Eczema vs psoriasis: The differences between these skin conditions

Eczema and psoriasis are two inflammatory skin diseases that can cause a great deal of discomfort thanks to the red, dry, scaly and itchy skin sufferers often experience.

Both of these skin conditions can range from mild to severe, with the latter often having a huge impact on one's quality of life. The good news? There are straightforward ways to relieve symptoms, avoid flare ups and soothe eczema and psoriasis.

Ready to find out how? Let's dive in.

What is eczema?

Eczema, also known as atopic dermatitis or atopic eczema, is a skin condition that weakens your skin barrier, causing bumpy, dry and itchy skin. Your skin barrier is responsible for retaining moisture and protecting your body from outside aggressors, but people with eczema have a dysfunctional barrier which can lead to more dehydrated and dry skin [1].

This impaired skin barrier also means you're often more susceptible to infection and you experience a skewed inflammatory immune response, causing skin to be easily irritated by fragrances and allergens [1].

Eczema is actually a form of dermatitis, which refers to a group of skin conditions that cause inflammation.

What is psoriasis?

Psoriasis is a chronic skin disease that causes flaky patches of skin on the body — these patches can look red, pink, purple or dark brown and form a scaly texture on the skin that are silvery, white or grey in colour.

This is the result of an overactive immune system, which leads to skin cells multiplying too quickly [2]. These scaly skin patches, which are also known as plaque psoriasis, can appear anywhere on the body but tend to pop up on one's knees, elbows, scalp and back.

How many psoriasis cases turn into psoriatic arthritis?

Psoritatic arthritis is an inflammatory condition that occurs in the joints and as the name suggests, is a form of arthritis. People are often diagnosed with psoriasis years before they realise they also have psoriatic arthritis but in some cases, the issues with one's joints can occur way before the skin patches appear [3].

Symptoms of psoriatic arthritis include stiffness, swelling and joint pain, which can appear across the body, from your spine to your fingertips [3].

But, how common is it for psoriasis to turn into psoriatic arthritis? Well, a review of 20 studies found "that the reported proportion of psoriatic arthritis among psoriasis patients ranges from 7% to 26%" [4]. So, while not all psoriasis cases develop into arthritis, it is a common issue and one to keep an eye on.

Eczema vs psoriasis: What's the difference?

While eczema and psoriasis can be lumped together as similar skin conditions, there are key differences between them.

• Appearance: While both conditions tend to look red, eczema can include rashes, swelling and bumps and in some cases, crusting and oozing. Psoriasis, on the other hand, causes red patches of skin with silvery scales [5].
• Positioning: Eczema and psoriasis tend to pop up in different areas of the body as well. Psoriasis is usually seen on the outside of elbows and arms as well as the front of your knees, while bouts of eczema tend to appear in skin folds and the crook of body parts, like your elbows and the back of your knees.
• Itching: Psoriasis can cause itchy skin but it's usually considered relatively mild. Eczema, on the other hand, is known for its intense itchiness, which is often incredibly uncomfortable.

To break it down even further, think of eczema as extremely dry skin, while psoriasis is like a plaque on the skin.

What causes eczema and psoriasis?

As we mentioned above, it's thought that psoriasis is caused by a problem related to the immune system where it attacks healthy skin cells — instead of making and replacing skin cells every 3-4 weeks, those with psoriasis tend to go through this process in 3-7 days [2].

This skin condition tends to run in families, meaning that it has a genetic component but experts aren't exactly sure what this is exactly. But, if you experience psoriasis, chances are someone in your family does too.

Eczema also seems to have roots in your genes, with family history playing a role in the development of eczema. You're also at a higher risk of this condition if you have a history of hay fever and asthma.

The immune system also plays a role in eczema, which activates your body's defence system when it indicates a trigger like bacteria, as it assumes its an invader. This can lead to an immune response of inflammation, which can flare eczema [6].

Can you have psoriasis and eczema at the same time?

