A sheepskin mattress topper can reduce pressure on vulnerable skin, and there is genuine clinical research to support it. For people who spend long periods in bed or in a chair, the right topper can make a real difference to skin health and comfort.
This guide explains what the evidence actually shows, who benefits most, how sheepskin compares to other pressure care options, and what to look for when buying. If you are caring for someone at risk of pressure injuries, this is the practical information you need.
In this article
- Why Pressure Sores Happen (and Who Is at Risk)
- How Sheepskin Helps With Pressure Area Care
- Choosing a Sheepskin Topper for Pressure Care
- The Bottom Line
Why Pressure Sores Happen (and Who Is at Risk)
Pressure sores (also called pressure injuries or pressure ulcers) form when sustained pressure cuts off blood supply to the skin and the tissue underneath. Without blood flow, cells begin to break down. In mild cases the skin reddens. In severe cases a wound forms that can reach deep into the muscle.
The four factors that damage skin under pressure
Clinical guidelines identify four main factors that work together to cause pressure injuries:
- Pressure — the weight of the body pressing down on a surface, especially over bony areas like the heels, hips, and sacrum.
- Shear — the skin moves in one direction while the bone beneath moves in another (for example, when a person slides down in bed).
- Friction — the skin rubs against a surface, removing the protective outer layer.
- Moisture — prolonged dampness from perspiration or incontinence softens the skin and makes it more vulnerable to all three forces above.
Addressing even one of these factors lowers the risk. A good pressure care surface targets as many as possible.
Pressure injury risk for people with limited mobility
Anyone who cannot reposition themselves regularly is at risk. This includes people recovering from surgery or illness, wheelchair users, and people who are bedridden for extended periods. Older skin is also thinner and less resilient, which is why pressure injury prevention is a priority in aged care.
The Australian Commission on Safety and Quality in Health Care (ACSQHC) identifies pressure injuries as a significant and largely preventable harm. Early prevention, starting with the right support surface, is far more effective than treating an injury once it has formed.
How Sheepskin Helps With Pressure Area Care
Sheepskin has been used in pressure area care for decades, and the reason is straightforward: the dense wool pile distributes body weight across a larger surface area, reducing the peak pressure at any one point.
Pressure redistribution: how a sheepskin bed overlay works
Standard mattress surfaces are firm and relatively flat. They concentrate pressure directly on the bony prominences that bear the most weight. A sheepskin overlay works differently. The wool fibres compress under load and spread that load outward, so the pressure over a heel or sacrum drops.
The wool fibres also wick moisture away from the skin and allow air to circulate. This addresses two of the four pressure injury risk factors (moisture and, to a degree, friction) at the same time as reducing pressure. A cotton or polyester overlay cannot do this as effectively because the fibres do not breathe the same way.
What the clinical research says about sheepskin for pressure sore prevention
The most rigorous trial to date is a randomised controlled trial by Jolley et al. (2004), Medical Journal of Australia, which compared Australian medical sheepskin overlays against standard care in 441 hospitalised patients. The sheepskin group had significantly fewer new pressure injuries: 9.6% developed a sore compared to 16.4% in the control group.
The Cochrane Collaboration review on sheepskin and pressure ulcer prevention (Jolley et al., reviewed 2012) concluded that Australian medical sheepskin overlays reduce the incidence of pressure ulcers in patients at risk. The review noted the sheepskin must meet an appropriate specification to be effective.
This is not a marginal finding. For a preventive intervention, a reduction from 16% to under 10% is clinically meaningful.
Medical sheepskin vs foam overlays vs alternating pressure mattresses
| Product type | How it works | Best for | Limitations |
|---|---|---|---|
| Medical sheepskin overlay | Wool pile redistributes pressure and wicks moisture | Prevention; low-to-moderate risk; home and hospital use | Not suitable for active stage 2 or above wounds; requires laundering |
| Foam overlay | Shaped foam reduces peak pressure | Low-risk prevention; comfort | Retains heat and moisture; needs regular replacement |
| Alternating pressure mattress | Air cells inflate and deflate to shift pressure continuously | High-risk patients; active pressure injuries; hospital use | Higher cost; requires power; less suitable for home independence |
For people at low-to-moderate risk who are living at home, a medical sheepskin overlay is often the most practical and cost-effective starting point. It works well alongside regular repositioning and good skin care.
When sheepskin is appropriate (and when it is not)
Sheepskin overlays are appropriate for:
- Preventing pressure injuries in people at low-to-moderate risk
- Improving comfort for people who spend long periods in bed
- Supporting skin health alongside a regular repositioning routine
Sheepskin is not a substitute for clinical treatment if a pressure injury is already present. For stage 2 injuries or above (broken skin, open wound, or deeper tissue damage), the person needs an assessment from a healthcare professional such as a GP, nurse, or occupational therapist. An alternating pressure system may be more appropriate at that point.
If you are unsure about the right level of support for someone in your care, it is worth checking with their care team before choosing a product.
Choosing a Sheepskin Topper for Pressure Care
Not all sheepskin toppers are equal. For pressure area care, the specification of the product matters.
What to look for in a sheepskin bed overlay
Here is what to look for:
- Australian Standard AS4480.1 compliance. This is the benchmark for medical sheepskin in Australia. It covers wool pile density, pelt strength, and washability. Products that meet this standard have been independently assessed for pressure care use.
- Wool pile depth. A minimum of 25mm is the accepted standard for effective pressure redistribution. Thinner pile compresses too readily and loses its benefit under body weight.
- Washable at 60 degrees Celsius. For infection control, the topper needs to handle hot washing. Check that both the wool pile and the pelt backing can withstand repeated cycles.
- Size. The topper should cover the full length of the mattress so vulnerable areas like the heels are not left unsupported.
- Australian-sourced sheepskin. Australian Merino wool is finer and denser than many imported alternatives, which is one reason the clinical trials used Australian product.
Our Sheepskin Bed Topper Overlay meets the AS4480.1 standard, uses Australian Merino wool at 25mm pile depth, and is machine washable at 60 degrees. It is available in single, double, queen, and king sizes.
How NDIS and Home Care Packages can fund pressure care products
If you or someone you care for is eligible for the National Disability Insurance Scheme (NDIS) or a Home Care Package (HCP), pressure care products may be funded. Sheepskin mattress toppers are classified as assistive technology for daily activities, which falls within both funding streams.
An occupational therapist (OT) can assess the person's pressure care needs and recommend appropriate products. Their recommendation can support a funding request. If you need help understanding what is covered, give us a call and we will talk it through with you.
For a detailed look at NDIS coverage for pressure care aids, see our guide: Pressure Care Products and NDIS Funding (coming soon).
The Bottom Line
Key takeaways
- Pressure sores form when sustained pressure reduces blood flow to the skin, especially over bony areas.
- Sheepskin overlays reduce pressure injury incidence: a randomised controlled trial found the rate dropped from 16.4% to 9.6% with an Australian medical sheepskin.
- For pressure care use, the sheepskin must meet AS4480.1: 25mm pile depth, hot-washable, and Australian Merino wool.
- Sheepskin is appropriate for prevention at low-to-moderate risk. For active wounds (stage 2 or above), seek clinical advice.
- NDIS and Home Care Packages can fund pressure care products with an OT recommendation.
A good sheepskin topper is one of the most practical things you can do to protect skin health for someone who spends long periods in bed. If you are not sure which size or specification suits your situation, we are here to help. Give us a call and we will talk it through.