Key Differences Between Eczema and Psoriasis You Need to Know

Here’s how to tell what’s really causing your dry, itchy skin.

Eczema and psoriasis, two common skin conditions, often present similar symptoms, such as itching and patches of red, dry skin. Both conditions are considered chronic, meaning they persist over time, and their treatment strategies share some similarities. However, upon closer examination, important distinctions emerge between these dermatological disorders.

Causes of Psoriasis and Eczema

While both eczema (atopic dermatitis) and psoriasis are associated with an overactive immune system that mistakenly attacks the body, their underlying processes differ significantly. According to Dr. Emily Newsom, an assistant clinical professor of dermatology at UCLA David Geffen School of Medicine, psoriasis involves the overproduction of specific immune system chemicals, leading to an accelerated life cycle of skin cells. In psoriasis, skin cells form and shed in just days rather than the usual month, resulting in a build-up of rapidly forming cells on the skin’s surface. This phenomenon is responsible for the characteristic thick, red, and silvery scales seen in plaque psoriasis, the most common type.

Eczema, on the other hand, primarily affects the skin’s ability to protect against external irritants and allergens.

Symptoms

Distinguishing between eczema and psoriasis often revolves around their symptoms. Eczema patches tend to be thinner than psoriasis plaques and typically appear as dry skin that can swell, crack, and even ooze fluid. This fluid discharge is a key indicator of eczema rather than psoriasis. Moreover, the boundaries of eczema patches tend to be less defined compared to the sharply delineated patches of psoriasis.

In terms of location, eczema predominantly appears on the inside of the arms, the back of the knees, and in skin folds. This predisposes individuals with eczema to bacterial and yeast infections in these sweaty, moist areas. Psoriasis, on the other hand, is more commonly found on the scalp, lower back, knees, and elbows, though it can manifest anywhere, including the face.

Both eczema and psoriasis can cause itching, with eczema typically provoking more intense itching. However, some individuals with psoriasis describe sensations of burning and stinging in addition to itching.

Triggers

Although both conditions are chronic, they can experience flare-ups triggered by different factors. Eczema is often provoked by contact with substances such as fragrance, nickel, pollen, or preservatives. For some individuals, dust, mold, cigarette smoke, wool, polyester, and even hormonal changes can trigger eczema flares.

Psoriasis, on the other hand, can be triggered by skin injuries, sunburns, scratches, infections (like strep throat), as well as alcohol and certain medications. Stress and dry weather can also exacerbate both conditions.

Diet may play a role in managing both conditions. Some individuals with psoriasis find relief by following an anti-inflammatory diet, while those with eczema may benefit from working with a healthcare provider to identify food allergens that could trigger flares.

Onset and Risks

Eczema typically manifests in early childhood, often before the age of 5, whereas psoriasis typically develops between the ages of 15 and 35, though there are exceptions to these patterns.

Both conditions are not just cosmetic concerns; they are linked to broader health issues, although these health risks differ. Psoriasis-related inflammation raises the risk of diabetes, heart disease, and inflammatory bowel disease, among others. Psoriasis is even considered an independent risk factor for heart disease, regardless of factors like body mass index and weight.

Furthermore, up to 30% of individuals with psoriasis may develop psoriatic arthritis, a condition in which the immune system attacks the joints.

In contrast, individuals with eczema may be more prone to developing asthma and hay fever. A personal or family history of asthma or hay fever may indicate an increased risk of eczema.

Treatments

Effective treatments are indeed accessible for both eczema and psoriasis, and the therapeutic strategies, to some extent, exhibit a degree of convergence. In instances characterized by milder manifestations of either condition, implementing self-care practices proves invaluable. These measures encompass diligent moisturization routines and the astute avoidance of factors that may trigger or exacerbate symptoms, contributing substantially to alleviating discomfort and improving the overall skin condition.

Nevertheless, it is crucial to underscore that more severe and recalcitrant cases often necessitate a more comprehensive therapeutic approach. To ascertain the most appropriate course of action tailored to the unique aspects of your symptoms and individual requirements, consulting a skilled dermatologist becomes paramount. These specialists possess the expertise to meticulously assess the intricacies of your condition, offering insights that guide the selection of treatment modalities most likely to yield favorable outcomes.

The array of treatment options available for eczema and psoriasis is extensive, reflecting the multifaceted nature of these dermatological conditions. For instance, topical creams and ointments, formulated with specific active ingredients, are frequently prescribed to mitigate symptoms and manage flare-ups. Phototherapy, a method employing controlled exposure to ultraviolet light, can also be a viable option in certain cases, effectively reducing inflammation and promoting skin healing.

In more severe instances, oral medications may be recommended by healthcare professionals. These medications can modulate the immune response, helping to quell the underlying inflammatory processes responsible for the characteristic symptoms of eczema and psoriasis. Additionally, biologic drugs, which are administered via injections or infusions, target specific components of the immune system implicated in the pathogenesis of these conditions. This targeted approach can provide significant relief, especially for individuals with severe, treatment-resistant forms of eczema or psoriasis.

It is important to emphasize that the choice of treatment should be a collaborative decision between you and your healthcare provider, taking into account factors such as the severity of your condition, medical history, and individual preferences. Regular follow-up appointments with your dermatologist are instrumental in monitoring your progress and making any necessary adjustments to the treatment plan.

The spectrum of therapeutic interventions available for eczema and psoriasis encompasses a wide range of options, designed to address the varying degrees of severity and individualized needs of patients. While self-care practices play a pivotal role in managing milder cases, the expertise of dermatologists is indispensable in guiding the selection of appropriate treatments for more severe and complex presentations of these chronic skin conditions. By embracing a tailored treatment approach and maintaining open communication with healthcare professionals, individuals can aspire to attain not only relief from symptoms but also an improved quality of life, allowing them to effectively manage the challenges posed by eczema and psoriasis.

In conclusion, it is imperative to recognize that while eczema and psoriasis exhibit certain overlapping features regarding symptoms and therapeutic interventions, they fundamentally represent distinct skin maladies, each characterized by its own intricate set of underlying causes, symptom manifestations, triggering factors, associated risks, and specialized treatment modalities. The pivotal role of accurate diagnosis and adept management by healthcare experts cannot be overstated when addressing the complex challenges posed by these chronic dermatological conditions. By seeking the guidance and expertise of healthcare professionals, individuals grappling with eczema and psoriasis can embark on a path towards attaining not only relief from their distressing symptoms but also an enhanced quality of life, ultimately enabling them to better navigate the intricacies of these chronic skin afflictions.