If you have an itchy, scaly rash, you might wonder if it’s eczema. Or is it psoriasis? The two skin conditions can look similar, with areas of dry, inflamed, skin that’s red or brown.
But eczema and psoriasis are different in many ways. You’ll need to see a dermatologist to make the final call. But here are some ways to tell if you have eczema or psoriasis.
What Is Eczema?
Eczema is an inflammatory skin condition with severe itching and scaly rashes. On lighter skin, it’s pink or red. On darker skin, it may look dark brown, gray, or purple.
You may get eczema because you have dry skin that doesn’t retain moisture well. It often runs in families.
Doctors sometimes call eczema “atopic dermatitis.” It is not contagious.
Eczema often goes hand-in-hand with allergies to pet dander, dust mites, soaps, and cleaning products. In fact, 80% of children with eczema later develop asthma or hay fever. Cold, dry air, illness, and stress can all make eczema worse.
Eczema is common. According to the National Eczema Association, eczema affects about 32 million people in the U.S. There’s no cure for eczema, but treatment can ease symptoms during flare-ups.
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What Is Psoriasis?
Psoriasis is an autoimmune condition that causes inflammation of the skin. It occurs because an overactive immune system speeds up skin cell growth. That creates areas of thick, discolored-looking skin called plaques.
On people with light-colored skin, the plaques look pink or reddish. On darker skin, they tend to be dark purple or brown.
Like eczema, psoriasis isn’t contagious. You can’t get it from someone else. Triggers for flare-ups include sunburn, vaccinations, stress, and infections.
Psoriasis affects fewer people than eczema, but it’s still common. According to the National Psoriasis Foundation, more than 7.5 million people in the U.S. have psoriasis. There’s no cure for psoriasis, but treatment can help you manage symptoms when it flares.
Who Gets Eczema and Psoriasis?
Eczema and psoriasis tend to show up at different stages of life. They both occur equally in men and women. (You can have both conditions, but it’s not common.)
Eczema is most common in babies and young children, and they sometimes outgrow it. However, teenagers and adults can also develop eczema. It is rare for someone over 60 to develop eczema.
Unlike eczema, psoriasis is rare in babies. Symptoms of psoriasis usually begin between the ages of 15 and 35. It is a lifelong condition.
Symptoms of Eczema and Psoriasis
You may wonder: Eczema or psoriasis: Which is worse?
There’s no easy answer. Eczema and psoriasis share many of the same symptoms: painful itching and dry, irritated areas of skin. But they are two distinctly different problems.
Symptoms of eczema
People with eczema have areas of dry, inflamed skin that looks red or brown. It may be swollen. During a flare-up, the area may erupt with clear fluids and become crusty.
In general, eczema is itchier than psoriasis. Sometimes children scratch the inflamed areas so hard that they bleed.
Eczema in babies tends to occur on the scalp and face. Older children often have inflamed patches in the crooks of knees and elbows. It can also occur on ankles, wrists, neck, and hands.
Symptoms of psoriasis
With psoriasis, areas of inflamed skin look red, purple, silvery, or scaly. The affected areas tend to be thick, raised, and cover a large area of skin. The plaques have well-defined borders, unlike patches of eczema.
Psoriasis often occurs on the lower back, knees, elbows, scalp, palms, and soles of your feet.
Many people with psoriasis have other serious health problems, like diabetes, heart disease, or depression. One in three people with psoriasis also develops psoriatic arthritis. They have swelling and stiffness around the joints in addition to skin plaques.
Diagnosing Eczema and Psoriasis
If you have patches of dry, itchy skin that are brown, red, or scaly, you should see a doctor. Eczema and psoriasis can be difficult to tell apart. For that reason, you should go to a dermatologist, a doctor who specialize in skin problems.
To diagnose eczema or psoriasis, a dermatologist will do a physical exam. They can usually diagnose eczema or psoriasis by looking at your skin.
They will also ask you about your medical history and any family history of skin conditions. They will also ask you about any medications you take on a regular basis.
If the doctor needs more information to diagnose eczema or psoriasis, they may take a biopsy of your skin. They will collect a small tissue sample and examine it under a microscope. This can also rule out other conditions or diseases.
If you have eczema, your doctor may recommend a patch test. They apply small amounts of different substances to the skin and look for signs of a reaction. This can help determine what allergies may trigger the eczema.
Treatment for Eczema and Psoriasis
There is no cure for either eczema or psoriasis. Instead, your doctor will help you treat and manage symptoms when you have a flare-up. The treatments for eczema and psoriasis are similar.
Your dermatologist will be able to suggest the treatment that’s right for your eczema or psoriasis. That might include:
- Over the counter (OTC) creams and ointments for mild cases.
- Prescription medication, including steroids, antibiotics, and/or antihistamines for more severe cases. These drugs may be topical, oral, or injectable.
- Phototherapy, which is the supervised use of ultraviolet light to treat eczema or psoriasis.
- Biologics. Taken through the skin or in a vein, these medicines use human DNA to treat disease. They target parts of the immune system and help it work better.
Your dermatologist can recommend a good skin care routine, which will help with flare-ups. They may also recommend some lifestyle changes. Your doctor may suggest you:
- Stay away from things that irritate your skin, like harsh soaps, perfumes, lotions, tight clothes, or itchy fabrics.
- Avoid too much sun.
- Use lukewarm (not hot) water to bathe or shower.
- Use moisturizer daily, especially after a bath, to keep the skin from drying out.
- Wear gloves in cold weather.
- Eat a healthy diet and staying hydrated.
- Manage your stress.
- Avoid things you are allergic to, such as food, pollen, and animals.
It may take some trial and error, but proper treatment and lifestyle tweaks can help you manage your eczema or psoriasis. A dermatologist can help you find relief from the itching and discomfort of either skin problem.
National Eczema Association, Is It Eczema or Psoriasis? Link
National Psoriasis Foundation, Psoriasis or Eczema? Link
National Psoriasis Foundation, About Psoriasis, Link
American Academy of Dermatology, What's the Difference Between Eczema and Psoriasis? Link
National Library of Medicine, Eczema, Link
American College of Allergy, Asthma, & Immunology, Eczema, Link
CDC, What Is Psoriasis? Link
Connect with UPMC
The UPMC Department of Dermatology diagnoses, treats, and manages numerous hair, skin, and nail conditions and diseases. We care for common and uncommon conditions, and our treatments include both surgical and nonsurgical options. We operate several specialty centers for various conditions. The UPMC Cosmetic Surgery and Skin Health Center is a comprehensive dermatologic laser facility, offering a full range of cosmetic services and procedures. With UPMC Hillman Cancer Center, we offer a Skin Cancer Program that provides complete care from screenings, diagnosis, treatment, and beyond. Find a dermatology provider near you.