Certain symptoms of eczema and psoriasis can help determine which condition you have. Eczema tends to develop in the folds of the skin, while psoriasis develops on outer surfaces, such as the elbows or scalp.
Eczema and psoriasis are two common skin conditions that can cause inflammation, irritation, and skin discoloration. The two conditions are very similar.
If you or your child has a chronic rash-like condition, it’s not always easy to know if it’s eczema or psoriasis. Fortunately, there are some significant differences in appearances and symptoms that can help you get a better idea of which condition you might be looking at.
A dermatologist can confirm a diagnosis and recommend a treatment plan. In this article, we take a closer look at these two skin conditions, including symptoms and causes, and how they’re treated.
Eczema and psoriasis are both chronic skin conditions. Sometimes, it can be difficult to tell at home which condition you or your child has.
A dermatologist is the best person to assess and diagnose either condition. But here are some significant differences between the two conditions that can help you get a better idea of which one you might have.
Eczema
Eczema (also called atopic dermatitis) is a condition that causes people to break out in itchy, flaky, irritated, and red skin. Severe eczema can disrupt sleep and can make it difficult to concentrate at work or school.
Eczema often develops during childhood, but it can start at any time. When eczema starts during childhood, it’s common for it to resolve by adulthood. When eczema starts later in life, the condition is often chronic.
Psoriasis
Psoriasis is a skin condition that causes dry, flaky, and red skin. Skin often piles up in thick patches called plaques.
Psoriasis can start at any age, but it’s more common in adults. It typically appears in early to late adulthood. While eczema only affects the skin, psoriasis can affect other parts of the body. Psoriasis can affect the nails, eyes, and joints. Inflammation of the eyes associated with psoriasis is called uveitis.
The symptoms of eczema and psoriasis can also help you determine which condition you have. For instance, eczema tends to develop in the folds and creases of the skin, such as behind the knees, on the neck, in the creases of the arms, and on the face.
Conversely, psoriasis typically develops on the outer surface of the skin in areas, such as the scalp, front of knees, and belly button. You can see a complete breakdown of symptoms in the chart below.
| Eczema symptoms | Psoriasis symptoms |
| dry skin | thick and raised skin areas called plaques |
| itchy skin | scaly skin |
| rashes in the folds of the skin, typically in the inner creases of the arms, on the face, hands, and neck, or behind the knees | itchy skin |
| differently sized raised areas | |
| red, gray, purple, or ashen skin patches | |
| typically located on the outer knees, scalp, belly button, and outer elbows | |
Eczema and psoriasis can look different on different people.
The severity of your condition, as well as your skin color, will affect how the condition appears. For example, on dark skin tones, psoriasis generally causes gray, purple, or ashen patches with silvery white scales. On light skin tones, it can cause red or pink patches with silvery white scales.
Eczema also appears differently on different skin tones. On light skin tones, eczema typically looks red. On dark skin tones, eczema flare-ups may look more brown, purple, or ashen than red.
The gallery below can give you a good idea of what these conditions look like on different skin tones.
Eczema and psoriasis have different causes and risk factors.
Psoriasis causes and risk factors
Psoriasis is an autoimmune condition. It happens when your body’s immune system overworks and attacks healthy skin cells. This causes your body to make new skin cells far too quickly. This leads to excess skin cells that form as skin plaques in psoriasis.
Eczema causes and risk factors
Medical science doesn’t know the exact cause of eczema. It appears to run in some families, and some people with eczema have a mutation on a protein-making gene called filaggrin. However, there are many people with eczema who don’t have this mutation or any family members with eczema.
Psoriasis and eczema triggers
Doctors do know there are triggers that can cause flare-ups of eczema or psoriasis. Triggers are different for individual people, but there are a handful of common triggers that tend to make both eczema and psoriasis worse in people who have these conditions. These include:
- stress
- dry weather
- cold weather
- bug bites, bee stings, and other injuries that cause allergic reactions in the skin
- harsh soaps
- dry skin
A dermatologist can often diagnose eczema or psoriasis after an exam and visual assessment. They’ll ask you questions about your health, symptoms, and allergies you have. They’ll examine your skin and nails and they may order tests, including:
- A patch test: A patch test can help determine if you have any allergies that may be causing rashes or reactions. For this test, a doctor will apply small amounts of different allergens and irritants to your skin and cover each area with a patch. You’ll return to the doctor 2 days later to remove the patches. A few days after that, you’ll return again so your doctor can perform a formal reading to assess your reaction to the irritants.
