Differences Between Eczema And Psoriasis
Visually, it can be difficult to tell atopic dermatitis and plaque psoriasis apart.
You have to look at all the clinical aspects of a rash to distinguish between eczema and psoriasis, including the history and the patients other medical problems, Dr. Fernandez notes. We can often visually distinguish psoriasis lesions from eczema lesions, but there are definitely times when we cannot tell the difference. In those cases, we perform biopsies.
He explains some of the differences between the two diseases.
Conditions That Can Look Like Eczema But Arent
Evan Starkman Brunilda Nazario, MD
Eczema is the name for a group of conditions that can make your skin irritated, inflamed, and itchy. Your doctor may call it atopic dermatitis, which is also the most common type of eczema. Youâre more likely to get eczema when youâre a child, but adults can get it, too.
The symptoms you have and where they show up on your body vary from person to person. You might have one or more of these signs:
- Red patches on white skin
- Gray or violet-brown patches on dark skin
- Oozing or crusty skin from scratching
- Swelling
Several health problems can bring on similar symptoms, so itâs important to talk to your doctor, a dermatologist, or an allergist to find out whatâs going on with your skin. They might tell you that you have one of these conditions that looks like eczema but isnât:
Psoriasis. This long-term condition is partly due to your immune system attacking your skin by mistake. Both psoriasis and eczema can bring on symptoms like:
- Red, scaly patches
- Dry, cracked skin
- Itching
Eczema patches tend to be thinner than psoriasis patches. Another difference: Fluid can ooze from your skin with eczema.
Scabies. This contagious condition happens when tiny bugs called mites burrow into the top layer of your skin and lay eggs. You might have symptoms like bad itching and a rash that looks like pimples. Like eczema, you could also get scaly-looking patches.
Acne. This skin condition can take several forms, including:
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What Causes Eczema In Infants And Children
Eczema is brought about by the complex interplay of a genetic predisposition and the childs environment. Many things from the climate to possible allergens can cause eczema to flare. We know that eczema tends to run in the families with a predisposition to other atopic diseases, such as food allergies, asthma and hay fever. Individuals with atopic dermatitis may lack certain proteins in the skin, which leads to greater sensitivity. Parents with eczema are more likely to have children with eczema. However, the exact way it passes from parents to children is still not known. Most children who have eczema will show signs of the condition in the first year of life. It tends to wax and wane in severity.
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Look For Visible Signs Of Infection
Examining your childs skin for signs of infection is the first step in determining whether your child is experiencing more than eczema. Of course, this isnt always easy. Eczema is typically itchy, red and scaly. When its flaring, the skin may even appear weepy, oozy or crusty from all the inflammation.
Still, skin infections caused by bacteria usually present with a red, hot, swollen and tender rash that often is accompanied with pus. Skin infections caused by viruses usually result in red welts or blisters that can be itchy and/or painful. Meanwhile, fungal infections usually present with a red, scaly and itchy rash with occasional pustules. Overall, if your child has pus-filled blisters, yellow or orange-colored crusts, swollen red bumps or streaks of redness spreading across the skin, its possible that theyve contracted an infection.
Eczema And Atopic Dermatitis Treatment
Your doctor may prescribe a corticosteroid cream or ointment to apply to your rash. This will help reduce itching and calm inflammation. Use it right after bathing. Follow your doctors directions for using this medicine or check the label for proper use. Call your doctor if your skin does not get better with regular use of the medicine.
Antihistamines like hydroxyzine reduce itching. They can help make it easier to not scratch. A new class of drugs, called immunomodulators, works well if you have a severe rash. Two drugs in this class are tacrolimus and pimecrolimus. These drugs keep your immune system from overreacting when stimulated by an allergen. However, they can affect your immune system. The Food and Drug Administration recommends that these drugs be used only when other treatments dont work.
Try not to scratch the irritated area on your skin, even if it itches. Scratching can break the skin. Bacteria can enter these breaks and cause infection. Moisturizing your skin will help prevent itchiness.
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What Other Questions Might My Healthcare Provider Ask To Diagnose Dermatitis
The conversation with your healthcare provider will need to cover a lot of information. Be sure to be specific about your symptoms.
- Where is your dermatitis located?
- What have you used to try to treat your dermatitis?
- What medical conditions do you have? Allergies? Asthma? Celiac disease?
- How long have you had symptoms of dermatitis?
- Do you take hot showers?
- Is there anything that makes your symptoms worse?
- Are you around chemicals?
- Have you noticed that something triggers or worsens your dermatitis? Soaps? Detergents? Cigarette smoke?
- Is there so much pain or itchiness that you have trouble sleeping? Working? Just living your normal life?
