Distinguishing between eczema and psoriasis can be tricky so we’re here to help you understand the difference between these two skin conditions


Eczema and psoriasis are both dry skin conditions, 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.


So if you suspect either of these conditions could be causing you to have dry, itchy and uncomfortable skin, read on to find out more about them and how to manage your symptoms.


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, depending on your skin tone.


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 exacerbated 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, for example. 

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 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.


Psoriasis is commonly found on the elbows, knees and scalp but can also appear on the palms of the hands, soles of the feet and lower back, although it can develop on other parts of the body, too. 


Eczema & psoriasis differences


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 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?


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 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 stress, but it may also develop in response to an injury, illness or hormonal changes.


Who it affects


One in five children and one in ten adults in the UK has 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.


Diagnosis


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 psoriasis arthritis is suspected, you may be referred to a rheumatologist who may do some blood tests and take some x-rays.


Treating eczema and 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 eczema or psoriasis by your GP and you’re seeking treatment specifically for flare-ups, Boots Online Doctor* can give you access to advice and treatment for flare ups for eczema and 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 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.


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 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.


We have online clinics for contact dermatitis, eczema and psoriasis.


*Access to treatment is subject to a consultation with a clinician to assess suitability and eligibility. Charges apply.

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