How to Tell the Difference Between Eczema and Psoriasis

Last Updated: November 18, 2020 References

Eczema and psoriasis are conditions that affect the skin. They both produce red areas or bumps on the skin, so they can be difficult to tell apart. Eczema starts earlier in life and usually causes more itching, while psoriasis develops later and is characterized by thick patches of skin.^{[1]
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Expert Source

Heather Richmond, MD
Board Certified Dermatologist
Expert Interview. 15 September 2020.} Learn how to tell the difference between eczema and psoriasis so you can get the proper treatment.

Method 1

Method 1 of 3:

Identifying Eczema

1
Monitor for red-brown patches. Eczema and psoriasis both cause red patches on the skin; however, eczema has red patches that may also have a brownish or gray tint to them. The skin may also be covered in smaller bumps that are filled with fluid or that are crusty.^{[2]
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Mayo Clinic
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- The red patches of skin may be covered in raised bumps that look like goosebumps.
- The affected skin may thicken or develop knots.
- The color may be darker or lighter depending on the type of eczema, how long it has been affecting you, or how serious the flare up is.
2
Check for dry skin. Eczema often makes your skin dry.^{[3]
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Expert Source

Heather Richmond, MD
Board Certified Dermatologist
Expert Interview. 15 September 2020.} Your skin may be flaky or peel off when scratched. In extreme cases, the skin may be cracked because it is so dry.^{[4]
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Research source}
- The skin may crack and ooze a clear substance. The cracked skin may lead to skin infections.
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3
Identify where eczema occurs. Eczema often occurs on the inside of the elbows, the back of the knees, the wrists, and the ankles.^{[5]
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Expert Source

Heather Richmond, MD
Board Certified Dermatologist
Expert Interview. 15 September 2020.}
- In babies, eczema tends to start as red, wavy plaques on the face, especially on the cheeks. It might also appear on the scalp and the outer areas of the arms and legs.
- Later in childhood, eczema will become more localized in the arms, especially the bend of the elbow, as well as the bend of the knee, and sometimes the neck and face.

Method 2

Method 2 of 3:

Recognizing Psoriasis

1
Look for red patches of skin. The most common symptom of psoriasis is thick, scaly, raised red patches of skin.^{[6]
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Expert Source

Heather Richmond, MD
Board Certified Dermatologist
Expert Interview. 15 September 2020.} The patches of red skin are covered with silver-colored or white scales. A different type of psoriasis may have small red spots all over the skin. Psoriasis may also cause swollen red areas of the skin or bumps with pus.^{[7]
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Professional organization made of over 20,000 certified dermatologists
Go to source}
- The raised scaly patches of skin are extremely dry. The patches may crack and bleed.
- Pus-filled bumps will dry out and may turn brown or become scaly.
2
Notice the areas where afflicted. Where the red areas appear on your skin depends on the type of psoriasis you have. Psoriasis can happen pretty much any place on your body. If you have the large, thick silvery-red scales, this can be anywhere, including your mouth or genitals. Mostly it forms on the knees, elbows, lower back, and scalp.^{[8]
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Mayo Clinic
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- Guttate psoriasis causes small red bumps mostly occur on the torso, back, arms, legs, and scalp.
- Inverse psoriasis gives you patches of red skin along the folds of your skin, such as on your armpits, groin, under the breasts, along your buttocks, and around your genitals.^{[9]
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- You may also get psoriasis of the nails or hands. Pustular psoriasis may only affect the palms or the soles of the feet.
- In babies, psoriasis may occur first on the face or the diaper area. In children and adults, you're more likely to see it on the knees and elbows.
3
Check for pain. Psoriasis sometimes causes pain. The red patches on your skin may have a burning sensation or become sore and tender. Some bumps may cause blisters that are painful to touch or throb. You may also experience swollen or painful joints.^{[10]
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Mayo Clinic
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- Some psoriasis may leave the skin feeling raw and achy.
- Psoriasis tends to be less itchy than eczema.
- You may also have pain due to psoriatic arthritis, which is inflammation of the joints—it's similar to rheumatoid arthritis.^{[11]
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  Expert Source
  
  Heather Richmond, MD
  Board Certified Dermatologist
  Expert Interview. 24 September 2020.}
4
Determine if there was a related cause. Some psoriasis may occur after or alongside other conditions. Some types of psoriasis, such as the small red bumps, may show up after certain illnesses like strep throat.^{[12]
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- Some forms of psoriasis may be accompanied by fever, fatigue, chills, muscle weakness, or an overall feeling of sickness.
- Some types of psoriasis are accompanied by rapid heart rates or a rapid pulse.
- Psoriasis is an autoimmune condition, and it can also have genetic components.^{[13]
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  Expert Source
  
  Heather Richmond, MD
  Board Certified Dermatologist
  Expert Interview. 24 September 2020.}
- Psoriasis can also be associated with metabolic syndromes such as diabetes, hypertension, or high cholesterol.^{[14]
  X
  Expert Source
  
  Heather Richmond, MD
  Board Certified Dermatologist
  Expert Interview. 24 September 2020.}

Method 3

Method 3 of 3:

