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Distinguishing between eczema and psoriasis can be tricky so we’re here to help you understand the difference between these two skin conditions
On this page…
- What is eczema?
- What is psoriasis?
- The difference between eczema & psoriasis
- What are the causes of eczema & psoriasis?
- Who do eczema & psoriasis affect?
- Diagnosing eczema & psoriasis
- What role does the immune system play in eczema vs. psoriasis?
- What is psoriatic arthritis?
- Treating eczema & psoriasis
- When to seek help
- Using Boots Online Doctor
- Frequently asked questions
Eczema and psoriasis can both cause dry and irritated skin, but there are a few differences that may help you distinguish between them.
Both conditions can be lifelong and you may get flare ups that come and go. Although neither condition is contagious, they can be severe enough to impact your quality of life and emotional wellbeing.
Since they can both cause dry, itchy and uncomfortable skin, it can be tricky to understand the differences. Read on to find out more, including ways to manage symptoms and treatment options, including psoriasis creams, eczema treatments and more…
What is eczema?
Eczema refers to a group of skin conditions that causes dry, itchy and irritated skin that can crack and appear red and pink, or purple and brown, on darker skin tones.
Atopic eczema is the most common type and is usually a lifelong condition, although it may come and go in cycles.
It often appears in patches on the hands, inner elbow and knee creases, and is also fairly common on the neck and wrists. In some cases, it can cover most of the body.
In children, eczema is more common on the face and scalp.
In severe cases, skin can crack and bleed and this can be made worse by scratching in response to intense itchiness. If the skin becomes incredibly dry, its natural protective barrier doesn’t work as well as it should, which may leave you more vulnerable to infections from bacteria.
Other types of eczema include contact dermatitis, caused by contact with an irritant or allergen, such as make-up or jewellery, and discoid eczema, where circular patches of eczema develop.
What is psoriasis?
Like eczema, psoriasis is a skin condition which causes patches of dry, itchy and uncomfortable skin. However, one distinct difference is that psoriasis causes flaky patches of skin that form scales.
It’s a complex and varied condition which comes in different forms and severities and can make the skin feel intensely itchy and sore.
The most common form causes raised plaques of thickened skin which can appear red on lighter skin and may appear purple on darker skin tones.
The plaques may have a scaly appearance on top, which may look silver on lighter skin and greyish on darker skin tones.
While psoriasis can develop all over the body, it is more commonly found on the elbows, knees and scalp and sometimes even on the palms of the hands, soles of the feet and lower back.
The difference between eczema & psoriasis
The appearance of dry skin is one way to distinguish between eczema and psoriasis.
With plaque psoriasis, the skin is often more inflamed, and the patches of affected skin are raised with more well-defined borders.
Eczema has less well-defined borders and the skin isn’t as thick. It may also be distinguished by having a more skin rash-like appearance and you may see tiny red clusters of dots.
Noting where the dryness appears can also be helpful. Symptoms on the soles of the feet and palms of the hands, lower back, elbows, knees and scalp are generally more typical of psoriasis. Half of all people with psoriasis also get it on the finger and/or toenails and it may cause the nails to loosen and separate from the nail bed.
Atopic eczema is more commonly found in creases like the inner elbow and knees and may also appear on the wrists and ankles.
What are the causes of eczema & psoriasis?
Atopic eczema is the most common type of eczema which can sometimes run in families. It can affect anyone of any age, though it’s more common in children and is often found in people prone to allergies – atopic means ‘sensitivity to allergens’.
It can develop in people who have asthma and hay fever.
It’s caused by a mix of genetic and environmental factors and can be brought on by several triggers including everyday stress, soaps, detergents, hot weather and dry winters. It may also be triggered by certain types of food, especially in children with severe eczema.
Psoriasis causes skin cells to be replaced more quickly. The exact reason why this happens is unknown, but research suggests it’s thought to be caused by overactive T cells (a type of immune cell). In people with psoriasis, T cells make the body turnover new skin cells in a week or less, rather than three weeks to a month.
Like eczema, it can be triggered by everyday stress, but it may also develop in response to an injury, illness or hormonal changes.
Who does eczema & psoriasis affect?
One in five children and one in 10 adults in the UK has atopic eczema – the most common form of eczema.
Atopic eczema is more common in children and often appears before their first birthday. Some children outgrow their eczema but it can return in adulthood. You may also develop eczema for the first time as an adult.
