Can You Have Psoriasis and Eczema at the Same Time?

Psoriasis and eczema are skin conditions that cause patches of itchy skin and rash. They have similar symptoms but are different conditions with different causes.

Psoriasis is a chronic autoimmune disease that increases the speed at which you build skin cells. Eczema is also a chronic immune reaction and is the name for a group of conditions that cause rashes, itching, and skin inflammation. Eczema has seven types. Atopic dermatitis is the most common.

You can have psoriasis and eczema at the same time. According to the National Psoriasis Foundation, psoriasis most commonly begins in adulthood between the ages of 20 and 30. It also occurs in people around the age of 60. According to the National Eczema Association, eczema can start at any time in life.

Research suggests you can have eczema and psoriasis at the same time.

A 2021 review of 31 studies that included the words “atopic eczema,” “psoriasis,” and “co-existence” suggests that both atopic eczema and psoriasis occur 2% of the time. The results were the same regardless of whether psoriasis or atopic eczema was the condition diagnosed first.

A 2020 study included 38 children who received a diagnosis of both eczema and psoriasis, 41 children with only eczema, and 28 children with only psoriasis. Researchers were looking for differences in their immune systems and how the diseases interact.

The researchers suggest that while it’s possible for both conditions to occur together, it’s very rare for them to flare up at the same time. More commonly, one will flare while the other subsides. Although this study included children, the researchers also believe that the two conditions may appear and subside at different stages in life.

Psoriasis is sometimes treated with biologic medications that block the function of immune cells called T cells, or proteins in the immune system. One small 2022 study suggests that some people treated with biologics might develop a type of eczema flare called paradoxical eczema (PE).

In this study, 23 people with psoriasis treated with biologics developed PE 36 times. Of these, in 15 instances, people stopped taking the biologic but switched to another biologic class. One switched to a different biologic within the same class.

Nine people developed PE on more than one class of biologic, and two people continued to have PE despite discontinuing all biologic treatment.

Psoriasis and eczema share some similar symptoms that can make them hard to tell apart. Both psoriasis and eczema cause:

• itching
• a burning sensation
• redness on light skin and purplish on darker skin
• dry skin
• scaling

Symptoms unique to eczema

Eczema often begins in childhood but can develop during any stage of life. You might have eczema if you experience the symptoms above as well as:

• rash
• oozing fluid
• fine scaling
• blisters

Eczema typically appears on the face, hands, and feet. It also appears inside the elbows, behind the knees, and in other skin folds, especially in children. Adults may get eczema on their face or hands as well.

Symptoms unique to psoriasis

Psoriasis causes too many skin cells to grow too quickly. You might have psoriasis if you experience the symptoms above and:

• thick, silvery scaling patches on lighter skin
• purplish-gray, smooth, shiny patches on darker skin

Psoriasis can develop anywhere on the body but commonly occurs on the palms or feet, in skin folds, on the elbows, on the knees, or on the scalp.

Psoriasis patches are more well-defined and thicker, due to the overgrowth of cells.

To diagnose eczema and psoriasis, a doctor will ask questions about family history and health history. They will want to know if you have certain conditions, like asthma or hay fever. They may also ask if you have symptoms like joint pain or blood relatives who have eczema or psoriasis.

Your skin may be clear when you see a doctor. If a rash is present, they may take a skin biopsy. This requires numbing a small area and removing a tiny piece of skin to look at under a microscope.

If the doctor thinks you might have psoriatic arthritis, a type of psoriasis that causes joint pain, they may also draw blood to send to the lab and order an MRI scan or X-ray.

The location and type of rash often give the doctor insight into whether the rash is eczema or psoriasis.

You should contact a doctor if you have any painful, infected, or blistered rash, the American Academy of Dermatology Association advises. Eczema and psoriasis are chronic conditions, and a doctor may recommend a treatment that provides relief.

You should also reach out to a doctor if the condition worsens or does not improve despite treatment.

It’s suggested that atypical action by the immune system causes both eczema and psoriasis, two skin conditions that can closely resemble one another. More research is needed to understand the exact cause.

You can have both conditions, though they rarely flare up at the same time.

Typically, eczema rashes are dry, itchy, scaly patches found in the creases of the skin or on the hands and feet. Psoriasis patches are thick, silvery-white, or smooth red or purplish areas of skin that may itch, crack and burn.

Both psoriasis and eczema are chronic conditions that will flare and subside. Treatment includes medication, ointments and creams, and skin care.