Eczema vs Psoriasis

Reviewed By: Christopher Lowe, MD, FAAD, specialist in dermatology at Galen Dermatology 

Eczema and psoriasis are both common skin conditions in the United States, with 32 million Americans affected by eczema and around 7.5 million Americans affected by psoriasis. Both conditions look similar to the untrained eye because they both can occur in the same locations on your body and both cause a similar red, raised, and itchy rash to develop. This makes self-diagnosis hard, and it is why you should see a board-certified dermatologist to determine if you have one of these conditions and a treatment plan.

What are the differences between eczema and psoriasis?

Eczema is an inflammation of the skin that can be triggered by many different factors ranging from soaps/detergents to dust, pollens, and certain foods. Other triggers can include heat, sweating and stress. The most common type of eczema is atopic dermatitis. It usually occurs in individuals who have a family history of asthma, hay fever, or other allergies. Eczema can make the skin more sensitive and more likely to get infected. An individual can develop eczema at any time throughout life. Common signs of eczema include: 

  • Dry and/or cracked scaly skin
  • Itchy skin 
  • Small, raised bumps, that could leak fluid and crust over 
  • Raw/sensitive skin from scratching 
  • Red to brownish-gray patches, usually on the hands, feet,
    ankles, wrists, neck, upper chest, eyelids, inside the bend of
    the elbows and knees.
  • Infants will typically have patches on their face and scalp

Unlike eczema, psoriasis is an auto-immune disease. This means that the immune system goes into overdrive, which causes the skin to change. While psoriasis and eczema share some triggers such as stress, psoriasis can flare up with certain medication and skin injuries such as sunburns and scratches. There are different subtypes of psoriasis with the most common type being plaque psoriasis which accounts for 80-90% of cases. Common signs of psoriasis include: 

  • Red patches of skin covered in thick silvery scales 
  • Small scaling spots 
  • Dry, cracked skin that may bleed or itch 
  • Itching, burning or soreness 
  • Thickened, pitted, or ridged nails 
  • Swollen and stiff joints 

When should you see a doctor and what does treatment look like?

You should see a board-certified dermatologist when the eczema or psoriasis is persistent and will not go away with over-the-counter medications. The dermatologist will observe the red patches and will determine which one you have and the severity of the disease. Once it is determined which one you have and the severity of the disease, your dermatologist will discuss the treatment options. Those options could include: 

  • Systemic medications (pills or injections) for extensive disease
  • Topical medications for limited disease 
  • Phototherapy or ultraviolet light 

At Galen Dermatology we pride ourselves on providing quality care and education to our patients. If you are experiencing persistent itchy, red patches, call our office at (423) 954-9017 to schedule an appointment with one of our board-certified dermatologists.