Most bed sores on the buttocks can be treated at home when they’re caught early, before the skin breaks open deeply. The two keys are relieving pressure on the area and keeping the wound clean while it heals. A Stage 1 sore (red, unbroken skin) can improve within days with proper care, while a Stage 2 sore (shallow open wound or blister) typically takes one to three weeks. Anything deeper than that needs professional wound care.
Identify What Stage You’re Dealing With
Before you start treatment, you need to know what you’re looking at. Home care is appropriate for Stage 1 and Stage 2 pressure sores. Anything beyond that involves exposed fat, muscle, or bone and requires medical attention.
A Stage 1 sore looks like a patch of skin that stays red even after pressure is removed. On darker skin tones, the discoloration may not look red but will differ noticeably from the surrounding area. The spot often feels warmer, firmer, or softer than the skin around it, and it’s usually painful or tender to the touch. The skin is still intact at this stage.
A Stage 2 sore has broken through the top layer of skin. You’ll see a shallow, pinkish-red open wound, or a blister that’s either intact or has ruptured. The wound bed looks shiny or dry but doesn’t contain any thick yellow or black tissue. If you see dark, crusty tissue or the wound appears deep enough to see fat or muscle, that’s Stage 3 or 4, and you should not treat it at home.
Take Pressure Off the Area Immediately
A bed sore can’t heal if the same pressure that caused it keeps being applied. For sores on the buttocks, this means changing your position frequently and using the right support surfaces.
Reposition every two to three hours at minimum. International wound care guidelines recommend not extending this interval beyond three hours, even with a good mattress underneath. When lying on your side, aim for a 30-degree angle rather than rolling all the way to 90 degrees. This takes weight off the tailbone without simply transferring all the pressure to the hip bone. Place a pillow between or under the legs to hold the position comfortably, with the upper leg slightly forward of the lower one.
If you’re sitting in a wheelchair or recliner, shift your weight every 15 to 30 minutes. Avoid sitting directly on the sore for extended periods. If the sore is on one side of the buttocks, lean toward the opposite side when possible.
Choose the Right Support Surface
A standard innerspring or older foam mattress puts too much pressure on the tailbone. At a minimum, use a pressure-redistributing foam overlay, which spreads your body weight across a larger area. Alternating pressure mattresses, which cycle air through chambers to shift contact points, can reduce peak pressure on the tailbone more effectively than static foam alone. These are available for home use and can be rented through medical supply companies. Your doctor or home health nurse can often write a prescription that insurance will cover.
Do not use a donut-shaped cushion. While they seem like they’d help by creating a hole around the sore, they actually concentrate pressure in a ring around the wound and can cut off blood supply to the surrounding skin, making things worse.
How to Clean the Wound
For Stage 1 sores where the skin is still intact, gentle washing with mild soap and water is sufficient. Pat the area dry rather than rubbing.
For Stage 2 sores with broken skin, clean the wound each time you change the dressing. Use normal saline (available at any pharmacy) or a commercial wound cleanser. Gently flush the wound to remove debris. You want enough pressure to clean effectively but not so much that you damage the new tissue forming at the base. A squeeze bottle works well for this. Avoid using hydrogen peroxide, rubbing alcohol, or iodine on open sores. These products kill the new cells trying to grow across the wound and slow healing significantly.
After cleaning, gently pat the surrounding skin dry. Moisture left sitting against intact skin around the wound can cause further breakdown, which is especially important on the buttocks where sweat and incontinence are common concerns.
Picking the Right Dressing
The goal of a dressing is to keep the wound moist (which speeds healing) while protecting it from bacteria and friction. The best choice depends on how much fluid the wound is producing.
Hydrocolloid dressings are a strong option for buttocks sores. They contain gel-forming agents that absorb fluid from the wound and create a moist healing environment, all sealed under a waterproof outer layer. This makes them practical for the buttocks area because they stay in place well and form a barrier against contamination. They can typically stay on for three to five days unless they become loose or visibly soiled. You’ll know it’s time to change one when the edges start lifting or the white gel area has expanded to within a centimeter of the border.
Multi-layered foam dressings with a soft silicone adhesive are another recommended option, particularly for sores producing moderate fluid. International wound care guidelines specifically recommend silicone foam dressings for protecting the sacral area. They cushion the wound while absorbing drainage. Transparent film dressings are thinner and less absorbent, so they work best for Stage 1 sores or as a cover over other dressings. They let you see the wound without removing the dressing, which is helpful for monitoring.
If you’re using plain gauze, dampen it with saline before placing it on the wound. The gauze should be moist, not dripping wet. Fluff it gently so it fills the wound space without packing it too tightly. Gauze dressings need to be changed more frequently, often once or twice daily, which makes them less convenient but more widely available.
Eat Enough Protein and Calories
Your body builds new tissue from the nutrients you take in, and wound healing demands significantly more protein and calories than normal daily life. Experts at Mount Sinai recommend about 1.5 grams of protein per kilogram of body weight per day during wound healing. For a 150-pound person, that works out to roughly 102 grams of protein daily, which is substantially more than most people eat normally. Calorie needs also increase to about 13.6 calories per pound of body weight per day.
In practical terms, this means adding protein at every meal and snack. Eggs, Greek yogurt, chicken, fish, beans, and protein shakes can all help you hit that target. If appetite is poor, which is common in people who are bedridden or elderly, small frequent meals and liquid supplements are easier to manage than three large meals. Vitamin C and zinc also support tissue repair. A daily multivitamin can fill gaps, but getting enough total protein and calories matters more than any single supplement.
Keep the Area Dry and Protected
The buttocks are uniquely challenging because of moisture from sweat, urine, or stool. Prolonged moisture exposure softens and weakens the skin, making existing sores worse and creating conditions for new ones. If incontinence is a factor, use absorbent pads or briefs and change them as soon as they’re soiled. Apply a moisture barrier cream (the same type used for diaper rash) to intact skin around the wound, but not inside the wound itself.
When bathing, avoid hot water on the affected area. Lukewarm water is less likely to irritate fragile skin. After bathing, make sure the skin folds around the buttocks are completely dry before applying a new dressing.
Signs the Sore Needs Medical Attention
Even with good home care, some sores worsen or become infected. Watch for these warning signs: the wound develops a foul smell, the surrounding skin turns increasingly red and warm, you see pus or thick greenish drainage, swelling increases rather than decreases, or the wound gets deeper or larger despite treatment. Fever and chills are often the earliest signs of an infection spreading beyond the wound itself.
Pain that’s getting worse rather than better is another red flag. A healing sore should gradually become less tender over the first week. If it becomes extremely painful or the pain begins radiating outward from the wound edges, that suggests the tissue underneath is being affected. Any sore that hasn’t shown improvement after two weeks of consistent home care, or any wound that was Stage 2 and appears to be getting deeper, warrants evaluation by a healthcare provider who can assess whether you need prescription wound care products, antibiotics, or a different treatment approach.