float the heels. Put pillows under the legs from mid-calf to ankle so the heels lift off the bed. Never put a pillow under the knee (patient guide). Foam heel protectors also cushion the heels.
3. Keep the head of the bed low. If possible, keep it at 30 degrees or less, which cuts down on sliding and shear (Mayo Clinic).
4. Don't lie directly on the hip bone. Tilt slightly when on your side.
5. Use a pressure-relieving cushion or mattress. Skip doughnut cushions, which push pressure onto the skin around them (Mayo Clinic).
6. Check the skin every day. Look for redness that doesn't fade, warm or hard spots, and blisters. Check the heels, hips and tailbone first.
7. Keep skin clean and dry. After an accident, clean gently with a no-rinse foam cleanser or adult wipes. Then protect the skin with a barrier cream such as Remedy Essentials zinc oxide paste. See Barrier Cream vs Zinc Oxide vs Barrier Film.
8. Use pads that pull moisture away. Underpads keep wetness off the skin and protect the bed.
9. Smooth the bedding. Wrinkles, buttons and seams press into skin (Mayo Clinic).
10. Support eating and drinking. Enough protein, calories and fluids helps skin stay strong.

Can a foam dressing help prevent bed sores?

Some hospitals put a soft silicone foam dressing on the tailbone or heels of high-risk patients before any sore appears. Studies, mostly in hospitals and ICUs, suggest this may lower the number of heel and sacral pressure injuries, but the evidence is low certainty (International Pressure Injury Guideline). A dressing never replaces turning and offloading. Ask the person's nurse whether one makes sense. If so, a sacrum-shaped silicone dressing such as Optifoam Gentle EX Sacrum (box of 5) is the usual type. For how the Optifoam options differ, see Medline Optifoam Dressings Explained. For what to look for, see Dressings for Sacral and Pressure-Prone Areas.

Frequently asked questions

What does a Stage 1 bed sore look like?

A patch of unbroken skin that stays red when you press it, instead of going pale. It may feel warm, firm or sore.

Can you treat a bed sore at home?

A Stage 1 area often improves once all pressure is taken off it. Anything open, blistered, discolored or deeper needs a nurse or doctor to assess and plan the dressing.

How often should a bedridden person be turned?

About every two hours (Mayo Clinic), or as often as the care team advises.

Sources: Mayo Clinic, Bedsores (pressure ulcers); NPIAP, Pressure injury stages (2016); Minnesota Hospital Association, Preventing Pressure Ulcers (Bedsores); International Pressure Injury Guideline: preventive dressings for heels.