Eschar: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Eschar?
A wound care doctor, a doctor who treats wounds that heal slowly, or a surgeon often treats eschar. A dermatologist, a doctor who treats skin problems, may also help. A primary care doctor can look at the wound first. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is eschar?
Eschar is a layer of dead tissue that commonly forms over a wound or burn. Another name for it is necrotic tissue, which just means dead tissue.
Symptoms
In pressure sores, the dead skin can be yellow, tan, green, or brown.
Signs that a pressure sore may be infected include:
- A foul odor from the sore.
- Pus coming out of the sore.
- Redness and tenderness around the sore.
- Skin near the sore that is warm or swollen.
- Fever.
Causes and who gets it
Eschar can be caused by anything that destroys healthy skin. Examples are burns, trauma, infections, insect bites, pressure ulcers, and diabetic foot ulcers.
Pressure sores happen when too much pressure stays on the skin for too long. This lowers blood flow to the area. Without enough blood, the skin can die and a sore may form. These sores tend to form over bony areas, such as the heels and buttocks.
You are more likely to get a pressure sore if you:
- Use a wheelchair or stay in bed for a long time.
- Are an older adult.
- Have a disease that affects blood flow, such as diabetes or vascular disease.
- Have fragile skin.
- Do not get enough nutrition.
An escharotic is a substance that leads to eschar formation. Examples are acids, alkalis, carbon dioxide, and metallic salts.
How doctors diagnose it
Doctors group pressure sores into stages. Stage I is the mildest stage. Stage IV is the worst.
Dead skin over a pressure sore makes it hard to tell how deep the sore is. This type of sore is called unstageable, which means it cannot be given a stage yet.
Treatment
Eschars may need treatment so the wound can heal and infection can be prevented or treated. Your provider decides the right care for the wound under the eschar.
For pressure sores, the first step is to take pressure off the area. Change position often. In a wheelchair, try to change position every 15 minutes. In bed, move or be moved about every 2 hours. Keep the wound clean to prevent infection.
Do not massage the skin on or near the sore. Do not use donut-shaped or ring-shaped cushions. Do not use hydrogen peroxide or iodine cleansers unless your provider tells you to.
Stage III and IV pressure sores are harder to treat and may take a long time to heal. Most will be treated by your provider.
For pressure sores, a common treatment is debridement, which means a provider removes the dead tissue so the wound can heal. A provider can do this with surgery, with tools, or with a medicine that breaks down the dead tissue.
Not every eschar is removed. A dry, stable eschar on the heel with no signs of infection is often left in place, because it protects the skin underneath. Your provider makes this choice, so do not remove an eschar on your own.
When to see a doctor
Contact your provider right away if you develop blisters, an open sore, or any sign of infection. Signs of infection are listed in the symptoms section above. If a pressure sore changes or a new one forms, tell your provider.
Call 911 or go to the emergency room if you have a sudden burn injury, a deep or large wound, trouble breathing, fainting, or a sudden change in mental status such as confusion.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care or concierge doctor can look at a wound, check for signs of infection, and arrange wound care. They can also follow your healing over time and refer you to a wound care doctor or surgeon.
Common questions
Is eschar the same as dead tissue?
Yes, eschar is a layer of dead tissue. It commonly forms over a wound or burn.
Does eschar need treatment?
It may. Eschars may require treatment to allow healing or to prevent or treat infection. Ask your provider what care is right for your wound.
Can a burn cause eschar?
Yes, burns can cause eschar. Eschar can be caused by anything that destroys healthy skin, and burns are one example.
How often should I change position to protect my skin?
In a wheelchair, try to change position every 15 minutes. In bed, move or be moved about every 2 hours. Changing position often takes pressure off the skin.
Sources
- MedlinePlus - Eschar
- MedlinePlus - How to care for pressure sores
- StatPearls (NCBI Bookshelf) - Pressure Injury
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
