How Can I Tell if It's Psoriasis or Eczema?

Maybe you're in your easy chair settling down for a little Sunday siesta. Or you're heading out the door for a day of fun in the sun. Either way, you stop and pause, because you've got an itch that just won't leave you alone -- along with blotches of red on your skin. What gives?

Your doctor needs to make the final call, but psoriasis or eczema could be the problem. Both are skin conditions with similar symptoms, but there are ways to tell them apart.

How It Feels

Eczema causes an intense itch. It can get so bad that you scratch enough to make your skin bleed.

If you have psoriasis, you also could be itchy, but there's something extra going on. Your skin may sting or burn. Some people say it feels like you're getting bitten by fire ants.

What It Looks Like

Eczema makes your skin red and inflamed. It may be scaly, oozing, or crusty. You may see rough, leathery patches that are sometimes dark. It can also cause swelling.

There are some things that are similar in the way psoriasis appears. You may have red patches. They may be silvery and scaly -- and raised up high. But if you look closely, the skin is thicker and more inflamed than eczema.

Where It Shows Up

Eczema often appears on parts of your body that bend, like your inner elbow or behind your knees. You can have it on your neck, wrists, and ankles. Babies sometimes get it on their chin, cheeks, scalp, chest, back, arms, and legs.

Psoriasis often shows up on places like your:

  • Elbows
  • Knees
  • Scalp and face
  • Lower back
  • Palms of your hands
  • Soles of your feet

You may also have patches on other areas, such as:

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What Triggers It

Eczema is often brought on by things that are irritating to your skin, like:

  • Soaps
  • Detergents
  • Disinfectants
  • Juices from produce or meats

Things that cause allergies can also set off eczema, like:

Infections can start up eczema, and so can stress, sweating, heat and humidity, and changes in your hormones.

Psoriasis shares some of these triggers, like stress and infection. But you can also get flare-ups when your skin is injured, for example by:

Some medications can also bring on a psoriasis flare, like lithium, which treats bipolar disorder, or drugs for malaria.

What Age Does It Start?

Most people get eczema when they're babies or young children. Often, symptoms improve when a kid becomes a grown-up.

It's less common, but possible, to get it as an adult. When that happens it's usually because you have another condition like thyroid disease, hormone changes, or stress.

Psoriasis, on the other hand, usually shows up between ages 15 and 35. But you can get it at other ages too. It's rare for a baby to have it.

Conditions It's Linked To

If you have eczema, you probably have dry, sensitive skin. You may have someone in your family who has it or has asthma or hay fever.

Psoriasis is linked to other serious health conditions. If you have it, you may also have diabetes, heart disease, or depression.

Whether it's psoriasis or eczema, your doctor can recommend ways to get relief for either problem.

WebMD Medical Reference Reviewed by Stephanie S. Gardner, MD on July 15, 2017

Sources

SOURCES:

American Academy of Dermatology: "Atopic dermatitis: Who gets and causes."

CDC: "Psoriasis."

National Eczema Association: "Eczema," "Symptoms of Eczema," "Causes & Triggers," "Treatment."

National Psoriasis Foundation: "About Psoriasis," "Life with Psoriasis," "Causes and Known Triggers," "Psoriasis Treatments."

O'Neill, J. Acta Dermato-Venereologica, April 2011.

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