Unfortunately yes. You can experience both psoriasis and eczema and they can occur at the same time, making for an uncomfortable experience. While it's considered rare to have an eczema and psoriasis flare up at the same time, know that it can happen, especially if you've previously experienced both.

Who is impacted most by psoriasis and eczema?

The risk factors associated with eczema and psoriasis are also different. For starters, eczema is most common in children — the lifetime prevaence of this condition is around 15-30% in kids and just 2-10% in adults. A staggering 60% of eczema cases tend to develop within the first year of a baby's life [1].

Research also shows that there is a corelation between eczema, asthma and hay fever (officially known as allergic rhinitis). Around 50% of people with severe eczema tend to develop asthma, while 75% develop hay fever [1].

On the flip side, psoriasis most often develops in adults, generally around the ages of 20-30 and 50-60 years old [2]. It's estimated that the prevalence of psoriasis in countries across the globe ranges from 0.09% to 11.4% [7].  

Psoriasis and eczema triggers

While the underlying causes of psoriasis and eczema lay in genetics and your immune system, there is a lot other set of triggers that can lead to flare ups of these conditions.

Eczema, for example, is hugely impacted by your environment and can become red and irritated as a result of outside aggressors. On the other hand, one's emotional well-being can also play a role. Common eczema triggers include:

• Harsh soaps and detergents
• Smoke and air pollutants
• Makeup and skincare products
• Dry weather and low humidity
• Heat and high humidity
• Stress, anxiety and depression [6]

While psoriasis is a life-long condition, you can actually be symptom-free for long periods of time — sometimes years! — before it's triggered by something environmental. These triggers can include:

• Cold, dry weather
• An injury to the skin, including a cut, sunburn or insect bite
• Smoking or exposure to smoke
• Certain medications including high blood pressure meds
• Withdrawal from oral or injected corticosteroids [8]

How to treat eczema and psoriasis

Before we dive into treatment options for both eczema and psoriasis, it's important to avoid triggers where possible. For those with eczema, do your best to steer clear of common allergens and irritants like soaps, heat, fabrics like wool and acrylic and anything else that might cause a trigger.

The same goes for psoriasis — do your best to avoid any triggers that you know could cause a reappearance of the pesky skin condition.

Eczema treatments

Treating a skin condition like eczema will require a treatment plan that is based on your individual circumstances. But, your plan might include the following steps.

• Apply a thick, gentle moisturiser every day, twice a day, to help skin protected and moisturised. Software's Ceramide Repair Balm is a great addition to your daily routine, with our gentle and hydrating formula working to replenish and protect the skin barrier with the help of ingredients like ceramides, hyaluronic acid and squalane
• Treat eczema flare ups with creams or ointments from your doctor or health practitioner — these can include steroid creams, also known as topical corticosteroids, which help to soothe inflammation and encourage skin healing [6]
• Oral medications like antihistamines and anti-inflammatory medications can also be helpful in controlling itching and swelling
• Light therapy is thought to help improve the appearance of eczema on the skin as it helps inhibit the inflammatory response that occurs in the skin [9]

Psoriasis treatments

Psoriasis treatments don't differ too much from eczema treatments. Here are a few things to consider when soothing psoriasis.

• Sun exposure can be incredibly helpful in clearing psoriasis and sufferers may find that their condition eases in the sunny months (be careful to limit your exposure to the sun as sunburn has the opposite effect on psoriasis and always use sunscreen, like Software's Daily Sun Defence SPF50+)
• Like eczema, light therapy is also considered effective in the treatment of psoriasis
• Baths can help soothe and soften the dry patches of skin
• The same goes for moisturisers and emollients, which can soften the psoriasis and relieve dryness
• Topical steroids are another common way to treat psoriasis and can be obtained from your doctor or health practitioner [10]

Be sure to talk to your doctor about any skin concerns and to explore treatment options.

Photo credit: Getty Images