How Is Dermatitis Treated What Medications Are Used
The type of treatment depends on the type of dermatitis and its location. Step number one is to avoid whatever triggers the dermatitis. That may be stress, a chemical, tobacco smoke and/or a number of other irritants that cause or worsen your dermatitis. Step number two is to try remedies on your own. Step number three is medication prescribed by your healthcare provider.
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Wear Gloves To Protect The Skin On Your Hands
Wear vinyl or plastic gloves for work that requires you to have your hands in water. Also, wear gloves when your hands are exposed to anything that can irritate your skin. Wear cotton gloves under plastic gloves to soak up sweat from your hands. Take occasional breaks and remove your gloves. This will prevent a buildup of sweat inside your gloves.
Wear gloves when you go outside during the winter. Cold air and low humidity can dry your skin. Dryness can make your eczema worse. Wear clothes made of cotton or a cotton blend. Wool and some synthetic fabrics can irritate your skin.
Keep Your Skin Hydrated
There is no cure for psoriasis and multiple types of eczema, including atopic dermatitis, but you can help limit the symptoms by getting proper treatment and taking good care of your skin, Dr. Fernandez assures.
Dry skin is itchy skin, so one of the keys to managing these conditions is to try to keep your skin moist and hydrated. Dr. Fernandez recommends using a moisturizing cream or ointment, regardless of the need for prescription medications, if you have either eczema or psoriasis.
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What’s The Difference Between Eczema And Psoriasis
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Children get eczema. They can also get psoriasis.
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While more children develop eczema than psoriasis, almost 1% of children have psoriasis.
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Its not always easy to tell whether a child has eczema or psoriasis. A study conducted in Australia found that most children who had psoriasis were initially diagnosed by their primary care doctor as having another disease, often eczema.
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To a dermatologists trained eye, psoriasis and eczema tend to look quite different.
Is A Cure Or Better Treatment For Eczema On The Horizon
Without a cure on the near horizon, we here at Johns Hopkins are creating an Eczema Day Treatment Unit to help our patients with moderate to severe eczema keep their symptoms under control and prevent flare-ups. We anticipate that this novel, multidisciplinary program will include experts from Child Life, behavioral psychology, allergy, dermatology and infectious diseases to provide the comprehensive care these children need care that cannot be provided in an average clinic visit.
A primary goal of the day treatment unit will be education children and their families will learn techniques such as wet-wrap therapy, to help deeply moisturize the skin. This therapy involves coating the skin with a topical ointment, followed by a greasy ointment like petroleum jelly, then dressing in wet pajamas, followed by dry pajamas, allowing the skin to soak in the moisture.
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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.
What Worsens Dermatitis What Triggers It
Try your best to figure out what triggers your dermatitis. Its important to remember that it can affect people differently.
Is your dermatitis triggered by a chemical you clean with? Do you get it every time you go to your uncles house, because hes a smoker? Does your scalp feel itchy since you started that new shampoo? Did that rash on the inside of your wrist appear after you tried that new perfume? Does excessive sunlight make your dermatitis better or worse? Do you feel itchy every time you wear that wool sweater?
Remember what else worsens dermatitis: stress, hot showers, allergens like pollen and pet dander, etc. Find out what worsens your dermatitis and do your best to avoid it.
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How Is Each Treated
Eczema treatment depends on how severe it is. For mild to moderate cases, youâll use a topical corticosteroid to control inflammation, and youâll 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.
If you have moderate to severe eczema, you may need to try a medicine that affects your immune system like , methotrexate, azathioprine, or cyclosporine. If nothing else works, your doctor may prescribe a biologic drug called dupilumab . You might also try light therapy using ultraviolet light.
Psoriasis treatment is either systemic, which means it affects your entire body, or topical, which goes on your skin. If your disease is limited, or mild, you may be able to control it with topical corticosteroids and emollients.
Light therapy paired with methotrexate, cyclosporine, acretin, or a biologic is also an option for more severe cases. Or you could use just a biologic drug, which includes:
Are There Complications Of Dermatitis
There are complications that come with dermatitis. The following do not apply to all types, and do not apply to all people, but are still common:
- Viral skin infections. Try not to scratch because that can worsen the infection.
- Bacterial skin infections. Try not to scratch because that can worsen the infection.
- Sleep loss.
- Blepharitis .
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What Do Eczema And Psoriasis Have In Common
Atopic dermatitis and plaque psoriasis are different conditions, but they do have some similarities.
- They look similar. The conditions can be difficult to tell apart when they appear on your skin because they both cause dry, cracked and scaly skin.
- Theyre not infectious. Neither psoriasis nor eczema is contagious, Dr. Fernandez says. You cant pass them from person to person.
