Key differences between psoriasis and eczema

Psoriasis and eczema are inflammatory skin conditions. Eczema is the more common of the two. Both can cause itchy, irritated skin, and blotchy, discolored patches, making it difficult to tell them apart. Psoriasis and eczema also share some similar triggers, like stress. Neither will spread from one person to another.

The conditions have some key differences, however. Being aware of them can help you get the proper diagnosis and treatment for your symptoms. One main difference is the cause.

• Eczema is the general term used to describe a set of itchy skin conditions. It occurs when the skin’s barrier, which usually protects against bacteria and irritants, is more sensitive and reactive to an allergen or irritant, or even stress.
• Psoriasis is an autoimmune condition. It occurs when the immune system attacks healthy skin cells, causing them to grow too quickly. This results in thick and uncomfortable raised patches of skin.

Here are four more important differences between eczema and psoriasis.

1. The time of onset can differ.

Eczema is most common in babies and young children, often starting before age 5. In many cases, the symptoms will become less severe as kids get older, and they may go away completely over time. Eczema also occurs in many adults.

Psoriasis can begin at any time, but it’s most common between the ages of 20 and 30, and it can be a lifelong condition. It’s also not unusual for psoriasis to begin later in life, between ages 50 and 60.

2. The conditions may look different.

Eczema can look red or pink on lighter-colored skin or dark brown, gray, or purple on darker skin. The affected area may appear dry and cracked, or it may develop fluid-filled bumps. In severe cases, the skin can blister and ooze fluid. Symptoms can occur anywhere on the skin but are most likely to appear on softer areas. On babies, eczema often shows up on the face. In adolescents and adults, it commonly crops up in elbow crooks and on the back of the knees.

Psoriasis causes thick, discolored patches of inflamed skin. Patches can also appear silvery and scaly. They can appear anywhere, but often show up on the chest, lower back, palms of the hands, knees, elbows, and on the scalp, ears, mouth, or eyelids. Psoriasis may also cause nail changes, leading them to become brittle or even crumble and fall off. Many people with the condition develop psoriatic arthritis, as well, which causes joint pain and damage. Itching associated with the condition is frequently not as intense as it is with eczema.

3. They have some different triggers.

Eczema triggers can differ depending on the type that you have. The most common causes of flare-ups include soaps, laundry detergents, certain foods, and environmental allergens like dust and pets, as well as viruses, cold, dry air, and itchy materials like wool. Stress and sudden changes in temperature can also trigger the condition. In addition, too much heat, sweating, and sun can make eczema worse.

Common psoriasis triggers include stress, illness, dry and cold air, and medications such as beta-blockers (for blood pressure) and lithium (for bipolar disorder). A scratch or bad sunburn could also lead to a flare-up, though moderate sunlight may help ease psoriasis symptoms. Some people believe dairy, alcohol, sugar, and red meat may also trigger psoriasis flares.

4. Treatment differs for psoriasis and eczema.

People with eczema can use topical creams and lotions to help manage the dryness and irritation, and cold compresses to relieve painful itching. A healthcare provider (HCP) might also prescribe an antihistamine (allergy medicine) or steroid cream. Phototherapy with ultraviolet (UV) light is another treatment option for eczema.

For psoriasis, an HCP may prescribe topical, oral, or injected medications to prevent skin cells from reproducing as quickly. These could include biologics, topical corticosteroids, retinoids, tar-based topicals, immunosuppressants, and other immune-modulating drugs. Phototherapy may be done in your HCP’s office or at home with a special device. You can also manage the condition at home by taking oatmeal baths to ease itching, using a humidifier to help prevent dryness and irritation, and using plenty of moisturizer.

If you develop a skin condition, keep a journal to track flare-ups and symptoms. This can help you and your HCP discover potential patterns and triggers, which can lead to a more accurate diagnosis and effective treatments.