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Pressure sores start as a patch of discolored skin. The patch might be red if you have pale skin or bluish-purple if you have dark skin. Then the skin gets a graze or blister. If nothing is done to relieve the pressure, the skin dies off quickly and leaves a shallow wound.

Like other wounds, pressure sores may:

• Hurt
• Ooze
• Bleed
• Get infected.

You are most likely to develop a pressure sore where your skin gets squashed between one of your bones and your bed or chair. This tends to happen:^{1 2 3}

• At the bottom of your back bone
• On your buttocks
• Over your hip bone
• On the back of your heels
• Over your elbows, if you are lying on your back
• On the back of your head where it touches the bed.²

If you are looking after someone who is likely to get a pressure sore, you need to know about the early warning signs. Get help from your doctor to make sure everything is being done to prevent pressure sores.

You should tell someone immediately if you find any signs of skin damage, for example a discolored or bruised patch that won't go away. If you discover pressure sores early, there's a good chance you can stop them getting worse. Here are some other early warning signs to look out for:⁴

• Swelling
• Blisters
• Patches of skin that are shiny, too warm, too cold, or too dry
• Hard skin
• Cracks in the skin.

Doctors and nurses give pressure sores a grade, according to how serious they are. Grade 1 is the least serious. A grade 4 sore is the most serious.¹

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.