- Skin biopsy: During a skin biopsy, a small sample of skin tissue is removed. This sample is then sent to a lab. A skin biopsy can help diagnose psoriasis and eczema. It can also rule out similar conditions.
Can a ringworm infection be confused with eczema and psoriasis?
Eczema and psoriasis are chronic conditions that cause irritation and redness. Ringworm is a contagious infection that causes a distinct circular skin rash.
Although all three conditions affect the skin, ringworm is different from a condition like eczema or psoriasis. It’s caused by a fungal infection, and it can be treated with antifungal medications. It can also be transmitted from person to person.
Neither eczema nor psoriasis are contagious. Symptoms can be relieved with topical medications, but flare-ups cause symptoms to return.
There isn’t a cure for either eczema or psoriasis, but treatment can help relieve symptoms and prevent flare-ups. The right treatment plan will depend on your condition, the severity, and on your symptoms.
Psoriasis treatments
Common psoriasis treatments include:
- Controlling psoriasis triggers: Avoiding irritants and stressors is an important part of managing your psoriasis.
- Topical corticosteroid creams: Topical corticosteroids reduce inflammation and can calm itching.
- Medicated shampoos: Medicated shampoos can help treat scalp psoriasis. They’re available both over the counter and by prescription.
- Topical vitamin D: Vitamin D products can help slow down skin cell overgrowth and treat scaly skin.
- Topical retinoids: Topical retinoids can help stop skin cell overproduction.
- Oral medications: Oral methotrexate, acitretin, and apremilast (Otezla) are common medications used to treat psoriasis.
- Light therapy: Light therapy uses controlled exposure to UV light to reduce inflammation and slow down the growth of new skin cells.
- Injectable medications: Injectable retinoids and steroids can sometimes help when topical forms of these medications aren’t working.
- Biologic medications: Biologic medications target your immune system.
Eczema treatments
Common eczema treatments include:
- Controlling eczema triggers: Managing triggers is often one of the most effective ways of managing eczema.
- Antihistamines: Antihistamines can control itching.
- Topical corticosteroids: Topical corticosteroids can bring down inflammation.
- Light therapy: Light therapy uses UV light to reduce inflammation.
- Calcineurin inhibitors: Calcineurin inhibitors control inflammation.
- Biological medications: Biological medications target your immune system to bring down inflammation.
Can eczema turn into psoriasis?
No. Eczema and psoriasis are very different conditions. Eczema can’t turn into psoriasis. However, it’s possible for the two conditions to be mistaken for one another, especially in children. Sometimes, a child can receive a misdiagnosis of eczema, and then later get a correct diagnosis of psoriasis.
What percentage of psoriasis cases turn into psoriatic arthritis?
It’s estimated that between 20% and 40% of people with psoriasis will develop psoriatic arthritis.
Can you have both eczema and psoriasis at the same time?
Yes, it’s possible to have both conditions at the same time. The conditions aren’t affected by each other, and some people have both eczema and psoriasis.
Does either condition (eczema or psoriasis) ever go away?
When eczema is a childhood condition, it often resolves on its own by the time that child reaches adulthood. In most other cases, both eczema and psoriasis are chronic. There isn’t a cure for either condition. However, with treatment, symptoms can be managed, and flare-ups can be minimized.
It can be difficult to tell the difference between eczema and psoriasis. These two common skin conditions both cause inflammation and itching and can even be triggered by many of the same irritants.
However, there are some significant differences between the conditions. For instance, eczema tends to develop in places where the skin creases and folds, such as the neck or behind the knees, while psoriasis tends to develop on surface areas, such as the scalp or outer elbows.
No matter which condition you have, treatment can help manage your symptoms. Treatment depends on the severity of your symptoms, but often includes managing triggers and good skin care along with treatment options, such as corticosteroid creams and light therapy.