OpenHealth Q&A

Intermittent Pressure Sores: Seeking Insights on Persistent Skin Issues

I’m a 35-year-old female, around 178 cm tall and weighing approximately 330 pounds. I reside in Canada and have a noticeable lack of buttock tissue. I’ve been experiencing intermittent pressure sores every six months for about seven years. Initially, these occurrences were more frequent. They start as minor bruises, evolve into small holes, and gradually enlarge before ultimately healing. Recently, I've made strides in my weight loss journey and sit less frequently than someone in a typical office job, so I'm curious about alternate explanations for this condition beyond the common notions of weight and prolonged sitting. Years ago, I sat on a very warm chair while weighing closer to 400 lbs, but after switching chairs, the incidents reduced significantly. These days, I consistently use specially designed seat cushions or chairs with openings in the back, which provide airflow and support for my tailbone. Additionally, I make it a point to take regular breaks to avoid sitting for extended periods. Yet, despite these preventive measures, the sores still manifest, often without any clear triggering event. The progression begins with soreness and redness in the coccyx area, located just above the gluteal crease, often accompanied by swelling. To improve the skin’s elasticity, I immediately start applying moisturizing lotion. Previously, I utilized a skin barrier cream, but now I’ve switched to a moisturizing body lotion. During bathing, I feel it’s beneficial to use a moisturizing face wash while ensuring the area remains well dried and not overly moist. In a few days, small bruises develop; they're not petechiae-sized but are still quite noticeable, usually appearing singularly—though this time I have four bruises. The pain intensifies as I continue to apply cream to the area. A couple of days later, a tiny pinhole emerges, at which point I stop using lotion and start covering it with a dry bandage designed to absorb any drainage. As time passes, this pinhole expands, resulting in the need to frequently change the bandage, which becomes quite painful. I strive to limit my sitting during this healing phase, which typically takes around two weeks. Upon my first encounter with a general practitioner regarding this issue, the response was that it was a pressure sore. He bandaged it but offered little else in terms of help. After mentioning a few more incidents, he seemed disinterested, likely due to burnout and our strained rapport. I’m set to see a new GP next week, and I haven't previously disclosed this recurring issue to her in the last five years. I felt it was necessary to reach out for possible assistance, as I find myself perplexed. Despite knowing larger individuals who lead less active lives without similar problems, I can’t help but think my lack of cushioning may contribute to my predicament. For additional context, I have been diagnosed with hypothyroidism, IBS, and psoriasis. Prescriptions I’m currently on include Synthroid, Mirvala (birth control), Clonazepam, Alprazolam, Pantoprazole, Ranitidine, Escitalopram, Trazodone, Bilastine, and Wegovy. Any insights or suggestions would be greatly appreciated as I navigate this ongoing challenge.

Answers (1)

7/4/2025, 9:20:42 PM

OpenHealth AI

Experiencing intermittent pressure sores can certainly be frustrating, particularly when you are taking steps to prevent them. Given your history and the background provided, let’s explore the factors involved and outline prioritized steps for improvement.

Main Points

1. Intermittent pressure sores can originate from a variety of factors beyond weight and prolonged sitting.
2. Skin condition, circulation, and skin elasticity play significant roles.
3. Immediate actions focus on optimizing skin care and tracking your progress.

Explanation

Pressure sores, also known as pressure ulcers, develop when there is prolonged pressure on the skin, especially over bony areas, leading to reduced blood flow. While your weight and sitting habits are relevant, other factors such as skin elasticity, moisture levels, and pressure redistribution can contribute to the condition.

Factors You May Want to Consider:

• Skin Elasticity & Health: Conditions like psoriasis can affect skin integrity, making the skin more prone to injury. Additionally, hypothyroidism can alter skin properties.
• Circulation: Ensuring proper blood flow is crucial. If there are circulatory issues, they may worsen pressure-related concerns.
• Nutrition: Adequate nutrition supports skin health, so a balanced diet rich in vitamins and minerals is essential.
• Hydration: Ensure you are well-hydrated, as this can contribute to overall skin condition.

Specific Next Steps

1. Continue Using Seat Cushions: Stay with your specially designed seat cushions or chairs that enhance airflow and support areas prone to pressure.
2. Monitor Skin Regularly: Keep an eye on skin integrity in high-pressure areas to catch any issues early. If you notice redness or soreness, address it immediately.
3. Optimize Skin Care:
   • Consider returning to a skin barrier cream instead of just moisturizer for additional protection against friction and irritation.
   • Use a mild cleanser; look for products free from harsh additives to avoid exacerbating psoriasis.
4. Hydration & Nutrition: Ensure your diet includes plenty of fruits, vegetables, lean proteins, and healthy fats to support skin health and overall well-being. Drink sufficient water to stay well-hydrated.
5. Document Changes: Keep a journal of your skin condition, noting any changes, treatments, and routines. This will provide valuable information to your new GP.
6. Communication with Healthcare Providers: During your upcoming appointment, clearly explain the history of your pressure sores, current strategies, and your concerns regarding skin health. Don't hesitate to ask specifically about improving circulation and skin integrity measures, such as potential referrals to a dermatologist or wound care specialist.

Recap

While your preventive measures are solid, fine-tuning your skin care and dietary habits can offer further protection. Continue monitoring your skin closely, and ensure you communicate effectively with your healthcare provider. Remember that addressing skin integrity is a gradual process, and consistent care is key. You're taking meaningful steps on your health journey, and I'm here to support you as you navigate through this challenge.