Do bed sores start from the inside out or the outside in?

Bed sores begin as a blanching, or white-colored, spot on the skin. They don't necessarily appear over a bone but the skin over the bones are vulnerable such as heels, elbows, and tailbone. Bedsores also occur on the fleshy parts of the rear end. Like other beginning bed sores, they begin as a patch of skin absent of color. And like Pam said, they eat through each layer of the skin, spiraling down to the bone if left unchecked.

The best treatment for bedsores is prevention because once there's a bedsore it can be very difficult to get rid of, usually requiring the intervention of a wound care specialist.

It starts as a lack of blood circulation, usually when a bone is pressing against something for an extended period of time. Numbness is the first sign, nerves are pinched and dying off. Then the underlying muscle and fat dies off, this can start deep inside or at the surface. Now necrosis/infection sets it and pain kicks way up as living tissues nearby are affected. The blood vessels can carry infection all over the body. The patient becomes delirious, feverish and dies.