Psoriasis vs. Eczema: How to Tell the Difference

Do you have dry patches of red itchy skin that won’t go away? If you do, you may be suffering from psoriasis or eczema. Psoriasis and eczema are chronic skin conditions. Sometimes they look so similar that doctors can struggle to tell the difference.

They have similarities such as red patches and itchiness. They both can cause dry and scaly skin. However, there are different types of each condition, some of which are more easily recognizable than others.

Getting to Know Psoriasis

In the United States, as many as 7.5 million people have psoriasis. (NPF, 2018) 

Psoriasis is a chronic autoimmune disease, which means the immune system attacks healthy cells mistakenly.

People who have psoriasis may experience flare-ups that subside after a few days or weeks. Sometimes psoriasis causes are unknown, but psoriasis triggers include infection, bug bites, scrapes to the skin, or sunburn.

There are five main types of psoriasis. Learning which one you have can help you understand which treatment is best for you.

Plaque Psoriasis

Plaque psoriasis is the most common form of this disease.

It causes thick, scaly patches on the skin. These raised patches may be red or may have a silvery color. The silvery color is due to a build-up of dead skin cells.

Plaque psoriasis most commonly appears on the elbows, knees, scalp, and lower back, although you may have it show up in other areas. Typically, plaque psoriasis symptoms include itchiness and pain.

When the skin gets really dry, it can crack and bleed.

Guttate Psoriasis

Guttate psoriasis affects about 10 percent of people who develop psoriasis. (NPF, 2018)

‍It has the appearance of small red lesions that can vary from the size of a pinhead to the size of a penny. The lesions can appear on the face, scalp, and ears, though you may also have them on your torso. Guttate psoriasis causes itchiness and pain. It often begins in childhood.

This form of psoriasis can also coexist with plaque psoriasis.

Inverse Psoriasis

Also known as intertriginous psoriasis, inverse psoriasis occurs in the body’s folds such as in the groin, behind the knee, or in the armpit. It has the appearance of very red, smooth, and shiny lesions. This form of psoriasis causes itching and skin irritation. It can also coexist with other types of psoriasis.

Pustular Psoriasis

Pustular psoriasis derives its name from the appearance of blisters which contain white pus surrounded by red skin. The pus contains white blood cells, and the condition is not infectious.

Pustular psoriasis can occur anywhere on your body, but it’s most common on the hands and feet. This condition is itchy and painful. It can make it difficult to move your fingers and toes.

Erythrodermic Psoriasis

Erythrodermic psoriasis is a very severe form of psoriasis and can, in some cases, be life-threatening. It causes bright red lesions over most of the body. It can also cause itching and severe pain.

Erythrodermic psoriasis can cause the skin to come off in sheets. It's a rare form of psoriasis — it occurs only once in the lifetime of 3 percent of people living with psoriasis. (NPF, 2018)

Getting to Know Eczema

Eczema affects 10 percent of adults in the United States. (NPF, 2018)

‍Like psoriasis, eczema is a condition involving immune dysregulation, however it isn’t absolutely clear as yet that there is an autoimmune component.

Like psoriasis, eczema  can cause itchy, scaly lesions on the skin. People suffering from eczema will often have flare-ups where the condition worsens for a period of time. Eczema flare-ups can be triggered by some chemicals including perfumes, hot water, woolen clothes, sweat, sunscreen, soaps, shampoos, and stress.

There are five main types of eczema.

Atopic Dermatitis

This type of dermatitis is a chronic inflammatory disorder and is strongly associated with hay fever and asthma. Typically, it begins in childhood.

Though the exact cause is unknown, a flare-up is triggered when your body has an extreme response to an irritant inside or outside your body. Symptoms of atopic dermatitis include dry, scaly skin, red patches, itching, and crusted or weeping sores.

Contact Dermatitis

This form of eczema occurs when an allergen or irritating substance touches the skin. There are several subtypes of contact dermatitis, although irritant and allergic contact dermatitis are the most common.

Typically, this condition occurs on the hand, but it can also occur on other parts of your body. Symptoms of contact dermatitis include red, inflamed, and itching skin. The most common triggers for contact dermatitis include paints, tobacco, industrial chemicals, skin care products, and wool.

Dyshidrotic Eczema

Dyshidrotic eczema causes tiny, itchy blisters on the edges of feet, toes, palms, and fingers. Triggers for this type of eczema include seasonal allergies, exposure to specific metal plated jewelry, as well as moist hands, and feet. The blisters can worsen to form deep cracks. This type of eczema may become chronic and painful.

This form of eczema is twice as common in women as it is in men.

Nummular Eczema

Also known as discoid eczema, nummular eczema can occur at any age, although it is more common in men. It differs from other types of eczema, which can sometimes make it tricky to treat. This condition causes red, inflamed discs to appear on the skin, which can be very itchy. It can also cause weeping, open sores. Nummular eczema triggers include dry skin, exposure to chemicals such as formaldehyde, or exposure to metals such as nickel.

Seborrheic dermatitis

Seborrheic dermatitis is a chronic form of eczema and can occur at any age. It typically occurs on areas of the body that produce a lot of oil from the sebaceous glands. These include the scalp, nose, and upper back.

When seborrheic dermatitis occurs on the scalp, it is commonly called dandruff.

The exact cause of this condition is unknown, though it is thought that genetics and hormones may play a role. It may also be triggered by microorganisms that live on the human skin, such as yeast. People with Parkinson’s disease, HIV, or AIDS are more at risk of seborrheic dermatitis than others. This condition can cause red, itchy skin with yellowish or white crusty flakes.

Treating Psoriasis and Eczema From the Inside Out

Eating an anti-inflammatory diet may help to mitigate some of the symptoms of psoriasis and eczema. An anti-inflammatory diet aims to reduce low-grade chronic inflammation, which is a critical factor in both these diseases. An anti-inflammatory diet is one which is rich in:

Antioxidants

• Berries
• Artichokes
• Apples
• Sweet potatoes
• Avocados
• Broccoli
• Nuts beans
• Whole grains
  

Omega-3 fatty acids

• Mackerel
• Salmon
• Walnuts
• Oysters
• Flaxseeds
• Soybeans
  

Spices

• Ginger
• Turmeric
• Garlic
• Paprika
  

Additionally, avoiding gluten-containing foods and alcohol can make a significant positive difference as both of these substances increase intestinal permeability which is a feature of autoimmune diseases.

Further, an elimination diet can help to pinpoint foods that are problematic for each individual.

Probiotics such as Lactobacillus may also help reduce skin inflammation. Probiotics are live bacteria and yeasts that live in the human gastrointestinal tract. They help to maintain the digestive and immune systems, can be found in yogurt and fermented foods such as kefir, and can also be taken in the form of a nutritional supplement.

In a small study of people with psoriasis, Bifidobacterium infantis 35624 was found to reduce inflammatory markers. This is available in the probiotic Align.

When it comes to probiotic use for eczema, there is more evidence for use in children including as a preventative. These include probiotic products such as Metagenics UltraFlora Baby, nu Skin ProBio PCC and Xymogen Probio Defense.

You should consider avoiding food that can increase your body’s production of inflammatory chemicals. These include foods which are rich in omega-6 fatty acids, such as vegetable oils including corn oil and safflower oil), meat, and dairy products. Sugar, refined grains, and processed food may also trigger an inflammatory response.

Though there is no cure for psoriasis and some forms of eczema, you may be able to limit your symptoms by keeping your skin hydrated and maintaining a healthy diet.

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