eczema psoriasis - woman scratching shoulder with rash

Eczema vs. Psoriasis

Eczema and psoriasis both affect the skin, and share similar signs and symptoms. However, there are some differences between the two skin conditions. Getting the right diagnosis is important in order to evaluate progression and the right treatment.

Talk to your doctor if you aren’t sure if you have eczema or psoriasis. Dermatologists have special expertise in skin conditions. Therefore, they’re the best to spot the difference between psoriasis and eczema.

American Academy of Dermatology Association (AADA) explains a few things to consider when it comes to differences between eczema and psoriasis. For example, your age and characteristics of the rash are very telling as to which condition you may have.

eczema psoriasis - baby with eczema rash on cheeks

Considering Age in Eczema vs. Psoriasis

Children can get both eczema and psoriasis. However, eczema is more common at this age, affecting about 13 % of American children. Only about 1% of children have psoriasis. It isn’t always easy getting the right diagnosis for children. Many family physicians diagnose children with eczema instead of psoriasis. In this case, consulting a dermatologist can help.

For adults, the prevalence of these two conditions is different. An estimated 7.2 % of adults have eczema, and 3.2% have psoriasis in the US. While eczema can occur early in life, psoriasis often begins between ages 15-25 or later on in life.

Psoriasis is more often diagnosed in women. However, men are more likely to experience severe forms of this condition as well.

Underlying Causes

Psoriasis is a chronic autoimmune, inflammatory condition. The immune system mistakenly attacks skin cells and causes inflammation and the characteristic skin patches. There are different types of psoriasis, including plaque psoriasis, which is the most common. Other forms include guttate, pustular, nail, erythrodermic, and inverse psoriasis.

In up to 30% of cases, individuals with psoriasis will experience psoriatic arthritis. Triggers for psoriasis include:

  • Infections like strep throat
  • Skin injuries
  • Smoking
  • Alcohol
  • Certain medications

Eczema is inflammation of the skin caused by allergens. When triggered by an allergen, the immune system overreacts and causes a flare-up. Common triggers include:

  • Household cleaners
  • Personal care products
  • Synthetic fabrics
  • Dust
  • Pollen
  • Cigarette smoke
  • Some foods
  • Stress

Both eczema and psoriasis are genetic and tend to run in families. Certain genetic mutations seem to increase the risk of getting these skin diseases.

Neither eczema nor psoriasis is contagious.

eczema psoriasis - rash on elbow

Skin Rashes from Eczema and Psoriasis

A skin rash from eczema can appear on the feet, hands, ankles, neck, wrists, and the back of knees and elbows. In infants, rashes can appear on the face and scalp. An eczema rash has the following characteristics:

  • Dry
  • Itchy
  • Red, brown, or gray
  • Patchy
  • Small raised bumps

The skin from an eczema rash is raw, sensitive, and inflamed. The inflammation gets worse after scratching.

Psoriasis is more often found on the face, buttocks, and scalp, as well as on the back of the elbows and front of the knees. The rash in psoriasis is more well-defined, with scaly, silvery patches overlying redness. The rash is less itchy than eczema, but the skin is dry and bleeds easily.

Eczema has a less defined contour and generates a liquid that oozes and leaves crusts, where psoriasis is less likely to ooze.

Both eczema and psoriasis are chronic conditions. Children with eczema may outgrow it and do not have issues later on in life. In other cases, eczema could develop during adulthood. Generally speaking, eczema is chronic, with periods of flare-ups and remissions. Eczema affects primarily the skin and is associated with allergic asthma and allergies.

Psoriasis is also chronic and tends to go through cycles, with flare-ups lasting for a few weeks to months followed by periods of remission. Psoriasis symptoms go beyond the skin. In the case of psoriatic arthritis, the joints are also painful and swollen. Psoriasis also increases the risk of getting diabetes, heart disease, obesity, depression, certain eye diseases, and other autoimmune conditions.

eczema psoriasis - hands with rash pointing to different treatment options

Treatment Options

While eczema and psoriasis are different conditions, they may use the same treatments. The following treatments may help both conditions:

  • Moisturizers
  • Corticosteroid Creams
  • Antihistamines
  • Calcineurin Inhibitors (tacrolimus)
  • Phototherapy

Biologics are a new class of drugs reserved for severe cases that don’t respond to first-line therapies. People use them more for psoriasis than eczema.

Specific treatments for psoriasis include:

  • Vitamin D analogs
  • Retinoid (Vitamin A derivative) creams
  • Salicylic acid shampoo
  • Coal tar
  • Immunosuppressant drugs (oral corticosteroids, methotrexate, and cyclosporine)

As usual, a healthy lifestyle can help manage both psoriasis and eczema. Drink plenty of water, don’t smoke, sleep well, and exercise. Avoid highly processed foods with artificial flavors, colors, and preservatives, as they can worsen skin inflammation. Avoiding physical and emotional triggers is also important to prevent flare-ups.

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