Eczema vs. Psoriasis

Vladimir Neychev, M.D., Ph.D., FACS

What are eczema and psoriasis? 

Both eczema and psoriasis are treatable yet incurable skin conditions that affect a wide range of people around the globe. Each has its own distinct causes, symptoms and treatments, but also overlap in some areas. 

• Psoriasis is caused by an overactive immune system that causes skin cell growth to speed up. It is actually an autoimmune disorder. This sped up production can create plaques, scaly patches and red splotches. Psoriasis is tricky to treat and manage because there are so many forms and causes of it. In comparison to eczema, psoriasis is a more serious, often more irritating and debilitating skin disorder. 

• Eczema refers to a number of skin-related conditions, all of which are triggered by some sort of stimuli that prompts the immune system to overreact. This time, instead of the immune system attacking itself (like with Psoriasis) it goes after external or internal triggers. Eczema can appear like red, itchy, inflamed patches and often comes up because of food allergies, weather irritation, fragrances and the like. Eczema can come and go throughout life and range in severity depending on one’s current skin condition, environment or stress levels. 

Is Psoriasis or Eczema More Common? 

Eczema and psoriasis affect millions of people worldwide, can come on at any point in life and require care and attention to mitigate symptoms and suffering. They are both chronic, common and can affect a wide array of people, although some population groups are adversely affected. 

• Psoriasis: 8 million Americans have this autoimmune condition, while it is estimated that 125 million people globally suffer from psoriasis. The autoimmune skin condition is much more common in adults than children and often develops in one’s 20’s to 30’s. 
• Eczema: This skin condition is much more common, affecting an estimated 30 million Americans. Contrary to psoriasis, eczema disproportionally affects children rather than adults and is likely to develop in childhood or adolescence. 

Psoriasis Has More Potential Complications. 

There are many different types of psoriasis as well as eczema, however, psoriasis has the potential to be more painful and complicated to treat. Eczema’s various forms are usually some type of dermatitis. 

• Plaque psoriasis. Plaque psoriasis is the most common type and causes dry, raised red to purple scaly patches. The most common areas for plaque psoriasis to occur are the elbows, knees, back and scalp but it may present anywhere. 
• Guttate psoriasis. Characterized by small, pink-colored dots that appear after an infection, guttate psoriasis can appear after an illness like strep throat, then subside on its own. 
• Pustular psoriasis. Small, pus-filled yellow blisters are a tell-tale sign of pustular psoriasis. This rare form creates bumps that look similar to white heads. 
• Inverse psoriasis. Inverse psoriasis appears like red, smooth patches within the folds of the skin, for example, in the breasts, armpits, buttocks or abdomen.
• Erythrodermic psoriasis. This is the only type that can be life threatening and is extremely rare. Erythrodermic psoriasis takes over much of the body causing a red, inflamed appearance, severe burning or itching sensations.  

What are the symptoms of Psoriasis?

These skin disorders share many of the same symptoms. Symptoms of psoriasis are: 

• Itchy skin
• Scaly patches of skin
• Silver-colored patches of skin 
• Skin cracking 
• Bleeding skin
• Swollen joints
• Stiff joints
• Burning sensations on the skin
• Thickened nail beds 
• Red skin

What are the symptoms of eczema?

• Itchy skin
• Leathery-feeling skin
• Oozing skin 
• Crusty skin
• Bleeding skin
• Swelling skin
• Discolored patches of skin
• Dry feeling skin
• Redness

Treatments for Eczema and Psoriasis 

Treatments vary greatly depending on which type of psoriasis or eczema one exhibits. 

Patients with both psoriasis and eczema usually must go through a trial-and-error method to find what treatments work with their skin type and outbreak needs. 

Psoriasis treatments may include: 

Topical treatments. 

• Topical corticosteroids. Topical corticosteroid creams need to be prescribed by a doctor but provide a great first-line of defense in suppressing current breakouts. 
• Topical retinoids. Retinoids that go on the skin, like Tazorac or Avage, are typically applied daily to minimize a current breakout or prevent future ones.  
• Anthralin. This tar-based paste is applied topically directly to psoriasis outbreaks and left for short periods of time. Depending on where your psoriasis occurs, anthralin may not be your best treatment option. 
• Vitamin D analogues. Lab-created forms of vitamin D, like calcipotriene and calcitriol, can slow skin cell growth. 
• Soothing moisturizers. Psoriasis causes much irritation so finding a lotion that doesn’t exacerbate irritation but soothes irritable skin can be a great help in quelling breakouts. Oatmeal lotions, calamine and chamomile creams that don’t contain fake fragrances are a wonderful option in soothing psoriasis breakouts. 

Alternative Therapies for psoriasis

• Light therapy. Consult with an Orlando dermatologist to see if exposure to UVB broadband and UVB narrowband rays is right for your type of psoriasis. 
• Stress management practices. Elevated stress or anxiety is a part of life, but can lead to outbreaks for this with chronic psoriasis. Creating a routine of stress management practices can help mitigate risk of outbreaks. 
• Diet. As much as possible, avoid drinking and smoking as these are irritants to the stomach, throat and skin. Take vitamin supplements like fish oil and a varied, rich diet of fresh, organic produce. 

Oral medication. 

• Methotrexate. 
• Cyclosporine. 
• Biologics. 
• Retinoids. 

Eczema treatments are often preventative and work to eliminate the trigger that causes eczema. As you work with a dermatologist to ascertain what causes your breakouts, you may move through the following list of potential treatments to see what works best. 

• Allergy medication.
• Restrictive diets if food is a trigger. 
• Stress relief practices
• Using mild detergent, personal care products and fabric. 
• Cold, wet compress on inflamed skin
• Avoiding hot baths or showers
• Using a soothing, organic body lotion to keep skin moisturized

Schedule an Appointment Today

If you are experiencing chronic skin inflammation, irritation or redness, consult with a dermatologist to determine if you have psoriasis or eczema. UCF Health’s patient portal connects our community to local health care professionals whose top priority remains human health and wellbeing. It also provides current COVID-19 updates and healthy lifestyle tips. Use our online scheduling tool to book an appointment, today.