Doctors Explain the Difference Between Eczema vs. Psoriasis

While certain skin conditions such as acne can seem easy to diagnose from home, others can be a bit trickier, like eczema and psoriasis. These two skin conditions, which usually present themselves in the form of a rash on the skin, are fairly common but very difficult to distinguish between.

Eczema, otherwise known as atopic dermatitis, is an itchy inflammation of the skin and usually appears in children and can continue to adulthood; psoriasis is a chronic condition that causes a buildup of scaly, dry patches on the skin, affecting areas like your scalp, elbows, knees, neck, and even your nails. While they can appear similar to the untrained eye, they're two very different conditions and therefore, should be treated accordingly. To help you better understand what you're dealing with, we asked two doctors to explain the difference between psoriasis and eczema ahead.

Elroy Vojdani, MD, IFMCP, is a functional medicine pioneer.

Dhaval Bhanusali, MD, is a board-certified medical and cosmetic dermatologist.

"Eczema is a general inflammatory skin condition and psoriasis is a specific autoimmune skin condition," functional medicine pioneer Elroy Vojdani, MD, IFMCP, tells PS. The main difference between the two is the cause. "Psoriasis is thought to occur due to immune dysregulation," says board-certified medical and cosmetic dermatologist Dhaval Bhanusali, MD. This is when the immune system attacks the body thinking it's a virus or bacteria. "Whereas eczema has a host of reasons that may cause it, including genetic mutations and environmental factors," he says.

The symptoms of eczema and psoriasis are very similar, which is what makes it so hard to tell the two apart, but there are a few minor distinguishing characteristics. "Psoriasis will go on the outer portion of a joint, so that's on the elbow itself or the top of the knees," says Dr. Vojdani. Dr. Bhanusali adds: "[It] presents as thick scaly plaques that are sometimes itchy."

Eczema, on the other hand, usually appears in the crease of joints, like behind the knees, in the bend of the neck, in armpits, and on eyelids. "Eczema tends to present as pinkish patches," says Dr. Bhanusali.

The triggers of eczema and psoriasis are nearly identical. Genetics, foods, medications, and stress levels can cause the skin conditions to flare up but it varies from person to person. "For eczema, often environmental factors, like weather [and] cosmetic products can trigger symptoms," says Dr. Bhanusali. According to Dr. Vojdani, foods with large amounts of histamine, such as strawberries, are another common eczema trigger.

Because eczema is an inflammatory condition, it's easier to treat than psoriasis. "Whereas, when someone develops an autoimmune condition like psoriasis, they are much more difficult to treat, and they cannot be reversed," says Dr. Vojdani. "They can only be placed into remission." But that doesn't mean there's no hope for those diagnosed with it.

"Both can be treated with topical steroids like triamcinolone or clobetasol," says Dr. Bhanusali. "If systemic symptoms occur, which is more common in psoriasis, we can add biologic medications." This is an advanced medication or injection that interrupts the immune system's natural response.

There are additional ways to manage psoriasis and eczema at home. This includes avoiding known triggers as much as possible, moisturizing the skin regularly, using a humidifier to keep the air in your home from getting too dry, and avoiding hot water showers or baths. Many people also find success in switching to fragrance-free, sensitive skin-safe products formulated with ingredients like ceramides. When flare-ups do occur, over-the-counter hydrocortisone can be used to alleviate irritation and itchiness.

"In the functional medicine space, we put patients on anti-inflammatory diets like a paleo diet and also reduce the consumption of high histamine-containing foods and support the gut environment with probiotics," says Dr. Vojdani.

To determine if you have eczema vs. psoriasis once and for all, and to get the best, most effective treatment, it's always best to see your doctor or dermatologist.

Jessica Harrington is the senior beauty editor at PS, where she writes about hair, makeup, skin care, piercings, tattoos, and more. As a New York City-based writer and editor with a degree in journalism and over eight years of industry experience, she loves to interview industry experts, keep up with the latest trends, and test new products.