Bed Sore Stages with Pictures

Bed Sore Stages with Pictures

Understanding bed sore stages is important to keeping your loved one safe. Why? depending on the stage, bed sores may be a non-blanchable area of the skin or a massive hole in the body. It all depends on the stage. Using the bed sore stages pictures on this site can help. Please note that this site cannot substitute for proper medical advice. 


Bed sores can begin at the skin, or far deeper, and work up until the skin is ulcerated. Because a bed sore can appear drastically different from one stage to another, nursing home staff may misidentify them. That’s why it is important for nursing homes to provide appropriate bed sore stages identification training. Proper training includes providing bed sore stages information with pictures of each.

For more information about bed sore stages, please check out the Nursing Home Abuse Podcast:

Bed sores are a sign of nursing home neglect in most residents. Nursing facilities are required to take steps to prevent bed sores before they occur. This includes a comprehensive assessment of the resident’s skin at admission, creation of a personalized care plan, and consistent updating of the care plan. If a nursing home fails to implement these requirements, they may be liable to the resident. 

Because bed sores are so common in nursing homes, families of residents are encouraged to understand bed sore stages and what such wounds look like. We’ve provided this page showing bed sore stage pictures for that purpose.

What are bed sore stages? Why are pictures important

Typically, bed sores progress through four stages, representing the level of depth to the wound. Stage 1 represents the least amount of damage to the body while Stage 4, represents the most amount of damage. An “unstageable” bed sore is one that cannot be staged because the wound cannot be completely viewed. 

Appropriate staging is important. Often, the stage and progression determines the type of treatment the resident received. 

Unfortunately, bed sore staging is not an exact science. There is not one uniform staging model across the healthcare industry. So home health nurses have their own staging scale. Many hospitals have their own staging scale. Nursing homes often have their own staging scales. Then, there are academic and advocacy groups, like the National Pressure Ulcer Advisory Panel, that have their own model. 

Still, there are many characteristics to bed sore stages that are shared among the many models. In other words, even though there may be different methods for identifying stages, each follows the same basic pattern. For example, one group’s Stage 1 will never be another group’s Stage 4. 

What do bed sores look like?

Bed sores look different at each of the four stages. Most often, there is not much to see with Stage 1 and Stage 2 bed sores. However, Stage 3 and Stage 4 bed sores can appear as terrible, open wounds. 

Also, bed sores may look different depending on the part of the body in which they occur. For example, a bed sore on the sacrum, coccyx, or buttocks will appear differently than a bed sore on the heal. Generally, this is the case because some parts of the body where pressure is applied have more tissue, muscle, and skin that may be deteriorated. 

Stage 1 Bed Sore

Non-Blanchable redness
Stage 1 Bedsore

A Stage 1 bed sore is a red patch of skin typically appearing over a bony area like the heel or tailbone that does not blanch. Blanching means the paleness or whiteness that results when pressure is applied to the skin. Skin that does not turn white is called “non-blanchable.” 

The deep redness of a Stage 1 bed sore is typically erythema. Erythema is the result of widening blood vessels compensating for the restriction of blood flow (“ischemia”) caused by the pressure. 

The skin of a Stage 1 bed sore is non-blanchable because the blood flow to the area has been restricted. The red area on the surface of the skin remains red despite pressure being applied. In most people, when pressure is applied, the blanched skin returns to normal in a few minutes or hours. When the skin does not change is an indicator of a deeper problem.  

In African Americans, the area may be purple, bluish, or shiny. Also, blanching in darker skin is difficult to detect. As such, other indicators, like color change and skin hardness compared to the surrounding areas, is necessary to properly assess the wound. 

A Stage 1 bed sore may also feel hard or warm to the touch. 

Stage 2 Bed Sore

Partial Thickness Skin Loss

Stage 2 Bedsore

A Stage 2 bed sore is most often a very shallow opening of the top layers of skin. Wounds extending only to the top two layers of skin are called “partial thickness” wounds. Stage 2 bed sores often look like rug burn, scrapes, blisters, or burns. 

Often, the skin within the wound appears pink or red. At this stage, there typically is no  granulation tissue (new tissue forming), slough, or eschar (dead or dying tissue)

Unfortunately, Stage 2 bed sores can be misdiagnosed as moisture associated, like incontinence associated dermatitis, or misidentified as a traumatic wound, like skin tears or abrasions. 

Stage 3 Bed Sore

Full Thickness Skin Loss

Stage 3 Bedsore

A Stage 3 bed sore occurs when the wound extends below the layers of skin and into the top portions of the “subcutaneous tissue” (underlying fat and muscle). Wounds extending to the subcutaneous tissue are called “full thickness” wounds. 

