Psoriasis vs. eczema: Can you treat them the same way?

Creator: SingleCare
Published: 2020-11-09T13:53:09-05:00

By SingleCare Team | Nov. 9, 2020 Medically reviewed by Gerardo Sison, Pharm.D.

Psoriasis and eczema are two common skin conditions that affect millions of people in the United States and around the world. Psoriasis is an autoimmune disease that causes dry, itchy, and thick patches of skin. Eczema is a chronic skin condition that causes red, itchy, and dry rashes on the skin. Let’s take a look at the difference between the two conditions.

Causes

Psoriasis

Psoriasis is caused by an overactive immune system that speeds up skin cell growth. It’s considered an autoimmune disease, but doctors and researchers aren’t sure what causes the immune system to become dysfunctional. For those with psoriasis, their skin cells will shed at a much quicker rate than the average person, and those skin cells will build up on the surface of the skin and cause psoriasis plaques.

Eczema

Eczema is caused by triggers that produce inflammation in the body. Once the body is exposed either internally or externally to a trigger, the immune system overreacts and skin can become painful, dry, itchy, or red. Eczema triggers may include things like cold weather, food allergies, fragrances, stress, and dry skin.

Some research suggests that eczema may be caused by a gene mutation of the gene that makes filaggrin. Filaggrin is a protein that’s responsible for maintaining a protective barrier on the surface of the skin, and if it isn’t created properly the skin can let in bacteria and viruses. A deficiency in filaggrin can also cause moisture to escape, leading to dry skin symptoms often seen in those with eczema.

Psoriasis vs. eczema causes
Psoriasis	Eczema
Autoimmune disease Skin cells shed quicker than normal Dead skin cells build up on the surface of the skin, causing psoriasis plaques	Chronic skin condition Triggers cause inflammation in the body The inflammation causes dry, itchy, red patches of skin May be caused by a gene mutation that affects the protein filaggrin

Prevalence

Psoriasis

Psoriasis affects more than 8 million Americans, and the World Psoriasis Day consortium estimates that 125 million people globally have the condition. Psoriasis is more common in adults than in children, with the average age of onset being between 20-30 years of age or between 50 to 60 years of age. About 30% of people who develop psoriasis will also get a condition called psoriatic arthritis, a chronic and inflammatory disease of the joints.

Eczema

Eczema, also known as atopic dermatitis, is a very common skin condition that affects about 20% of children and 3% of adults in the United States. Overall, more than 30 million Americans will have some form of eczema over the course of their lives. It’s more common for children to get eczema, but adults can develop it even if they never had it as a child. According to the National Eczema Association, the prevalence of atopic dermatitis during childhood has steadily increased from 8% to 12% since 1997.

Psoriasis vs. eczema prevalence
Psoriasis	Eczema
8 million Americans 125 million people globally More prevalent among Caucasians than African Americans and Hispanics	30 million Americans 10 million children have eczema in the U.S. More common in adult females than males

Symptoms

Psoriasis

Psoriasis causes itchy, red, scaly, silver-colored patches on the skin. It most commonly appears on the elbows, knees, scalp, though it can appear elsewhere on the body. Psoriasis can also make the skin crack or bleed, and in severe cases, it can cause swollen and stiff joints, burning sensations, and thickened or ridged nails.

Eczema

Eczema causes the skin to become itchy, red, and dry. Some people can also develop leathery, scaly, or swollen patches of skin. Oftentimes, people with eczema will scratch their itchy skin, which leads to more inflammation and dry skin, causing more itching. This is called an “itch-scratch cycle.” Eczema most commonly appears on the back of the knees, insides of the elbows, the face, and on the front of the neck, but it can appear anywhere on the body.

Psoriasis vs. eczema symptoms
Psoriasis	Eczema
Itchy skin Red skin Scaly patches Silver-colored skin Bleeding Skin cracks Swollen joint Stiff joints Burning sensations Thickened/ridged nails	Itchy skin Dry skin Red skin Leathery skin Scaly skin Bleeding Swelling Crusty skin Oozing skin Discolored skin

Diagnosis

Psoriasis

Psoriasis is easiest to diagnose when someone is having an outbreak. A doctor or dermatologist will examine the skin to determine whether or not the rash looks like psoriasis. In rare cases, a skin biopsy may be needed, but psoriasis is most often diagnosed just by the appearance of scaly, silver-colored skin. There are five types of psoriasis that someone could be diagnosed with: guttate psoriasis, pustular psoriasis, plaque psoriasis, inverse psoriasis, and erythrodermic psoriasis. Psoriasis treatments may vary depending on the specific type of psoriasis someone has.

Eczema

Eczema is usually self-diagnosable by the appearance of red and itchy skin. It can be helpful to visit a dermatology clinic to determine the exact type of eczema you have and figure out what may be triggering it. Here are the seven types of eczema: atopic dermatitis, contact dermatitis, neurodermatitis, dyshidrotic eczema, stasis dermatitis, seborrheic dermatitis, and nummular eczema. A dermatologist will be able to recommend treatment options and specific medications based on the exact type of eczema someone has.

