Psoriasis Vs. Eczema: How to Tell The Difference

Curated by Claudia Shannon / Research Scientist / Honayst

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 Psoriasis & Eczema Feel Different

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

Psoriasis could also 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.

The Differences In Appearances

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.

Psoriasis can also cause red patches. They may be silvery and scaly -- and raised. But if you look closely, the skin is thicker and more inflamed than with eczema.

Where They Show 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:

  • Fingernails and toenails
  • Mouth and lips
  • Eyelids
  • Ears
  • Skin folds

What Triggers Them

Eczema usually results from things that irritate your skin, like:

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

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

  • DustPets
  • Pollen
  • Mold
  • Dandruff
  • Some foods

Infections can start up eczema, and so can stress, sweating, heat, 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:

  • Vaccination
  • Sunburn
  • Scratches

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

At What Age Do They Start?

Eczema usually starts in 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 They're Linked To

Eczema usually comes along with 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 it.

How They Are Treated

Eczema treatment depends on how severe it is. For mild to moderate cases, you’ll use a topical corticosteroid to control inflammation, and you’ll use an emollient on your skin. This type of moisturizer has an oil or cream base, not a water base, like lotion, which could dry your skin out more.