- They may be genetic. You can be genetically predisposed to either or both conditions, which means they may run in your family.
- They can impact anyone. Both conditions can impact people of any age, gender/sex or race.
What Is Psoriatic Arthritis
Up to 30% of people who have psoriasis get this condition as well. It causes inflammation and swelling in your joints that can lead to pain and stiffness.
If you have psoriasis and feel any discomfort in your joints, tell your doctor. It’s important to treat it quickly so your joints don’t get damaged.
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What Are The Risk Factors For Eczema
There are a few factors that can increase your risk of developing eczema.
Eczema is more common in children who suffer from asthma or hay fever as well as adults who develop these conditions before age 30.
People with family members who have eczema are also at higher risk of developing the condition.
Eczema can lead to some complications, including:
- Sleep troubles. Eczema can cause difficulty sleeping and disrupt your sleep hygiene.
- Skin infections. Repeated scratching can leave your skin open to bacteria and viruses that can cause infections.
- Asthma and hay fever. Eczema can often lead to developing asthma or hay fever, especially in children younger than age 12.
- Thick and scaly skin. Scratching can cause your skin to harden and thicken over time.
- Additional types of eczema. Often, having one type of eczema can increase your risk of another developing.
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.
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Is Psoriasis Contagious
You can’t “give” it to anyone, and no one can “catch” it from you.
“You can touch psoriasis all day long,” High says. “As a dermatologist ⦠I see at least one person if not a few people with psoriasis , and I don’t have it.” High adds, “My wife doesn’t have it. I didn’t bring it home. I don’t do special laundry. I don’t undress in the garage or anything like that.”
How Is Eczema Diagnosed
Theres no specific test that can be used to diagnose eczema. Often, a doctor can diagnose the condition by talking with you about your symptoms and examining your skin. Sometimes, a patch test might be done to help find eczema triggers.
A patch test can pinpoint certain allergens that trigger symptoms, like skin allergies associated with contact dermatitis
During a patch test, an allergen is applied to a patch thats placed on the skin. Your skin will become inflamed and irritated if the allergen is a trigger for you.
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Eczema Affects Everyone Differently
One persons triggers may not be the same as anothers. You might experience eczema symptoms at certain times of the year or on different areas of your body.
Eczema affects everyone differently. One persons triggers may not be the same as anothers. You might experience eczema symptoms at certain times of the year or on different areas of your body.
Common triggers include:
Whats The Difference Between Dermatitis And Rosacea
Rosacea can cause red skin that looks like dermatitis. However, rosacea can also cause pimples, and the redness is typically found on your forehead, nose, chin and cheeks. Have your healthcare provider take a look at your skin to determine if your condition is dermatitis, rosacea, or something else.
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Ways To Tell If Its Eczema Or A Skin Infection
Eczema is a skin condition that affects many infants and children. Although its symptoms of dry, itchy and flaky skin are usually mild, eczema can become more than just a nuisance. The more severe forms of this condition can lead to skin infections when bacteria, viruses and other germs enter the body through bleeding and cracking skin.
A skin infection can look a lot like the more serious form of eczema, making it difficult for parents to decipher their childs symptoms. Luckily, there are a few guidelines to follow. If your little one is suffering from swollen, itchy, crusty and/or oozing skin, here are three ways you can tell if they have eczema or a skin infection.
Living With Eczema And Atopic Dermatitis
Eczema can flare up when you are under stress. Learn how to recognize and cope with stress. Stress reduction techniques can help. Changing your activities to reduce daily stress can also be helpful.
The area where you had the eczema may easily get irritated again, so it needs special care. Continue to follow the tips provided here even after your skin has healed.
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Make Stress Relief A Daily Practice
Psoriasis patches can crop up with little warning. When they do, they may feel itchy, tight, and painful. âThat can be stressful, even if youâve been living with the disease for years,â Kaminska says. Trouble is, stress can trigger psoriasis flares and pain. You might feel like youâre stuck in a vicious cycle.
Thatâs exactly why itâs crucial to make stress relief a part of your everyday routine. How? âExercise at least three times a week,â says Charles E. Crutchfield III, MD, medical director of Crutchfield Dermatology in Eagan, MN. As it boosts your mood, exercise also lowers inflammation and helps to keep your weight in check, which can ease your symptoms. Deep breathing, meditation, or time spent on something you enjoy, like chatting with a friend, also can tame tension and raise levels of feel-good brain chemicals called endorphins.
If you canât seem to shake the blues or a bad self-image, consider seeing a social worker or psychologist. Cognitive behavioral therapy, which is a form of talk therapy focused on watching for negative thought patterns to change your feelings and behavior, can be especially helpful. Your doctor should be able to recommend a therapist.