Eczema vs. Psoriasis

You notice a small rash on your skin that is somewhat irritating. Is it psoriasis or eczema or neither one? Do you treat it yourself or call your doctor? Here, you can earn a few ways you can tell the difference between eczema and psoriasis and when to see a doctor.

What is Eczema?

Eczema, also known as atopic dermatitis, is a broad name given to skin reactions that cause patches of dry skin to blister and rash. Severe eczema can include symptoms of oozing and weeping skin. Itchy skin usually accompanies these flare ups. Eczema is normally red and swollen skin patches that may or may not be fluid-filled and oozing. The skin will be rough, red, and possibly tight like leather. Eczema is very itchy and may tingle, but is not necessarily painful. It is a condition commonly found in children and can last many people a lifetime with breakouts being sporadic and sometimes seasonal.

Eczema can be caused by dry skin, allergens that you come in contact, high stress, or related to an underlying health disease. A dermatologist will often notice eczema in children on patches of skin in different areas of the face and in some cases, on the hands, elbows, knees, or feet.

What is Psoriasis?

Psoriasis is a skin condition that is characterized by symptoms of red scaly patches and often stinging, itchy skin. Psoriasis and eczema have similar symptoms like red patches that are typically very itchy and both tend to go through cycles of flare ups. Psoriasis often appears more scaly with a silvery color and greater inflammation with patches of raised thickened skin. The silvery scales are dead skin cells on top of the rash. Skin cells reproduce too quickly resulting in a build up of thickened skin known as plaque psoriasis. Seek medical advice if your psoriasis causes painful cracking and bleeding. The areas of skin most often affected by psoriasis are the face, hands, elbows, knees, and feet. Both Psoriasis and eczema are chronic diseases that don’t have a permanent cure but may go dormant for long periods of time.

Causes of Eczema and Psoriasis

A dermatologist will tell you that there is little difference between eczema and psoriasis when looking for a direct cause. Both of these conditions are somewhat of a medical mystery. The leading cause is thought to be a genetic predisposition to psoriasis and eczema. If a dermatologist has ever told any of your family members that they have cases of atopic dermatitis or psoriasis, then your odds increase for also having it. Both of these conditions may also be triggered by events, allergens, or stress.

Common triggers for psoriasis include:

  • Severe Stress
  • Medical conditions like strep throat
  • Underlying health disease
  • Certain medications
  • Excessive alcohol
  • Smoking
  • Cold weather

Triggers that are believed to cause eczema include:

  • Severe Stress
  • Dry skin
  • Environmental triggers like pollen and pet dander
  • Certain foods
  • Skin irritants like perfume and soap.

When Did It Start?

One factor that helps a dermatologist tell the difference in psoriasis, eczema; is determining the age of people at the onset of the skin condition. Eczema normally appears in infants and continues through adulthood. On the other hand, psoriasis typically appears in the late teens to early twenties but can appear in children.

Where Did it Appear?

Eczema and psoriasis both can appear on any part of the body. However, both conditions have areas where breakouts are predominant.

Eczema breakouts tend to appear on the areas of the body that bend like behind the knees and inside elbows. It can also be on your ankles, wrist, and neck. Babies may have it nearly anywhere on their bodies.

Psoriasis may also appear all over the body; however, there are areas where it tends to appear that eczema doesn’t, including:

  • Soles of the feet and palms of the hand
  • Fingernails and toenails
  • Ears
  • Eyelids
  • Mouth and lips

If your rash is in these areas, that is a good indicator that you are dealing with psoriasis and not eczema.

Treatment for Eczema and Psoriasis

Regardless of which health condition your doctor determines you have, a treatment plan is necessary for managing the disease in both the acute and long term stages.

Common Eczema treatment options usually include:

  • Topical corticosteroids and emollients for moisturizing your skin
  • Cyclosporine and other oral medications
  • Biologics that are specific for eczema
  • Ultraviolet Light therapy
  • Antihistamines for atopic dermatitis outbreaks

Common Psoriasis treatment paths are with a two pronged approach. Usually a dermatologist will treat people for the acute breakout to quickly reduce inflammation and then will make a long term systemic medication related to treatment of the immune system.

  • Ultraviolet light therapy
  • Medications for the immune system
  • Biologics that target specific molecules
  • Topical steroids

Although the treatments sound similar, there are major differences based on what is believed to be causing the eczema or psoriasis.

Should You Treat Yourself?

You may think it’s just a rash and that you can put some antibiotic cream on it and call it all good. However, if you are having a reaction to an allergen or something in your environment, you may not get any relief until a dermatologist or allergist helps you identify the source.

If you have a rash that is painful, oozing, hasn’t improved in a few days, or is getting worse, you should see a dermatologist to find out what it is and the best course of treatment. Eczema and psoriasis both may go through periods of dormancy and suddenly reappear. If you have a plan in place with your doctor, you will know how to treat your breakout without making it worse through guessing and self-treatment.

There are some things you can do at home that will help control these two skin conditions:

  • Use moisturizers daily
  • Take warm baths, avoid hot water that dries out your skin
  • Avoid known triggers like stress and allergens
  • Get a patch test or other testing to determine trigger sources

During an acute breakout, you can use over-the-counter topicals like calamine lotion and aloe vera gel to help relieve itching. You can ask your doctor about taking OTC Benadryl for itching as well.


Knowing the differences between eczema and psoriasis can help you look for clues and get help from a dermatologist. Eczema and psoriasis have many commonalities making it near impossible for most people to 100% diagnose themselves. It is better to get a diagnosis from a board certified dermatologist who can treat you in the beginning when symptoms are most mild than to try to wait it out.

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