If you or a loved one has patches of red, dry and itchy skin that may even come and go, you may be wondering is it eczema or psoriasis? Or are these two conditions the same thing? They’re not. Eczema and psoriasis are two distinct skin diseases that may require different treatment plans. That’s why it’s important to speak to your healthcare provider to get the right diagnosis.
While they may be difficult to tell apart, a dermatologist (a doctor who specializes in skin conditions) can spot the differences between these two non-contagious and common skin conditions:
- Plaque psoriasis, the most common type of psoriasis, causes well-defined, thick, silvery-white scaly patches, commonly found on areas like the elbows, knees, the scalp and lower back.
- Atopic dermatitis, the most common form of eczema, may look slightly different in children and adults. Eczema is typically very itchy in all who are affected. In children, it appears as a dry or scaly, red rash, often in the creases (bends) of the elbows or knees. Adults tend to have patches of thicker or more chronic scaly skin rashes in similar areas as children, but are most noticeable on the face or hands.
What are the key differences?
Cause. Psoriasis is an immune-mediated condition, meaning your immune system becomes overactive. In this case, certain inflammatory cells cause the body to make new skin cells too fast. These cells pile up on the surface of the skin, leading to thick, scaly patches that are often itchy and painful.
While experts do not know the exact cause of eczema, they think it’s a combination of genetic and environmental factors. Similar to psoriasis, there is also inflammation in the skin, and this may be related to an irritant or an allergen that triggers the immune system, or may cause an eczema flare-up.
Age. Eczema is most common in babies and children. Psoriasis often starts between the ages of 15 and 35. However, people of all ages can experience these conditions.
Itch. Another key difference between these conditions is the intensity of itching, particularly at night and in children. With psoriasis, the itching may be absent or mild to moderate. But for eczema, it is common, can be intense and can affect sleep.
Eczema up close
Eczema is a general term to describe a group of skin conditions that cause redness and inflammation, affecting nearly 30 million Americans. Some 16.5 million adults have the most common form of eczema, atopic dermatitis (AD).
The symptoms of AD are different in adults compared to children. Here’s how it often appears in children:
- A rash that begins suddenly, on the face, neck, trunk and extremities.
- Very intense itching
- Eczema flares, or episodes, are often triggered by itching, which leads to scratching, inflammation and then more itching. This is called the “itch-scratch cycle".
- Oozing and “weeping” of clear fluids from inflamed areas
- Rough, leathery patches of skin
Childhood AD may go away or improve with age, but in some cases, the condition persists into adulthood, where the symptoms may appear as:
- Thickened or darker, scaly patches all over the body
- It’s commonly found on the backs of the knees, crooks of the elbows, neck and hands
- Can be especially bad around the eyes
- Some common things that trigger eczema include: dry skin, irritants (such as fragrants, soaps or cigarette smoke), fabrics (such as wool and polyester), stress
Psoriasis up close
Psoriasis is an immune-mediated condition with several subtypes, affecting some 8 million Americans. Some 80 percent of people have the so-called type ‘plaque psoriasis’, where scaly, raised patches develop on the skin. Psoriasis is a chronic disease and most people with the condition may need to manage their condition over their lifetime. Psoriasis can also increase your risk of developing other diseases, such as cardiovascular disease or arthritis.
Psoriasis may cause thick patches of silvery skin lesions anywhere on the body, but appears most commonly on:
- Elbows, knees and scalp
- It can also affect the palms of hands and soles of feet, nails, genitals and skin folds under the arms, buttocks and breasts
Some common triggers for psoriasis include: stress, injury to the skin, medications, infection.
Seeking the right treatment
Unfortunately, there are currently no cures for these skin conditions, and many people have to manage their symptoms over a lifetime. Depending on several factors, including your age and severity of your condition, your doctor will develop a treatment plan that includes a combination of medicine, avoiding triggers, and having a good skin care regimen and healthy lifestyle. It’s important to get the right diagnosis with a doctor who specializes in these conditions, such as a dermatologist, and to develop a treatment plan that’s tailored to your specific needs.