Two in 100 people in the UK are thought to have psoriasis. It’s most common between the ages of 20 and 30 and also between ages 50 and 60.
Diagnosing eczema & psoriasis
Diagnosing eczema involves examining the appearance of the skin, as well as asking questions about you and your family’s medical history. They may ask about a history of allergies, asthma and hay fever which are common alongside atopic eczema.
Psoriasis is also often diagnosed on the basis of the appearance of the skin, but in rare cases, a biopsy may be carried out. If psoriasitic arthritis is suspected, you may be referred to a rheumatologist (a doctor who specialises in arthritis) who may do some blood tests and take some x-rays.
What role does the immune system play in eczema vs. psoriasis?
Both of these skin conditions involve the immune system, just in different ways.
With eczema, the immune system overreacts to triggers like allergens or irritants, causing red, itchy and inflamed skin. However, in psoriasis, the immune system mistakenly attacks healthy skin cells, making them grow too quickly and form thick, scaly patches.
While both are linked to immune system problems, the way the immune system acts and the symptoms it causes are different.
What is psoriatic arthritis?
Psoriatic arthritis is a condition that some people with psoriasis may develop as they get older.
Symptoms can include:
- Pain, swelling and stiffness in one or more joints
- Swollen fingers or toes
- Nails changing from their usual colour, or tiny dents or pits developing in your nails
- Feeling drained of energy
You may also get symptoms of psoriasis at the same time.
If you think you have this, you should speak to your GP to get treatment and support.
Treating eczema & psoriasis
Although eczema and psoriasis can’t be cured, they can be managed with certain treatments.
You can get help from your GP and in some situations, your GP may refer you to a dermatologist.
If you’ve been diagnosed with atopic eczema or plaque psoriasis by your GP and you’re seeking treatment specifically for flare-ups, the Boots Online Doctor Eczema Treatment Service* can give you access to advice and treatment for flare ups for atopic eczema, while the Boots Online Doctor Psoriasis Treatment Service* can provide support and treatment for plaque psoriasis.
There are a number of ways to treat and manage eczema including:
- Emollients to moisturise the skin daily
- Corticosteroids to help control a flare
- Avoiding triggers which may include bubble bath and washing up liquid
Keeping the skin well moisturised is the best preventative measure for eczema but you may occasionally need to use prescription medication to help manage flare ups.
Finding treatment to manage psoriasis depends on the severity and type you have. It can be a case of trial and error before you find something which works for you.
Treatments can include:
- Moisturisers and emollients to reduce dryness and make the skin more comfortable
- Topical steroids to reduce inflammation and irritation
- Vitamin D derivatives to apply to the skin to help encourage normal cell growth
- Ultraviolet light therapy recommended by a dermatologist for more severe cases
Both psoriasis and eczema may also benefit from self-care practices, especially if everyday stress is a trigger. Organisations like National Eczema Society and the Psoriasis Association are useful places to find out more about managing the psychological impact of these conditions.
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When to seek help
For some people, the above treatments may only provide mild, short-term relief. If you have been diagnosed with eczema or psoriasis and you feel your symptoms are not controlled or are worsening, you should speak to your GP. They can assess your symptoms and provide you with the appropriate treatment and advice to help you manage your condition moving forward.
Using Boots Online Doctor
You can use the Boots Online Doctor Eczema Treatment Service and Boots Online Doctor Psoriasis Treatment Service to get treatment without an appointment, if appropriate*.
To help, we ask you to complete an online consultation that takes five to 10 minutes. Your answers will then be reviewed by a clinician within 24 hours. If appropriate, they will provide you with treatment which you can pick up in store or have delivered to your home.
Frequently asked questions
Can you have both eczema and psoriasis?
While it’s quite rare, someone could have both eczema and psoriasis.
Can eczema turn into psoriasis?
No, eczema cannot turn into psoriasis because they are two different conditions.
Is coffee bad for psoriasis?
There isn’t enough evidence to say that coffee affects psoriasis.
How often should you shower with psoriasis?
Long, hot showers can cause psoriasis to flare up. Try to limit showers to five minutes and baths to 15, using warm water instead of hot.
Can you treat psoriasis and eczema the same way?
While some treatments overlap, each condition needs its own treatment plan. It’s important to know which condition you have and to follow your specific treatment plan.
