I have a Skwoosh pad, it's ok but I fortify it with various layers of other types of padding.
My arse doesn't come with much padding and what little I had 40 years ago is pretty much gone so I have real problems on extended trips (a month+) especially if there is little in the way of major rapids, portages, lining etc to give my arse a rest.
A few years ago on a 30 day trip I developed fairly severe "bed sore" that took a couple of months to fully heal and was truly "a pain in the arse" while on the trip.
I have some experience dealing with bedsores in the elderly, it never occurred to me that I had entered "elderly status" (almost 70 at the time). I know this is a major health issue for the bedridden, it never occurred to me that they could develop from paddling.