What is the difference between eczema and psoriasis?

Both eczema and psoriasis are hereditary and ongoing skin conditions that cause irritated and inflamed skin. Treatment for eczema and psoriasis depends on the type and the severity.
Both eczema and psoriasis are hereditary and ongoing skin conditions that cause irritated and inflamed skin. Treatment for eczema and psoriasis depends on the type and the severity.

Both eczema and psoriasis are hereditary and ongoing skin conditions that cause irritated and inflamed skin. They are often mistaken for each other, but they are different diseases.

Eczema

Eczema is the name for a group of conditions that cause inflamed, itchy, rash-like skin. While the exact cause of eczema is unclear, it is likely from an overactive immune system response. When you are exposed to an irritant or an allergen, your immune system switches on, creating inflammation and a skin reaction. 

Some people with eczema don't make a protein called filaggrin that builds your skin barrier. Without this protein, your skin loses moisture, and bacteria can get in, so people with eczema tend to have dry skin and skin infections. 

There are seven different types of eczema, which include allergic reactions. People who have asthma and allergies are likely to have eczema, but other things can trigger symptoms. These include:

  • Chemical irritants in cleaning and skincare products that touch your skin
  • Fabrics like wool or polyester that irritate the skin
  • Metals 
  • Smoke
  • Stress

Psoriasis

Psoriasis is an autoimmune skin condition that causes your skin cells to regenerate too quickly. In healthy skin, keratinocyte cells die, shed, and renew themselves in 21 days. In psoriasis, your skin cells regenerate in seven days but don't shed, leading to a buildup of skin cells that cause plaques or patches. 

It also causes inflammation throughout your body, which can affect your joints and lead to psoriatic arthritis

There are seven different types of psoriasis. Some can cause severe and life-threatening flare-ups that lead to shedding sheets of skin, fluid loss, changes to your body temperature, and a high risk for infection.

What are the symptoms of eczema and psoriasis?

So how do you tell the two diseases apart? Both cause red, itchy, and inflamed skin, but eczema is generally itchier than psoriasis. Psoriasis tends to cause painful cracking and bleeding. Eczema commonly affects children, while signs of psoriasis usually start around age 20. 

Symptoms of eczema include:

  • Dry skin
  • Sensitive skin
  • Rough or scaly patches 
  • Oozing or crusting skin
  • Swelling
  • Skin infections
  • Itchy, red, swollen rash after you touch something that irritates your skin 

Psoriasis patches look different than eczema patches Symptoms include:

  • Raised patches with well-defined edges
  • Red patches with silver scales
  • Patches look dry, cracked, and inflamed
  • Usually affects elbows, knees, chest, scalp, and lower back
  • Pus-filled bumps on your hands and feet
  • Discolored fingernails and toenails
  • Raised and crumbly nails
  • Shiny, red patches on your skin folds like your armpits or groin

Can eczema or psoriasis be cured?

There is no cure for both eczema and psoriasis. Both are ongoing and lifelong conditions, but some types of eczema and psoriasis can fully clear up. Guttate psoriasis, for example, often happens when you have an infection like strep throat and often goes away when the infection clears up. For some people, it never comes back.

But eczema and psoriasis are different for everyone. Some people have flares more often and severe symptoms while others need more treatment.

How are eczema and psoriasis treated?

Treatment for eczema and psoriasis depends on the type and the severity. Mild cases of both psoriasis and eczema can be managed with lifestyle changes and over-the-counter medications and creams. 

Eczema treatment

Eczema is often treated with:

  • Antihistamines to help with allergic reactions and itchiness
  • Pain relievers for burning, swelling, or pain
  • Over-the-counter hydrocortisone cream
  • Prescription topical calcineurin inhibitors that block immune cells
  • Prescription steroid cream
  • Steroid medications
  • Immune system medications like methotrexate
  • Prescription light therapy

Daily skincare and bathing routines are also important for eczema. Skin infections are a common problem, so regular bleach baths can manage bacteria and lower symptoms. You can also:

  • Moisturize daily to help with dryness and itchiness
  • Take lukewarm baths and showers
  • Avoid harsh and irritating chemicals
  • Use a skin barrier cream 

Psoriasis treatment

Psoriasis treatment is similar, but there are some differences. Your doctor might suggest:

  • Over-the-counter steroid creams for small plaques
  • Coal tar for small plaques
  • Biologics like methotrexate
  • Vitamin D, to slow down skin cell growth
  • Vitamin A
  • Prescription steroid medications
  • Prescription light therapy 
  • Prescription steroid cream

Lifestyle changes are also important to managing triggers and psoriasis flare-ups. You should:

  • Manage stress
  • Exercise regularly 
  • Avoid heavy drinking and smoking
  • Avoid skin injury
  • Avoid extreme temperatures
  • Moisturize daily, especially after showers 

Outlook

The right diagnosis is one of the essential parts of treating eczema or psoriasis. Treatment can help you manage your condition and ease your symptoms. Talk to your doctor about your skin and the right treatment for you. 

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Medically Reviewed on 1/3/2022
References
SOURCES:

American Academy of Dermatology Association: "Eczema Types: Atopic Dermatitis Causes," "Psoriasis: Signs and Symptoms."

Canadian Dermatology Association: "Article: Psoriasis vs. Eczema."

Eczema Foundation: "Eczema Versus Psoriasis: How to Tell the Difference."

National Eczema Association: Eczema Causes and Triggers," "Eczema Treatments Overview," "What is Eczema?"

National Psoriasis Foundation: "About Psoriasis," "Treatments for Psoriatic Disease."