Preventing pressure sores on your buttocks comes down to shifting your weight often, keeping skin clean and dry, and using pressure-relieving cushions.
For the full breakdown, see our best Cushions For Pressure Sores on Buttocks guide.
Pressure sores form when constant pressure cuts off blood flow to skin over bony areas like the tailbone and hips. They’re largely avoidable with consistent habits. The three pillars are repositioning on a schedule, protecting the skin, and using the right support surface.
How Often Should You Reposition to Prevent Pressure Sores?
Repositioning is the most effective prevention tool because it restores blood flow before damage starts. For wheelchair users, shift your weight every 15 to 30 minutes, holding each shift for 30 to 90 seconds, per the Model Systems Knowledge Translation Center (MSKTC). If you can’t shift yourself, someone should help you change position at least once every hour. In bed, the standard is every 2 hours—though some medical centers recommend every 1 to 2 hours for higher-risk patients, while others allow up to 4 hours for stable ones. Johns Hopkins Medicine and MSKTC both use the 2-hour mark as the baseline. Even a brief period of uninterrupted pressure can start the process, especially with limited mobility or impaired sensation.
The Correct Body Positions and Support Surfaces
Positioning technique matters as much as frequency. When lying on your back, keep the head of the bed as low as possible—ideally at or below 30 degrees, unless a medical condition requires it higher. Raising the head too far increases sliding, which multiplies pressure on your buttocks and creates friction. When lying on your side, use pillows to keep your body at about a 30-degree angle: one between the knees, one between the ankles, and, if needed, another behind your back.
Support surfaces are helpers, not replacements. Mayo Clinic, Hopkins, and MSKTC recommend specialized mattresses, foam cushions, or alternating-air mattresses that redistribute pressure. For anyone spending hours in a chair, a pressure-relieving cushion is essential. This is where a good product matters: Skip doughnut-shaped cushions—they concentrate pressure around the sore area and reduce blood supply, making things worse.
Skin Care and Daily Inspection Routines
Healthy skin resists breakdown far better than damp or damaged skin. Keep the buttocks clean and dry by washing with a gentle cleanser and patting—not rubbing—the skin dry. Change wet clothing and bedding promptly. If incontinence is a factor, apply a moisture barrier cream to protect the skin from urine and stool.
Check the skin daily. Look at the tailbone, buttocks, and hips for redness, discoloration, warmth, or tenderness. Press on a red spot—if it doesn’t turn white briefly when pressed, that’s a warning sign called non-blanchable redness. A spot that stays red or purple after pressure is removed needs a healthcare professional’s evaluation. Do not massage red bony areas; rubbing can damage fragile tissue, a point both Mayo Clinic and MSKTC make explicitly.
| Prevention Step | Frequency | Notes |
|---|---|---|
| Shift weight while sitting | Every 15–30 minutes | Hold for 30–90 seconds; get help hourly if unable |
| Reposition in bed | Every 2 hours | Sooner for high-risk patients |
| Inspect skin | Daily | Look for redness, warmth, or non-blanching spots |
| Keep head of bed low | ≤30° when possible | Prevents sliding and added buttock pressure |
| Use barrier cream | With each bedding change | For incontinence, sweat, or persistent moisture |
| Reinforce cushions | Ongoing | Adjuncts, not substitutes, for repositioning |
Nutrition plays a supporting role. A balanced diet with enough protein and fluids keeps skin strong and better able to repair itself, per MSKTC. Dehydration and poor intake make skin more fragile and slower to heal.
Friction, Shear, and Transfer Techniques
Pressure gets most of the attention, but friction and shear cause their own damage. Friction is skin scraping against sheets or clothing; shear happens when skin stays put while deeper tissue slides—the classic result of sitting propped up too high in bed. Prevent both by keeping sheets smooth, dry, and wrinkle-free. During transfers, lift rather than drag. Use a sheet or transfer aid to slide the person rather than pulling them across the mattress, which can cause “sheet burn.” For wheelchair users who can manage it, pushing up from the chair arms or doing wheelchair “pushups” is effective. If you notice open skin, blisters, or a painful spot that isn’t healing, get prompt medical evaluation.
FAQs
Can pressure sores heal on their own?
Stage 1 sores—red, non-blanching spots—can resolve if you remove pressure immediately and keep the skin protected. Deeper sores involving broken skin or tissue loss need medical treatment and will not heal without professional care.
Are doughnut cushions ever recommended for pressure sores?
No. Mayo Clinic and other major medical sources explicitly advise against doughnut-shaped cushions. They can concentrate pressure around the affected area and reduce blood flow, worsening the sore. Solid foam or gel cushions that distribute weight evenly are safer.
How do I tell a pressure sore from a normal red mark?
Press gently on the red area. Normal skin briefly turns white and quickly returns to red. In a pressure sore, the redness stays—it doesn’t blanch. The spot may also feel warm, firm, or tender. Non-blanchable redness is considered a Stage 1 pressure injury and warrants daily watching and pressure relief.
References & Sources
- MSKTC. “Preventing Pressure Sores.” Details repositioning schedules and skin inspection guidance.
- Mayo Clinic. “Bed Sores.” Outlines causes, risk factors, and why doughnut cushions are harmful.
- Johns Hopkins Medicine. “Bedsores.” Provides repositioning intervals and support surface recommendations.