Eczema and psoriasis are like twins –– they have a similar look, but deep down, they are fundamentally different.
Both eczema and psoriasis can cause a rash –– patches of red, raised, itchy skin — and they can appear in the same areas of the body, such as the hands and scalp. Neither is contagious but both can lead to infections. An experienced dermatologist may be able to spot the differences, but to the untrained eye, it’s hard to tell.
Although eczema can be more prevalent, psoriasis is also common. This makes self-diagnosis even harder, because the chance for getting either condition is high.
However, despite the confusingly similar appearances, there are clues that can help you tell them apart.
Genetics, Environment or Autoimmune: Which Causes Which
The biggest difference between eczema and psoriasis is the underlying causes. Psoriasis is an autoimmune disease, meaning your immune system is dysfunctional and your skin cells grow too fast. The cells start to pile up on the top of the skin, forming the white scale.
The cause of eczema is much more complicated and hard to determine. Both genetic and environmental factors could play a role in triggering the rash.
Researchers have found in some eczema patients that a gene responsible for creating a protective layer on the top of the skin has mutated (changed), leaving the skin prone to infection and flare. Climate can also play a role — people living in a dry climate or city where they are exposed to pollutants often have dry skin.
Subtle Differences in Itchiness
True — when you’ve got an irritating, itchy spot, who cares about the subtle difference? But this can help you and the dermatologist to decide which skin condition you are having.
Psoriasis tends to cause milder itching and, in some less common types of psoriasis, a terrible burn. Eczema, on the other hand, can lead to very intense itching. When it starts to become severe, some people scratch their skin so hard that it bleeds.
Both skin diseases can show up anywhere on your body, but they have their own favorite areas.
Psoriasis causes troubles commonly on the:
Eczema can occur in those places, but it most often inflames the skin on the back of the knees or the inside of the elbows.
Although you can get either disease at any age, eczema affects children more than psoriasis does.
Sunshine Can Ease Psoriasis But Not Necessarily Eczema
If you have eczema, summer might not be your favorite season. Some people with eczema are sensitive to heat. In hot weather, overheating can cause perspiration, which can lead to skin flaring up.
However, for most psoriasis patients, abundant natural ultraviolet B (UVB) light from sunshine can be a blessing. UVB light can slow down the abnormal growth of skin cells. It is used as a medical treatment for psoriasis.
But remember — too much of a good thing can become damaging. If you go sunbathing without using sunscreen or are exposed to sunlight for too long, overexposure can trigger psoriasis symptoms. If you start to feel itchy or see red spots, get out of the sun. Make sure to talk to your dermatologist about the best amount of time for exposure to the sun.
If you have itchy, red patches on any part of your body that don’t go away with over-the-counter medications, it’s better to see a dermatologist directly. Primary care providers can also help make a diagnosis and manage your symptoms, but a dermatologist has specialized training and extensive experience in recognizing the subtleties of the two skin conditions.
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