Psoriasis and eczema can both cause dry, scaly skin. However, the causes and treatments are different. Psoriasis is an autoimmune condition, while eczema often flares up in response to certain triggers.
Psoriasis occurs when the immune system causes skin cells to grow faster than usual, and dead cells build up on the skin’s surface instead of falling away.
Both conditions can cause flushed, irritated, and itchy skin, but they have different causes and treatments. Below, we explore the similarities and differences in detail.
There are several types of psoriasis, and the symptoms can vary. Plaque psoriasis is the most common type, representing 80–90% of psoriasis cases.
Plaque psoriasis causes areas of thick, raised skin called plaques. These areas may be:
- differently sized
It is important to note that psoriasis can present differently depending on the color of a person’s skin. An inexperienced doctor may find it difficult to diagnose for this reason.
On white skin, for example, psoriasis can cause red patches, while on dark skin, it can cause gray, purple, or ashen patches. Psoriasis may be more severe in skin of color.
Eczema is most common in babies and children, but it can affect adolescents and adults. There are several types of eczema, but some common symptoms include:
- dry skin
- itchy skin
- rashes inside the elbows, behind the knees, and on the face, hands, and feet
Certain factors can trigger psoriasis episodes or worsen ongoing ones.
Some examples of these triggers include:
- dry, cold weather
- sunburn and hot weather
- excess alcohol consumption
- certain medications, such as lithium and some high blood pressure medications
Avoiding these triggers may help ease the symptoms.
A person may also be able to relieve mild-to-moderate discomfort and reduce dryness and itchiness by keeping the skin clean and moisturized. It is best to avoid harsh soaps and very hot water.
A doctor may prescribe one of the following medications to treat moderate-to-severe psoriasis:
- Topical corticosteroids: These medicated ointments or creams work by reducing inflammation and itching.
- Anthralin: This topical medication aims to slow the accelerated growth of skin cells.
- Coal tar: This topical product can help reduce inflammation and scaling. Over-the-counter and prescription versions are available.
- Salicylic acid: This is an ingredient in medicated shampoos and topical solutions. It can remove the scaliness of skin, which may help other medications work better.
- Synthetic vitamin D creams and solutions: Prescription vitamin D creams include calcipotriene and calcitriol, and they can flatten raised areas, slow skin cell growth, and remove scaliness.
- Topical retinoids: Retinoids are a form of vitamin A that can slow skin cell growth.
Light therapy, or phototherapy, is another treatment for psoriasis. This involves controlled exposure to UV light, which slows skin cell growth and reduces inflammation.
If topical treatments do not work, oral and injectable medications are available. These include oral retinoids, methotrexate (Trexall), cyclosporine (Gengraf), and immune-modulating drugs, such as
A doctor may also prescribe biologic medications. These address the cause of psoriasis by targeting the immune system. Examples of biologic medications for psoriasis include:
Eczema is a lasting condition that may get better or worse with time. It tends to affect children in greater numbers than adults, and some children may “outgrow” their eczema.
A person may go for quite some time without experiencing symptoms, then have a flare-up. Many factors can trigger flare-ups, including allergic reactions. For people with eczema, avoiding known allergens may
Other strategies for
- avoiding harsh soaps and highly fragranced products
- not taking long, hot baths or showers
- applying topical corticosteroid creams to itchy areas
- taking an antihistamine, such as diphenhydramine (Histergan)
- applying cool, wet compresses to the skin to reduce itchiness
- taking steps to reduce stress, such as by practicing meditation, yoga, or tai chi
- avoiding extremely hot temperatures, as sweat can worsen symptoms
A person can also reduce eczema symptoms by keeping their skin clean, moisturized, and dry.
If eczema is severe and does not respond to home treatments, a doctor can prescribe medicated creams and ointments to reduce symptoms and their occurrence.
In addition to topical corticosteroid creams, the doctor may prescribe calcineurin inhibitors. Examples include tacrolimus ointment and pimecrolimus cream. However, a person should use these with caution, as they carry warnings about a
Excessive itching can break the skin, which can become infected. If this happens, the person may need to apply a prescription antibiotic cream or take an oral antibiotic.
A doctor may recommend treating some cases of eczema with:
A person may also benefit from:
- bleach baths
- wet wraps
- consistent moisturizing
It is important to check with a doctor before trying these treatments.
If scratching during sleep is a problem, wearing soft gloves might help.
- hormonal changes
- materials such as wool or synthetic fabrics
- allergic reactions
- cold,dry weather
- pet fur
- dust mites
- harsh or highly fragranced soap, detergent, or shampoo
In addition, certain fungi and viruses, such as the human papillomavirus, commonly known as HPV, are associated with psoriasis. Understanding exactly how will require further research.
It is possible to have both of these conditions, and a person may need to use different treatments for each.
Examples of other conditions that can resemble some presentations of eczema and psoriasis include:
- athlete’s foot
- contact dermatitis
- seborrheic dermatitis, also known as “cradle cap” in infants
If a person has skin symptoms and the cause is unclear, they should receive medical guidance.
Ringworm is a highly contagious fungal infection that causes a circular rash under the skin. Antifungal medications can treat it.
Psoriasis is an autoimmune disease that is not contagious. It often causes thick, raised areas of skin that are a distinct color, texture, or both.
Eczema is also not contagious. It can be triggered by external factors, such as stress or fragranced products. It can present in many ways, but it often looks like a discolored, dry, itchy rash.
Psoriasis and eczema can respond to oral, topical, or injected medications.
Psoriasis and eczema are different health conditions that can have similar symptoms. The two have different causes and treatments.
However, using topical medications, avoiding triggers, and keeping the skin clean and moisturized can help ease symptoms of either or both of these health issues.