In a Stage 3 wound, fat is visible in the wound bed. However, bone, tendon, and muscle are not yet exposed. The wound bed may appear red or pink and contain slough (dead tissue). Slough can either be wet and appear yellow or stringy, or dry and appear think, leathery, and black. 

Undermining may occur in Stage 3 bed sores. Undermining occurs when tissue under the wound edges become eroded. As a result, a pocket forms under the wound’s edge. Tunneling may also occur. Tunneling wounds occur when channels (like a cave or tunnel) extend from the wound into other subcutaneous tissue. 

Unfortunately, undermining and tunneling may go undiagnosed because they are not typically visible. Discovery and treatment of undermining and tunneling in Stage 3 of Stage 4 bed sores requires proper probing, measurement, and documentation.

Stage 4 Bed Sore

Full Thickness Tissue Loss

 Stage 4 Bedsore Stage 4 Bedsore 2

A Stage 4 bed sore occurs when the wound extends through the skin layers and into the subcutaneous tissue (underlying fat and muscle) such that bone, tendon, or muscle is exposed. Just like in a Stage 3 wound, a Stage 4 is a “full thickness” wound, meaning the wound bed is within the subcutaneous tissue.  

Undermining, tunneling, slough and eschar (dead or dying tissue) may be present. The wound bed may reflect the color of the exposed bone, muscle, tendon, or fat. 

Often, the depth of the wound will depend on where the bed sore is located. For example, bed sores of the sacrum can become much deeper and larger than those located on the heel or elbow. As such, depth is not necessarily a factor in differentiating Stage 3 from Stage 4, only whether bone, tendons, or muscles are exposed. 

Stage 4 bed sores may be misdiagnosed as Stage 3 because of the presence of slough or eschar in the wound. Eschar may prevent the healthcare provider from observing that the bone is exposed, or prevent an accurate measurement of the wound.


Full Thickness of Unknown Depth

An Unstageable bed sore occurs when the wound bed is covered with eschar and/or slough (dead, dying, and necrotic tissue) such that it is not possible to measure or stage the wound. In short, until the dead tissue is removed, the true extent of the wound is not known. 

Do Stage 4 bed sores heal?

According to many studies, Stage 4 bed sores can take months or years to heal. Healing times can depend on the resident’s age, comorbidities, cognition, and other factors. 

We hope you found our bed sore stages pictures helpful. If your loved one developed bed sores at a Georgia nursing home, please call and speak to one of our nursing home neglect lawyers. Our consultation are always free. 



  • What should I do if my loved one has bed sores?

    First, ensure they receive medical attention. Next, consider contacting a Georgia nursing home abuse lawyer if you suspect neglect or abuse.

  • Why are pictures of bed sore stages important?

    Visual aids help non-medical individuals understand the severity of bed sores and recognize when to seek more advanced care.

  • Can bed sores be a sign of nursing home neglect?

    Yes, particularly if the sores advance in severity despite the resident receiving care, it may indicate neglect.

  • How can a Georgia nursing home abuse lawyer help?

    They can evaluate whether the nursing home has met the standard of care required, help document injuries, and provide legal options for recovery.

  • What helps bed sores heal faster?

    To help bed sores heal faster, it is crucial to reduce pressure on the affected area, keep the wound clean and moist, manage pain, and ensure proper nutrition and hydration. Regularly changing positions and using support surfaces like mattresses or cushions can also accelerate healing.

  • What does a bedsore look like in the beginning?

    In the beginning, a bedsore typically appears as a persistent area of red skin that does not turn white under pressure (non-blanchable), especially over bony areas. For darker skin tones, the sore may appear purple or blue.

  • What is the best ointment to put on a bedsore?

    The best ointment for a bedsore depends on the stage and condition of the ulcer. Generally, hydrocolloid or hydrogel products are recommended for their moisture-retentive properties, which promote healing and protect the area. Always consult healthcare professionals before applying any ointment.

  • What does a Stage 3 pressure ulcer look like?

    A Stage 3 pressure ulcer is a full thickness skin loss resulting in a deep crater that may expose some subcutaneous fat. The ulcer looks much deeper than Stage 2 and is devoid of skin covering.

  • Is it better to keep a bed sore moist or dry?

    Keeping a bed sore moist is generally better as it helps in the natural healing process and aids in the prevention of tissue death around the sore. Moist wound therapy can encourage faster healing and lessen pain during dressing changes.

  • Is Vaseline good for bed sores?

    Vaseline (petroleum jelly) can be used to keep the area around a bedsore moist and protect against friction; however, it is not suitable for treating the bedsore itself. Specialized products designed for wound care are more effective for treating the sores directly.

  • Does Vaseline heal bed sores?

    No, Vaseline does not heal bed sores. While it can protect the skin around a bedsore from further irritation and moisture loss, it does not offer the necessary therapeutic benefits required to heal the ulcer. Appropriate wound care products and management strategies are needed for healing.