Psoriasis vs. Eczema: How to Tell the Difference

Learn how to tell the difference between psoriasis and eczema, including key symptoms, triggers, and treatment approaches for each condition.

Health Apr 18, 2025 40 Add to Reading List

Psoriasis vs. Eczema: How to Tell the Difference

Introduction

Skin conditions such as psoriasis and eczema can be challenging to differentiate, as they share similar symptoms like redness, scaling, and itching. However, understanding their distinctions is essential for proper diagnosis and treatment.

This article provides a detailed comparison of psoriasis and eczema, highlighting their key differences, causes, symptoms, and treatment options.

What Is Psoriasis and Eczema?

Psoriasis

Psoriasis is a chronic autoimmune skin disorder that accelerates the life cycle of skin cells, leading to excessive buildup and scaling. This condition is primarily associated with an overactive immune response that triggers inflammation. Psoriasis often appears as well-defined, thick, and silvery-white scales on red patches of skin.

There are several types of psoriasis, including:

Plaque Psoriasis	Thick, scaly patches that appear on the elbows, knees, and scalp
Guttate Psoriasis	Small, drop-like sores are often triggered by infections
Inverse Psoriasis	Smooth, red lesions in skin folds, such as under the breasts and around the groin
Pustular Psoriasis	White pustules surrounded by red skin, commonly affecting hands and feet
Erythrodermic Psoriasis	A severe, rare form that causes widespread redness, scaling, and pain

Eczema

Eczema, or atopic dermatitis, is a common inflammatory skin condition that causes dry, itchy, and irritated skin. It is linked to a compromised skin barrier and an overreactive immune system, leading to increased sensitivity to environmental triggers. Eczema typically manifests as red, inflamed, and sometimes oozing patches of skin.

There are diverse types of eczema, including:

Atopic Dermatitis	The most prevalent type, associated with allergies and asthma
Contact Dermatitis	It occurs when the skin reacts to allergens or irritants such as detergents or metals
Dyshidrotic Eczema	Defined by tiny, itchy blisters on the hands and feet
Nummular Eczema	Round, coin-shaped spots on the skin
Seborrheic Dermatitis	Marked by tiny, itchy blisters on the hands and feet

Psoriasis And Eczema: Know the Differences Between Them

Although both conditions involve inflammation and itching, there are key distinctions between psoriasis and eczema:

Feature	Psoriasis	Eczema
Appearance	Thick, scaly, and well-defined red patches with silvery-white scales	Red, inflamed, and dry skin that may ooze or crust
Itching	Mild to severe itching, often with a burning sensation	Intense itching, often leading to scratching and skin damage
Affected Areas	The most affected areas include the elbows, knees, scalp, and lower back.	Typically found in skin folds (e.g., behind knees, inside elbows, and neck)
Triggers	Immune system dysfunction, stress, infections, and certain medications	Allergens, irritants, stress, and environmental factors
Chronicity	A chronic condition with cycles of flare-ups and remission	Can improve over time, but may persist if triggers are present

Psoriasis And Eczema: Where They Show Up

While psoriasis and eczema can appear anywhere on the body, their distribution patterns differ:

Psoriasis commonly impacts the scalp, elbows, knees, and lower back. Eczema is more common in skin folds such as behind the knees, inside the elbows, and around the neck. Both conditions can appear on the hands and feet, but the texture and severity vary.

What Causes Eczema and Psoriasis?

Causes of Psoriasis

Psoriasis is caused by an overactive immune system that speeds up skin cell production, leading to buildup and inflammation. Contributing factors include:

Genetics: Family history increases the risk.

Immune System Dysfunction: Overactive T-cells attack healthy skin cells.

Triggers: Stress, infections, chilly weather, and medications like beta-blockers.

Lifestyle Factors: Smoking, alcohol consumption, and obesity can worsen symptoms.

Causes of Eczema

Eczema is caused by a combination of genetic and environmental factors that lead to skin barrier dysfunction. Contributing factors include:

Genetic Predisposition: A family history of eczema, asthma, or allergies.

Weakened Skin Barrier: Inability to retain moisture and protect against irritants.

Environmental Triggers: Allergens, detergents, soaps, stress, and weather changes.

Dietary Factors: Certain foods, such as dairy and gluten, may trigger eczema in some individuals.

Symptoms of Psoriasis and Eczema

Symptom	Psoriasis	Eczema
Red Patches	Yes, with silvery-white scales	Yes, often without thick scales
Itching	Mild to severe, sometimes burning	Intense and persistent
Cracking & Bleeding	Common in thickened areas	It can occur due to excessive scratching
Oozing	Rare	Common in severe cases
Skin Thickening	Common due to excessive cell turnover	It can occur over time due to chronic irritation

Can Someone Have Psoriasis and Eczema?

Yes, it is possible to have both psoriasis and eczema simultaneously, although it is rare. Some individuals may develop overlapping symptoms, making diagnosis challenging. In such cases, dermatologists use skin biopsies and patient history to differentiate between the two conditions.

Conditions That Cause Similar Symptoms

Several other skin conditions may mimic psoriasis and eczema, including:

Seborrheic Dermatitis: Causes scaly patches on the scalp and face

Contact Dermatitis: A reaction to allergens or irritants

Fungal Infections: Can lead to red, scaly patches like psoriasis

Rosacea: Primarily affects the face with redness and inflammation

Advances in Treatment Options

Both psoriasis and eczema have seen significant advancements in treatment options, improving symptom management and quality of life for patients. For psoriasis, biologic therapies such as TNF inhibitors, IL-17, IL-12/23, and IL-23 inhibitors have revolutionized treatment by targeting specific components of the immune system that drive inflammation. According to the American Academy of Dermatology (AAD), these biologics help reduce flare-ups and prevent disease progression in moderate-to-severe cases. Additionally, newer oral treatments like phosphodiesterase-4 (PDE4) inhibitors and Janus kinase (JAK) inhibitors offer alternatives for patients who may not respond well to traditional therapies.

For eczema, advances in targeted therapies have also expanded treatment options. The introduction of biologic drugs like dupilumab (an IL-4 and IL-13 inhibitor) has been a breakthrough for moderate-to-severe atopic dermatitis, significantly reducing itch and inflammation. As medical research progresses, personalized treatment plans tailored to individual triggers and genetic factors continue to improve disease management, emphasizing the importance of consulting a dermatologist for the latest, most effective therapies.

You may also read: Flare-Ups & Frustration Living with Psoriasis

Takeaway

Both psoriasis and eczema are chronic skin conditions that require proper diagnosis and management. While psoriasis is an autoimmune disorder characterized by thick, scaly plaques, eczema results from an impaired skin barrier and an overactive immune response, leading to extreme dryness and itching. Recognizing their differences is crucial in determining the appropriate treatment. If you experience persistent symptoms, consulting a dermatologist is the best step toward effective relief and long-term skin health.