Eczema vs psoriasis: What’s the difference?

Eczema and psoriasis – two frustrating skin conditions that are easily mixed up. To an “untrained eye,” they both look similar causing red, scaly areas on skin. But anytime areas of skin become inflamed, red, or peeling, this is not normal. Many people will try to self-diagnosis guessing whether it’s psoriasis or eczema.  But how to tell the difference and is there even a difference between them to begin with? 

First, if skin is showing any kind of symptoms such as the above, going to a dermatologist or family physician for an accurate diagnosis is advised.  Eczema and psoriasis are very similar, making it difficult to tell them apart. But to treat each condition effectively, it is important to have the right diagnosis – a treatment that works for one may not work for the other. 

What are the similarities between eczema and psoriasis?

Eczema and psoriasis are often confusing to tell apart as they look so much alike.  Both conditions can cause itchy, red and inflamed rashes and can erupt at any age.  The rashes tend to be itchy, dry and scaly and both typically appear in similar areas of the body which can include the hands, feet, knees, elbows, and/or neck.  The immune system is involved in the development of both in which the skin is affected in various ways. 

How are eczema and psoriasis different?

Even though the appearance and locations of these two chronic skin disorders are very similar, there are still distinguishing characteristics between them to help tell them apart.  Here are the characteristics features each of them have that are different from one another:

Eczema

·      Typically appears on the inside of the elbows and backs of the knees

·      Nail changes occur in eczema such as pitting of the nail

·      Eczema outbreaks can be triggered by external forces such as the weather/climate, harsh chemicals, dryness, rough fabrics, or allergic reactions

·      Also called “atopic dermatitis,” eczema is almost always itchy. 

·      Usually begins in childhood

·      Babies often get it on their cheeks

·      Has a tendency to become infected especially by staphylococcus or staph which causes it to be sticky or weep with a honey-colored ooze

Psoriasis

·      Rashes typically appears on the front of knees and outside of elbows and also on the scalp and lower back

·      Nail pitting can also occur along with a rash on hands

·      Rarely caused by contact with foreign objects

·      Usually caused by internal factors involving genetics and attacks to the immune system

·      May or may not be itchy

·      Can begin at any age but typically appears between ages 20 to 50

·      It rarely gets infected but it can bleed when scratched or rubbed

Treatment for eczema and psoriasis

The treatment for these two skin conditions are in some ways similar and in other ways different.  To reduce flare-ups of each condition, it is recommended to use ultra-hydrating creams and ointments that can help reduce itching and to provide moisture.  However, if eczema becomes inflamed by swelling or getting red, it is usually treated with an antibiotic – using an anti-biotic for psoriasis will have little effect.

Other treatments might include the following:

·      Topical steroids such as creams and ointments applied directly to the skin can treat both conditions. 

·      Antibiotics are used when eczema becomes infected

·      Oral steroids such as prednisone are often used to treat a severe flare-up of eczema.  They can be used short-term but are not a good choice for long-term treatment due to their side effects.

·      Light treatment such as narrow-band ultraviolet B can be used to treat psoriasis by lowering the immune system response in the skin.  This is a safe and effective treatment that is done in a doctor’s office.  This same treatment may also be beneficial for eczema.

·      Immune-suppressing medications can help both eczema and psoriasis.  However, they do reduce overall immune system functioning that could lead to a higher risk of severe or unusual infections.