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Psoriasis VS. Eczema: How to Tell the Difference

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Itchy, red, inflamed skin is the hallmark of both psoriasis and eczema. Anyone with the signs of psoriasis and eczema has tried every ointment, topical cream, lotion, and home remedy to find psoriasis and eczema treatment.

The itchiness can interfere with your ability to live your life and get in the way of your daily activities. Treating these conditions is crucial for your quality of life. However, treating either of them first requires accurate diagnosis and differentiating between the two.

What is Psoriasis?

Psoriasis is a dermatological condition that presents as flaky white patches of skin. It is a lifelong condition with no cure and often presents as an itchy rash. It is important to note that lifelong does not equate to a rash that is present for the rest of your life.

In most cases, psoriasis can be managed and the rash and itchiness only manifest during flare-ups that are triggered by different lifestyle habits and activities.

What is Eczema?

Eczema is a dermatological condition, also known as atopic dermatitis, which affects people from a young age. The condition often presents as dry and itchy skin in the natural creases of the skin. Much like psoriasis, atopic dermatitis is also a chronic condition that lasts a lifetime. There is no cure for eczema but can be managed successfully with home remedies and topical ointments.

How to Tell the Difference between Psoriasis & Eczema?

From the description alone, psoriasis and eczema appear quite similar. But they have major differences between the two, which are important to highlight and understand, for accurate and appropriate diagnosis.

Causes of Psoriasis and Eczema

The causes of psoriasis and eczema are quite different.

Psoriasis is caused by an autoimmune disorder that affects the rate at which skin cells form. Because of this disorder, the new cells keep on piling up on each other as the rate of production is rapidly increased. This presents as flaky and dry skin that is commonly associated with psoriasis.

Eczema is believed to be a multifactorial condition, the exact cause of which is not yet known. It is understood that genetics and environmental factors such as heat and cold play an important role in the development of eczema, however, not much more is known.

Signs of Psoriasis and Eczema

Signs and symptoms of both psoriasis and eczema are quite different. Signs of psoriasis include:

  • Red raised patches
  • Silvery white skin
  • Scaly patches
  • Thicker and inflamed skin
  • Mild to moderate itch

On the other hand, signs of eczema include:

  • Red inflamed skin
  • Scaly patches
  • Ooozing and crusty skin
  • Rough leathery patches where eczema flareup occurred
  • Swelling
  • Severe itchiness, when itched can lead to bleeding

Just the signs and symptoms of psoriasis and eczema are not different, but also the locations where these signs appear. Psoriasis develops in:

  • Elbows
  • Knees
  • Scalp and face
  • Lower back
  • Palms of your hands
  • Soles of your feet
  • Fingernails and toenails
  • Mouth and lips
  • Eyelids
  • Ears
  • Skin folds

Whereas, eczema develops in:

  • Inner elbow
  • Behind the knees
  • Neck
  • Wrists
  • Ankles
  • Babies can sometimes have eczema patches on their chin, cheeks, scalp, chest, back, arms, and legs.

Triggers for Psoriasis and Eczema

Since the causes for both psoriasis and eczema are different, it is no surprise that the things that trigger a flare up for both are also quite different.

A psoriasis flare up can be triggered by:

  • Stress
  • Humidity
  • Infection
  • Soaps
  • Detergents
  • Disinfectants
  • Juices from produce or meats
  • Allergies
  • Dust
  • Pets
  • Pollen
  • Mold
  • Dandruff
  • Some foods especially if they are spicy

An eczema flare up can be triggered by:

  • Sunburn
  • Stress
  • Infection
  • Vaccinations due to a break in the skin
  • Scratches
  • Smoking
  • Heavy alcohol consumption
  • Extreme weathers

Treatment options

The treatment options for psoriasis vs eczema are widely different as well. This is mainly because the former is caused by an autoimmune disorder and the latter by a mix of genetics and environment.

Treatment of psoriasis depends on the extent of spread and severity of psoriasis. In most patients with mild psoriasis, light therapy with methotrexate or a biological agent is sufficient for the successful management of the condition. The other options for psoriasis treatment include:

  • Topical Therapy
    • Corticosteroids
    • Salicylic Acid
    • Retinoid
    • Calcineurin Inhibitors
    • Vitamin D Analogues
  • Light Therapy
    • UVB Broadband
    • UVB Narrowband
    • Sunlight
    • Goeckerman therapy
    • Excimer Laser
  • Oral Therapy or Injectables
    • Methotrexate
    • Biological agent
    • Cyclosporine
    • Retinoid
    • Steroids

Eczema presents with a sensation of itching so deep that people will often itch so severely that they bleed. These scratches act as a breeding ground for bacteria and fungus, often resulting in infections. It is important to manage the itching with moisturizers and soothing creams, along with antihistaminic pills. Eczema treatment options include:

  • Topical Therapy
    • Moisturizers
    • Corticosteroids
    • Antibiotics
    • Calcineurin Inhibitors
  • Injectables or Oral Therapy
    • Steroids
    • Antibiotics
    • Antihistamines
  • Phototherapy