Dry, red, and itchy. Those are the three telltale skin symptoms of eczema—but here's the thing: they're also seen with psoriasis, a separate (and slightly less common) skin condition. So, what's the difference between eczema and psoriasis?
On the surface, not so much. Both can seem similar, fooling patients and even primary care physicians. According to the American Academy of Dermatology, research has found that some family doctors have misdiagnosed patients with eczema when they actually had psoriasis all along.
In terms of what's actually going on within the skin barrier, eczema and psoriasis do have some differences, and it's important to know what they are in order to get the right diagnosis and care plan. While it's best to check with a Dermatologist for a complete exam and needed testing, here's what you should know to spot the real cause of that mystery rash.
Eczema is just one name for a large group of conditions—including atopic dermatitis and contact dermatitis—that can all lead to swollen, itchy, or red skin. The causes of eczema can vary from outside irritants like chemical exposure or bug bites to immune system problems that make the skin more sensitive to irritants.
In the United States, eczema affects some 15 million people, many of whom are very young. Up to 20 percent of babies have some form of eczema that will resolve or get better as they age. That's not to say that adults don't have it, too; adults can get eczema whether or not they had it as a child.
All of that is important to know because eczema can look different depending on your age:
- Babies with eczema tend to have a rash on their cheeks or elsewhere on the face. It can feel dry or may also ooze with fluid from time to time.
- Kids with eczema tend to have a scaly, itchy rash in more hidden places, like in the crease of their knees, elbows, or between their bottom and legs.
- Adults with eczema tend to have areas of scaly, dark red skin that appear on the head, neck, eyelids, or hands. After years of scratching, the skin may even start to look leathery.
Whereas outside irritants typically cause eczema, psoriasis links back to a problem within. As an autoimmune disease, psoriasis happens when the immune system dysfunctions and speeds up the growth of skin cells in response to threats that aren't really there. As those overactive skin cells form in rapid succession, they tend to squeeze on top of each other, which can lead to similar symptoms experienced with eczema.
Both children and adults can have psoriasis, and symptoms can vary based on the specific type of psoriasis they have. Of the 8 million Americans with the condition, most cases are plaque psoriasis, which involves patches of scaly skin. This is similar to eczema, with one big difference: because the skin cells grow so fast, they can cause white, silvery scales in the rashy areas. Often, these areas appear on the scalp, elbows, knees, or lower back.
Treating Eczema vs. Psoriasis
Unfortunately, neither eczema nor psoriasis can be cured, but they can be controlled with medical and at-home care. This is especially important for people who find that their symptoms come and go during flareups or other exposures to certain irritants.
When treating the symptoms of eczema and psoriasis at home, focus on a good skin care routine (including a gentle cleanser and fragrance-free moisturizer) and learning to spot and reduce your triggers. You should also be mindful of how your daily routine impacts flareups. For example, taking long hot showers—however relaxing—can make skin irritation worse.
If the irritation persists, it's a good idea to seek medical care. For many cases, medical treatments are also similar for both eczema and psoriasis:
- Topical medications such as creams available over the counter or by prescription can help soothe irritated skin and alleviate flareups caused by both eczema and psoriasis.
- Oral or injection medications can help control the immune system's response to outside irritants. These may be more commonly used with psoriasis patients.
- Phototherapy shines ultraviolet rays on the skin to help minimize inflammation. It's typically used for psoriasis, but may also be used with eczema patients.
Similar though they may be, it's important to remember that there is a difference between eczema and psoriasis. Each condition comes with unique underlying factors—so what works for one diagnosis may not work for the other. Always check with a Dermatologist if you have any areas of concern. They can help you diagnose the issue and get the right treatment based on your needs.