Pressure Sores and the Ears

What is a pressure sore?

A pressure sore, sometimes called a pressure ulcer or bedsore, is an area of damaged skin and tissue. It develops when blood flow to a part of the body is restricted, usually because something has been pressing on it for too long. In some cases, damage begins in deeper layers of tissue before any visible changes appear on the skin surface.

Without proper blood flow, the skin and underlying tissue do not receive the oxygen and nutrients they need. The affected area may start as a patch of red or discoloured skin that feels warm or painful. If the pressure continues, the skin can break down further, creating an open wound.

Clinicians classify pressure ulcers into stages, from Stage 1 (intact skin with non-blanchable redness) through to Stage 4 (full thickness tissue loss with exposed bone, tendon or muscle). Deeper wounds take considerably longer to heal and carry a greater risk of serious infection.

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Why the ears are vulnerable

When people think about pressure sores, they tend to picture the heels, tailbone, hips or back. The ears rarely come to mind. Yet they are one of the most vulnerable areas on the body for this type of injury.

The outer ear has very little padding. The skin sits directly over cartilage, with minimal fat or muscle to cushion it. The helix, the curved outer rim of the ear, is particularly susceptible because of its prominent position. Even light, sustained pressure can quickly restrict blood flow to this area.

Several everyday situations can put the ears at risk:

• Lying on one side for extended periods, particularly during sleep or bed rest
• Wearing oxygen tubing, hearing aids or other medical devices that press against the ear
• Using headphones or earbuds for long stretches
• Resting the head against a pillow, headrest or hard surface for hours at a time

People who are unwell, have limited mobility, or spend extended time in bed or a wheelchair face a higher chance of developing pressure sores on the ears. The same applies to those who cannot easily reposition themselves or who may not feel discomfort in the usual way.

Carers and medical staff sometimes overlook the ears when checking for pressure damage. Regular inspection is particularly worthwhile for anyone at higher risk.

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Spotting the early signs

Catching a pressure sore early gives the best chance of preventing further damage. On the ears, the first sign is often a patch of skin that looks red or darker than the surrounding area. For people with darker skin tones, the discolouration may appear purple or blue rather than red.

The affected spot may feel warmer or cooler than nearby skin. It might also feel firmer, softer or slightly swollen. Some people notice pain, itching or a tingling sensation, though not everyone will.

If the pressure is not relieved, the skin can blister or break open. At this stage, the wound becomes harder to heal and the risk of infection increases.

Anyone who notices these signs on their own ears, or on someone they care for, should seek advice promptly. A GP, practice nurse or district nurse can assess the area and advise on next steps. For more complex or ongoing cases, referral to a tissue viability specialist may be appropriate.

Prevention and care

Reducing the risk of pressure sores on the ears involves relieving pressure and supporting skin health, though the approach should be tailored to individual circumstances. For those who spend time lying down, changing position regularly can make a difference. Turning the head or switching sides helps restore blood flow, with the frequency based on individual risk assessment rather than a fixed schedule.

Pillows designed to reduce pressure can be useful. Some have cutouts or softer zones to keep the ears free from direct contact with the surface beneath. For people using medical devices such as oxygen tubing, padding or repositioning the tubing can reduce the strain on the ear.

Keeping the skin clean and dry also matters. Moisture from sweat or other sources can weaken the skin and make it more prone to damage. If the skin is dry, seek clinical advice before applying any moisturising products, as some formulations may affect skin integrity.

For those at higher risk, regular skin checks are sensible. This includes the ears as well as the more commonly affected areas. Carers and family members can help with this, particularly for anyone who cannot easily see or reach their own ears.

If a pressure sore does develop, treatment will depend on its severity. Minor damage may heal with pressure relief and basic wound care. More serious wounds may need specialist dressings, antibiotics or other interventions. NICE guidelines on pressure ulcers provide detailed information on prevention and management, and the NHS website has specific pages on pressure sores covering symptoms, causes and treatment options.

Anyone with concerns about pressure sores, whether on the ears or elsewhere, can speak to their GP or contact NHS 111 for advice.

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