If you’ve got itchy, discolored, and flaking patches of skin, it’s natural to be a bit concerned about what’s causing those symptoms. And while it’s always best to book an appointment with a dermatologist when new skin symptoms crop up, it’s inevitable that you’ll be doing a little bit of self-diagnosis (hello, internet research rabbit hole), and likely doing a psoriasis vs. eczema comparison.
Psoriasis and eczema are two fairly common skin conditions, and both cause symptoms of itching and visible inflammation. These two conditions also share a few other similarities: They’re both chronic, which means symptoms are managed, not cured, and both can be triggered by genetics and environmental factors.
That being said, the treatment options and long-term management of psoriasis and eczema are quite different. So, it’s important to know for sure which one you are dealing with. “Both eczema and psoriasis cause inflamed, scaly areas on the skin, and to the untrained eye, they can look similar,” Alan J. Parks, MD, a board-certified dermatologist in Columbus, Ohio, tells SELF.
SELF spoke with several board-certified dermatologists to lay out the difference between eczema and psoriasis.
What are psoriasis and eczema, exactly?
Psoriasis is an autoimmune condition that affects about 7.5 million Americans, according to the American Academy of Dermatology. It happens when your skin cells go through their life cycle more quickly than normal. Typically, it takes about a month for skin cells to regenerate, but in people with psoriasis, this cell-turnover process happens every three to four days, according to the Cleveland Clinic. The buildup of new skin cells results in flaky scales on the skin’s surface.
Eczema is much more common than psoriasis, affecting between 2 and 10% of all adults.1 Eczema causes patches of dry, itchy skin that tend to turn into a rash when you scratch or rub it. These patches are prone to bacterial, viral, and fungal infections. That’s because, at its core, eczema is tied to a gene variation that affects the skin barrier and its ability to protect your skin from everything from bacteria to irritants and allergens. Eczema flares are triggered by environmental and lifestyle factors, such as irritating skin care products, dry skin, and stress. The main symptom of eczema is itchy, flaky skin, but people who have eczema as children are more likely to develop asthma and environmental allergies.
Why are eczema and psoriasis sometimes mistaken for each other?
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Eczema may sometimes be mistaken for psoriasis because it causes a painful, itchy rash that may even appear raised. To the untrained eye (or anxious self-diagnoser), this might make an eczema patch look like a psoriasis plaque.
Psoriasis and eczema aren’t likely to be confused by a trained dermatologist, though, Azeen Sadeghian, MD, FAAD a board-certified dermatologist in Baton Rouge, Louisiana, tells SELF. But she notes that there are some exceptions. “Some cases are challenging because the eczema patches have become thickened enough to resemble psoriasis,” she says. Experts call this thickening “lichenification.”
It’s tempting to think of eczema as “psoriasis light,” which will eventually worsen and become psoriasis. But eczema will not develop into psoriasis. They are two separate conditions, with separate underlying causes. However, it is possible to have both eczema and psoriasis. This condition is called eczematous psoriasis, sometimes known as PsE, according to a 2015 study published in the Journal of Clinical Medicine.2
Both psoriasis and eczema cause redness on lighter skin tones. If you have darker skin, that redness might look more like brown or purple discoloration. These differences can sometimes lead to a misdiagnosis, or a delay in the time it takes to get a proper diagnosis, according to the National Eczema Foundation. “It might be harder to perceive redness or what we call erythema because of the pigment of the skin,” explains Dr. Sadeghian. She also points out that psoriasis can rev up the pigment production in skin of color, causing darker plaques.
The National Psoriasis Foundation notes that a delay in diagnosis can mean people with darker skin tones aren’t able to take advantage of early treatment options. Research is still underway to understand how to best identify psoriasis in people with darker skin tones.
What is the age of onset for psoriasis vs. eczema?
One big difference between eczema and psoriasis is the age of diagnosis. Eczema is commonly found in children, many of whom grow out of their symptoms or see a severe reduction in symptoms as they age. That doesn’t really happen with psoriasis.
Source: SELF
