Get exclusive member benefits & effect social change. Join Today
Eschar, pronounced es-CAR, is dead tissue that sheds or falls off from healthy skin. It’s caused by burns and also occurs in pressure wounds (bedsores). Eschar is typically tan, brown, or black, and may be crusty.
Wounds are classified into stages based on how deep they are and how much skin tissue is affected. When a wound has eschar on top of it, the wound can’t be classified. This is because eschar is dead, dark tissue that makes it difficult to see the wound underneath. Because eschar is part of the body’s natural healing process, a physician will not always recommend removing it.
Eschar is characterized by dark, crusty tissue at either the bottom or the top of a wound. The tissue closely resembles a piece of steel wool that has been placed over the wound. The wound may have a crusted or leathery appearance and will be tan, brown, or black.
The eschar may be either softer or firmer than the skin around it.
Eschar is often a part of a larger wound. The area around the eschar may appear red or tender to the touch. The area also may be swollen or fluid-filled.
While an eschar wound can’t be staged in the same way most wounds can, a wound with eschar often signals a more advanced wound, typically a stage 3 or 4.
The four stages of wounds are:
The more advanced stages of wounds can be due to skin injury or pressure sores. One example is a bedsore where constant pressure on the skin affects blood flow to the tissues. As a result, the tissue becomes damaged and dies. These occur most often on the heels, ankles, hips, or buttocks.
Eschar is caused by burning or cauterizing — a method wherein you apply chemicals or heat to destroy tissue, stop bleeding, or prevent the spread of infection. It also occurs in pressure wounds such as bedsores.
Factors that increase your risk for eschar include:
Wounds that advance to the stages where eschar covers them can be very serious. For example, the broken skin on the wound allows bacteria to enter the body, which can lead to sepsis (body-wide inflammation) or cellulitis (a skin infection). Both conditions can be life-threatening. Your bones and joints also can become infected as a result of the wound.
Your physician will diagnose eschar by viewing the wound and examining the skin around it. A wound care specialist will often measure the length and width of the wound to determine if it’s getting larger or smaller.
Your doctor also will take into account any medical conditions you may have that could affect your body’s ability to heal wounds. These include diabetes or conditions that affect your circulatory system.
Your doctor also will test your pulse below the area where eschar appears to ensure the wound is not affecting blood flow to your nearby skin.
Prevention is vital to keeping eschar from occurring. Wounds are significantly easier to prevent than treat.
Constantly repositioning a patient who is confined to a bed or wheelchair is important to relieve stress and pressure to areas prone to skin breakdown. This may involve switching positions every 15 minutes to one hour. Cushions, specialized mattresses, and special repositioning devices can help.
Keeping skin clean and dry is vital to preventing wounds. If you can’t control your urine or stool, prompt cleaning is necessary to keep skin breakdown from occurring.
Eating a healthy diet high in protein, vitamin C, and zinc is vital to encourage skin healing. Drinking enough fluids is needed to prevent dry skin.
Stopping smoking and keeping active also can prevent pressure sores by keeping your body as healthy as possible.
Treatment for wounds with eschar depends upon your symptoms. For example, if the area around your wound is dry, isn’t peeling off, and doesn’t have redness around it, your doctor won’t recommend removing the eschar, as it’s considered the body’s natural covering.
If the eschar is peeling or oozing or has symptoms of potential infection, your doctor may recommend a wound treatment method known as debridement to remove dead tissues.
There are different methods of debridement, including:
In addition to treating the wound, your doctor will try to make you as comfortable as possible. This includes prescribing pain relieving medications and medications to relieve muscle spasms, which can affect wound healing. Antibiotics may be used to prevent infection. You’ll want to eat a healthy diet high in protein, which promotes skin healing.
In severe instances, surgery may be necessary to remove any infection and reconstruct the skin around the wound.
Written by: Rachel Nall
Medically reviewed on: Feb 11, 2016: Mark R Laflamme, MD
Enter your symptoms in our Symptom Checker to find out possible causes of your symptoms. Go.
Enter any list of prescription drugs and see how they interact with each other and with other substances. Go.
Enter its color and shape information, and this tool helps you identify it. Go.
Find information on drug interactions, side effects, and more. Go.