Psoriasis vs. eczema diagnosis
Psoriasis	Eczema
Examination of the skin by a doctor or dermatologist Presence of scaly, silver-colored skin Patches of skin appear thick and raised Five different types of psoriasis	Can often be self-diagnosable Examination of the skin by a doctor or dermatologist Presence of red, itchy skin Seven different types of eczema

Treatments

Psoriasis

Even though there isn’t a cure for psoriasis, its symptoms can be managed with proper treatment. Treating psoriasis will most likely involve a combination of medications, natural remedies, light therapy, and lifestyle changes. Topical medications are one of the most common ways to treat psoriasis. Retinoids like Tazorac, corticosteroid creams like Sernivo and Triderm, vitamin D analogs, and calcineurin inhibitors can be applied in a thin layer to affected areas to help slow skin growth and reduce inflammation. Natural remedies like aloe extract cream and coal tar can also be applied topically to help with psoriasis.

Light therapy is helpful for some people with psoriasis, and photodynamic therapy can be done by most dermatologists. For those with severe psoriasis, oral medications may be required. Biologics can help treat an overactive immune system and quicker than normal skin cell growth, as can the immunosuppressive drugs cyclosporine and methotrexate.

Eczema

There’s currently no cure for eczema, but its symptoms can be successfully managed for most people. Eczema treatment plans will often include medications, light therapy, natural remedies, and lifestyle changes. Topical medications are the most common type of treatment for eczema and include hydrocortisone creams, NSAID creams, and calcineurin inhibitors like Protopic and Elidel. They work by reducing inflammation and by suppressing an overactive immune system.

For severe cases of eczema, it may be necessary to take oral medications like antihistamines or immunosuppressive drugs. They can help stop severe itching and calm down an overactive immune system. Phototherapy with natural sunlight or with ultraviolet light can also help treat eczema, and many people can calm an eczema flare-up with natural remedies like lukewarm baths or coconut oil.

Psoriasis vs. eczema treatments
Psoriasis	Eczema
Biologics Methotrexate Cyclosporine Vitamin D analogs Corticosteroids Retinoids Salicylic acid Anthralin Calcineurin inhibitors Phototherapy Coal tar Aloe extract cream Turmeric Fish oil supplements	Topical corticosteroid Antihistamines NSAID ointment Calcineurin inhibitors Phototherapy Aloe vera gel Colloidal oatmeal Humidifier Coconut oil Taking lukewarm baths and applying moisturizer/treatment afterward

Risk factors

Psoriasis

Some groups of people may be more likely to get psoriasis than others. Here are the top risk factors of psoriasis:

Obesity
Certain medications like beta-blockers
Stress
Smoking
Family history of psoriasis
Being immunocompromised
Skin injuries
Alcohol

Eczema

Some people are more likely to experience eczema throughout their lives than others. Here are the top risk factors of eczema:

Family history of allergies
Family history of eczema
Family history of asthma
Family history of hay fever
Being immunocompromised
Skin infections

Psoriasis vs. eczema risk factors
Psoriasis	Eczema
Obesity Hypertension Stress Smoking Family history Being immunocompromised Skin injuries Alcohol	Family history of allergies Family history of eczema Family history of asthma Family history of hay fever Being immunocompromised Skin infections

Prevention

Psoriasis

Even though there’s no way to prevent psoriasis, there are ways to reduce psoriasis flare-ups and complications. Avoiding psoriasis triggers is one of the best ways to help prevent flare-ups. Stress, certain medications, skin injuries, and food allergies are common irritants that can be avoided with some mindfulness. Over time, it will get easier for someone to recognize what sets off their psoriasis, and if a flare-up does happen, using topical medications and other treatments can keep the skin from getting worse.

Eczema

According to the National Institute of Allergy and Infectious Diseases, a proper treatment plan for eczema can help reduce symptoms and control the condition. Even though eczema can’t be prevented, reducing stress, avoiding food allergies, and using moisturizers and topical medications can all help prevent eczema flare-ups or reduce their severity when they happen. A dermatologist can help determine what’s triggering eczema and help come up with the best treatment plan to reduce symptoms.

How to prevent psoriasis vs. eczema
Psoriasis	Eczema
Stress reduction Protecting the skin from injury or infection Avoiding topical or internal allergies Avoid certain medications Eat a healthy diet	Reducing stress Reducing anxiety Protecting the skin from injuries and infections Moisturizing Running a humidifier in cold weather Avoiding scented products and laundry detergent Using an air purifier inside the home

When to see a doctor for psoriasis or eczema

The National Psoriasis Foundation recommends that anyone living with psoriasis see a dermatologist. It’s especially important to see a dermatologist if your psoriasis symptoms are getting worse, if you develop new symptoms, if your joints start to hurt, or if the treatment recommended by your primary care physician isn’t working.

If you have eczema and your symptoms get worse or if you show signs of an infection—red, painful, oozing, or blistery skin—then it’s best to see a doctor as soon as possible. If you’ve seen a doctor already and the treatment plan they gave you isn’t working, a dermatologist will be able to give you more specialized care.

Frequently asked questions about psoriasis and eczema

What is the difference between eczema and psoriasis?

Psoriasis is typically more inflammatory than eczema. It’s an autoimmune disease that causes raised, scaly, silver-colored patches of skin; whereas eczema is a chronic skin condition that causes itchy, red patches of skin.

Can eczema become psoriasis?

Eczema and psoriasis are two separate conditions. It’s not possible for eczema to turn into psoriasis.

Can you have both psoriasis and eczema?

Although it’s rare, it is possible to have psoriasis and eczema at the same time.

Can you treat eczema and psoriasis the same way?

Some of the medications that are used to treat psoriasis may help treat eczema and vice versa. This doesn’t necessarily mean that there’s a one-size-fits-all treatment plan for both conditions though. A dermatologist can help you find a treatment plan that will work best for you based on your individual symptoms and medical history.