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Eczema vs Psoriasis: What’s The Difference?

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Eczema and psoriasis are both conditions that can make the skin red and itchy. Both are chronic (long-term) diseases that tend to flare periodically. If you’ve got itchy skin and/or red patches of skin, both psoriasis and eczema could potentially be the problem. Only a dermatologist (a doctor who specializes in skin conditions) can make the final call, but there are clues that can help you tell the two apart. Continue reading to learn how to tell the difference between eczema and psoriasis.

Are psoriasis and eczema the same thing?

No, psoriasis and eczema are two different skin conditions. Eczema, also known as atopic dermatitis, is caused by a genetic variation whereby the skin is excessively sensitive to environmental allergens and irritants. Eczema can go through cycles, flaring periodically and then going away for many months, even years. Atopic dermatitis is common in children but can occur in older individuals.

Psoriasis is an autoimmune disease. It is caused by a problem with the immune system that causes skin cells to grow faster than usual. The rapid turnover of skin cells leads to the formation of red plaques, scales, and patches on the skin. People with psoriasis can be symptom-free for many years until something in their environment triggers a flare-up. 

What are the differences between eczema and psoriasis?

There are various ways to tell the difference between eczema and psoriasis. Again, only a dermatologist can make an accurate diagnosis and prescribe the appropriate treatments. However, these certain features can help you figure out which skin condition you might have.

Distribution

Eczema affects the hands, feet, wrists, ankles, neck, chest, and the bends of the knees and elbows. It is also common on the face and scalp in babies. Psoriasis patches commonly develop on the knees, elbows, trunk, lower back, and scalp, and occasionally on the palms and soles.

Appearance

Eczema appears like red, brown, or gray leathery patches on the skin. It can also be small, raised, itchy bumps that leak fluid and crust over when scratched. Psoriasis causes dry, raised, itchy, silvery scaly patches of skin.

Feel

There are differences in how eczema and psoriasis feel. Severe eczema can be associated with intense itching. As a result, people with this skin condition often scratch to the point of bleeding and infection. Psoriasis, on the other hand, tends to cause less intense itching. Instead, it can have a burning or stinging sensation. Some patients describe it as feeling like getting bitten by red ants. 

Triggers

Things that can trigger flares or worsen the symptoms of eczema include stress, sweating, irritants like soaps, detergents, and disinfectants, as well as dust, pollen, and pet dander. Psoriasis flare-ups can be triggered by bacterial and fungal skin infections, skin injuries (sunburns or scratches), cold dry weather, emotional stress, heavy alcohol use, exposure to smoke including second-hand cigarette smoke, and certain medications.

Age

Eczema is usually diagnosed during childhood but it can occur at any age. Children who are diagnosed with this skin condition sometimes have improvement of symptoms when they grow older. Psoriasis is rare in children and usually first shows up in adolescents and young adults between the ages of 15 and 35. 

Treatments

A dermatologist can make the correct diagnosis and prescribe treatments for eczema and psoriasis. Treatment for eczema consists of emollients and moisturizers to treat dry skin. Severe eczema is treated with topical corticosteroids (creams or ointments) to control inflammation. Medications are sometimes prescribed to treat specific symptoms, such as itching. Drugs that modify the immune system, biologic agents, and light therapy are also prescribed for the treatment of eczema.

Psoriasis treatment consists of emollients and topical corticosteroids for mild disease. More severe cases are treated with light therapy and systemic drugs (medications that affect the whole body). Some types of vitamin D have been found to slow the growth of skin cells and they may be used to treat psoriasis as well.

Which is worse: eczema or psoriasis?

Both conditions can be difficult and irritating to live with. However, in general, eczema tends to cause more severe itching while psoriasis causes milder itching. In some cases, psoriasis may appear worse, due to the skin being thicker and more inflamed than eczema. Also, there are seasonal differences. People who live in hot climates may find that the weather triggers their eczema (warm weather and sweating can lead to eczema flares). Psoriasis, on the other hand, can benefit from exposure to sunlight. This is because the UVB radiation in sunlight slows the growth of skin cells and eases psoriasis symptoms. 

Can eczema turn to psoriasis?

No, psoriasis and eczema are two different conditions. One cannot turn into the other. Also, both eczema and psoriasis are NOT contagious. You cannot catch them through contact, i.e., by touching the itchy skin of someone who has these conditions.

What cures eczema fast? 

It is best to follow the medical advice of your dermatologist and other doctors for the treatment of both eczema and psoriasis. It is also worth remembering that there is no cure for these skin conditions. However, your dermatology office can prescribe medications and other treatments to keep you comfortable and prevent flares.

Keeping skin cells healthy

There are various lifestyle changes and home treatments that can help you manage your psoriasis and eczema. Moisturizing your skin twice a day with oil-based emollients can help relieve symptoms associated with dry skin. Hot, dry air can worsen itching, so using a humidifier indoors is an option. An anti-itch cream or oral medication can help with itchy skin. You should also try to avoid scratching as much as possible. Pressing on the area or using wet bandages protects the skin and offers relief from itching to many patients with eczema and psoriasis. 

It is also a good idea to use mild soaps, detergents, and household cleaning products that don’t irritate the skin. Avoiding tight and rough clothing and wearing cool, smooth, loose-fitting clothing can help prevent skin irritation and scratching. Since stress can worsen both eczema and psoriasis, it is important to treat stress and anxiety and get mental healthcare, if needed. 

Psoriasis and eczema can be frustrating, stressful, and embarrassing skin conditions to live with. However, both conditions are treatable and manageable. Doctors can use a variety of medications and treatments to make your life more comfortable. 


References:

  1. https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/symptoms-causes/syc-20353273
  2. https://www.mayoclinic.org/diseases-conditions/psoriasis/symptoms-causes/syc-20355840
  3. https://www.pennmedicine.org/updates/blogs/health-and-wellness/2019/august/psoriasis


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