Eczema and psoriasis are common skin conditions, and they can both appear as rashes that may itch or burn. If you get rashes often, you might wonder if you have one or the other. In fact, you could have both eczema and psoriasis at the same time, but it’s rare.
While both have a few things in common, there are some differences in symptoms, causes of flare-ups and health risks. That’s why you should see a dermatologist for a proper diagnosis if you have symptoms.
“Both eczema and psoriasis can cause visible, persistent rashes and itching, which impact sleep, self-esteem and daily comfort” says Emily Siegel, DO, a dermatologist at Rush. “They can also lead to anxiety or depression when symptoms are hard to control.”
Understanding the differences between psoriasis and eczema can help you make sure you’re taking the right steps to avoid flare-ups and get the treatment you need.
How can you tell if you have eczema or psoriasis?
Both eczema and psoriasis can appear as dry, flaky skin that may itch or burn. It can be hard to tell which you have just by looking. But there are a few key differences that might clue you in.
Both conditions can appear at any age, but eczema usually starts to present in childhood. It often develops along with allergic rhinitis and asthma, and together these conditions are sometimes called the “atopic triad.” Eczema also tends to be itchier than psoriasis
“Eczema often appears as dry, itchy patches involving the flexural areas of the body like the inner crease of the elbow or behind the knee,” Siegel says.
These itchy patches can present as bumps or even fluid-filled blisters.
Psoriasis differs in a few ways. While it can also cause itchiness for some people, it may not itch at all in other cases.
“Psoriasis tends to cause thicker, scaly plaques with sharper borders and involves the extensor areas of the body, like the elbows and knees,” Seigel says.
It can also affect the scalp or areas where there are skin folds, like the groin or genital region, as well as the hands or feet.
A dermatologist can easily tell the difference between psoriasis and eczema, so getting an examination will be the best way to know for sure which condition you have.
What are the different causes of eczema and psoriasis?
Both eczema and psoriasis have causes related to genetics and environmental factors. They also both result from overactive immune responses that lead to inflammation.
“Eczema is linked to an overactive immune response, skin barrier dysfunction and environmental triggers,” Seigel says. “It's more common in people with asthma or allergies.”
Overly hot showers and harsh soaps that remove oil from the skin can lead to flare-ups of eczema. Irritants like wool and fragrances in laundry detergent or perfumes can also be triggers.
“Psoriasis is an autoimmune condition with a strong genetic component, often triggered by stress, infection or certain medications,” Seigel says.
Medications that have been linked to psoriasis include beta-blockers and drugs to treat malaria. Other medications, like those used to treat depression and mental health issues, can worsen the condition.
As with many conditions, obesity and smoking can increase the risk of developing psoriasis.
What are the health risks?
Both eczema and psoriasis can put you at risk for other conditions. They can disrupt your sleep and worsen mental health issues. Excessive scratching or dryness can also lead to breaks in the skin, which can leave you open to secondary infections.
“Eczema can increase the risk of bacterial, viral and fungal infections due to impaired skin barrier function,” Seigel says. “It may also be associated with depression, anxiety and sleep disturbances.”
With psoriasis, the overactive immune response leads to inflammation not just in the skin, but in other organs of the body. That can lead to several other issues.
“Psoriasis is associated with psoriatic arthritis, cardiovascular disease and metabolic syndrome,” Seigel says.
Psoriatic arthritis can develop in about 30% of people with psoriasis.
It’s important to get treatment for both conditions not only to prevent rashes and itchiness, but to protect your overall health.
What are the treatments for psoriasis and eczema?
Mild cases of eczema and psoriasis are both often treated with topical anti-inflammatory medications, including corticosteroids and non-corticosteroids. Your dermatologist can prescribe these creams and lotions and instruct you on how to use them and the possible side effects.
“Eczema treatments range from moisturizers and topical steroids to immune-modulating creams or biologics,” Seigel says.
Your dermatologist will also likely recommend avoiding eczema triggers, like overly hot showers, fragrances and irritants. They may suggest that you switch to a less harsh soap and use moisturizer after bathing.
“Psoriasis may require topical therapy, phototherapy, oral medications or biologics,” Seigel says.
Since there is a risk that psoriasis may lead to psoriatic arthritis, your physician may also prescribe oral and injectable medications that treat both the skin and the joints.
“For both eczema and psoriasis, avoiding triggers, managing stress and keeping skin moisturized can help reduce flares,” Seigel says.
A dermatologist can talk with you about the benefits and risks of these different treatment options and come up with a plan that works for you.
If you need treatment for a skin condition like eczema or psoriasis, call Rush at (312) 947-7546 to schedule an appointment.
