A healthy living blog from Marshfield Clinic

Control persistent rashes with the right diagnosis

graphic of man walking through the park scratching his head in pain / psoriasis vs eczema

Itchy skin rashes like psoriasis and eczema can affect your job, school and social life.

Are you desperate for relief from red, irritated skin?

Psoriasis and eczema are common culprits of uncomfortable rashes. Knowing which one is causing your skin problem is crucial to relieving irritation.

“There can be a lot of overlap in symptoms, making it difficult to tell them apart,” said Dr. Clayton Green, a Marshfield Clinic dermatologist.

If you have a persistent rash, make an appointment with a dermatologist to learn about treatment options.

Eczema and psoriasis: Similarities and differences

  • They can cause itching. Itching is a requirement for an eczema diagnosis. Psoriasis can itch, but no itching is involved in about 30 percent of cases.
  • They cause redness. Eczema is a wet, weepy red rash while psoriasis is a dry, thick, scaly red rash.
  • They occur on or near the same body parts. Eczema usually shows up on the inner forearms and backs of the knees. Psoriasis strikes on the opposite sides of the same body parts – on the kneecaps and outer elbows. Eczema often affects the face, but psoriasis usually doesn’t. Both rashes can affect the hands.
  • They are lifelong conditions. Eczema and psoriasis go through phases of being fine and flaring up, but both need lifelong management.
  • They often occur alongside other health conditions. People who have eczema tend to have seasonal allergies and asthma. Psoriasis often occurs alongside autoimmune arthritis, Type 2 diabetes, obesity and heart disease.
  • Neither is contagious. Only a small number of rashes are contagious, and psoriasis and eczema aren’t among them.
  • They usually first appear at different stages of life. Eczema usually shows up for the first time in early childhood. Kids can get psoriasis, but it’s not common. It’s more likely to begin in the late teens/early 20s or when someone reaches their 60s.

Many treatment options are available

Good news: Eczema and psoriasis can be managed to reduce symptoms.

Eczema occurs when the skin barrier can’t stay hydrated. The skin becomes irritated when the top layer loses too much water.

“Applying thick, fragrance-free moisturizer to damp skin is very effective in sealing in hydration and preventing flare-ups,” Green said.

Taking warm or room temperature showers or baths and avoiding products and situations that irritate or dry out skin help keep eczema under control. Prescription steroid creams can help control more stubborn cases.

Psoriasis occurs when the immune system triggers skin cells to multiply faster than normal. Treatments including creams, ointments, oral medications and sometimes injections aim to reduce symptoms, slow skin cell reproduction or control the immune system.

Skin disorders affect quality of life

“Psoriasis and eczema aren’t just skin problems,” Green said. “People get teased because of how their rash looks or avoided because others think the rash is contagious.”

Itchy or painful rashes often are distracting and affect sleep, work and school performance.

Living with a chronic skin condition can be lonely and difficult. Online support groups can connect you with people having similar experiences. The National Eczema Association and National Psoriasis Foundation are good sources of information and support.

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