Telling Eczema and Psoriasis Apart

1
Notice when it occurs. Eczema and psoriasis affect people at different times in their life. This can help you determine which condition the person has. Eczema is common in babies and young children. Psoriasis is common in young adults or the elderly. If the condition starts in childhood, it’s probably eczema, but if it starts as a teenager or adult, it’s more than likely psoriasis.
- Eczema may occur in adults, but it mostly occurs in small children. Generally, the eczema gets better as the child grows up.
- Psoriasis is most common between the ages of 15 and 30. It may also begin between the ages of 50 and 60.^{[15]
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  American Academy of Dermatology
  Professional organization made of over 20,000 certified dermatologists
  Go to source}
2
Determine the cause. Eczema and psoriasis are triggered by different things. Psoriasis is caused by an unknown underlying reason, but some factors like stress, cold weather, damage to the skin, or medication side effects may cause it. Eczema occurs as a reaction to environmental factors.^{[16]
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Research source}
- For example, eczema may occur if a person is exposed to allergens like pet dander or hair, jewelry metal, fragrances, detergents, or stress.
- Psoriasis is thought to be caused by genetic factors. It may also be associated with metabolic syndromes, such as diabetes and hypertension.^{[17]
  X
  Expert Source
  
  Heather Richmond, MD
  Board Certified Dermatologist
  Expert Interview. 15 September 2020.} Some triggers such as strep throat, cold, dry weather; or a cut, scratch or sunburn can also trigger psoriasis if you're already genetically predisposed.^{[18]
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  Trustworthy Source
  American Academy of Dermatology
  Professional organization made of over 20,000 certified dermatologists
  Go to source}
3
Notice the intensity of the itching. Both psoriasis and eczema can cause skin discomfort. The difference in the intensity of the discomfort or itching can provide some insight on which condition the person has.^{[19]
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American Academy of Dermatology
Professional organization made of over 20,000 certified dermatologists
Go to source} If you have psoriasis, itching the skin may cause the skin or inflamed area to thicken.^{[20]
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American Academy of Dermatology
Professional organization made of over 20,000 certified dermatologists
Go to source}
- Psoriasis may be accompanied by mild or moderate itching; however, with psoriasis the skin or area may be painful to touch.^{[21]
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- If it’s eczema, the itching may be intense or severe, especially at night. The itching may keep someone up because it’s so bad.^{[22]
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  Mayo Clinic
  Educational website from one of the world's leading hospitals
  Go to source}

Expert Q&A
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Question

What does psoriasis look like?

Heather Richmond, MD
Board Certified Dermatologist
Dr. Heather Richmond, MD is a board certified Dermatologist at Dermatology and Laser Surgery Center in Houston, Texas. With over nine years of experience, Dr. Richmond specializes in comprehensive dermatology including medical, surgical, and cosmetic procedures. She graduated cum laude from Yale University with a BA in Molecular, Cellular, and Developmental Biology. She earned her MD from the University of California, Irvine School of Medicine, where she was inducted into the Alpha Omega Alpha Honor Medical Society. She completed her Internal Medicine internship at Cedars-Sinai Medical Center and her Dermatology residency at The University of Texas MD Anderson Cancer Center in Houston. Dr. Richmond is a fellow of the American Academy of Dermatology and is a member of the American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, and the Texas and Houston Dermatological Societies.

Heather Richmond, MD

Board Certified Dermatologist

Expert Answer

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Usually, psoriasis looks like thick, red patches of skin that tend to be scaly. It can occur anywhere, but it most frequently shows up on the skin outside of joints, like your knees or elbows.
Question

Can I treat mild psoriasis at home?

Mohiba Tareen, MD
FAAD Board Certified Dermatologist
Mohiba Tareen is a board certified Dermatologist and the founder of Tareen Dermatology located in Roseville, Maplewood and Faribault, Minnesota. Dr. Tareen completed medical school at the University of Michigan in Ann Arbor, where she was inducted into the prestigious Alpha Omega Alpha honor society. While a dermatology resident at Columbia University in New York City, she won the Conrad Stritzler award of the New York Dermatologic Society and was published in The New England Journal of Medicine. Dr. Tareen then completed a procedural fellowship which focused on dermatologic surgery, laser, and cosmetic dermatology.

Mohiba Tareen, MD

FAAD Board Certified Dermatologist

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You may be able to manage mild psoriasis by keeping your skin moisturized and minimizing your time in the sun. However, see your doctor if your psoriasis is painful or really bothers you.
Question

Do I need to see a doctor if I think I have psoriasis?

Mohiba Tareen, MD
FAAD Board Certified Dermatologist
Mohiba Tareen is a board certified Dermatologist and the founder of Tareen Dermatology located in Roseville, Maplewood and Faribault, Minnesota. Dr. Tareen completed medical school at the University of Michigan in Ann Arbor, where she was inducted into the prestigious Alpha Omega Alpha honor society. While a dermatology resident at Columbia University in New York City, she won the Conrad Stritzler award of the New York Dermatologic Society and was published in The New England Journal of Medicine. Dr. Tareen then completed a procedural fellowship which focused on dermatologic surgery, laser, and cosmetic dermatology.

Mohiba Tareen, MD

FAAD Board Certified Dermatologist

Expert Answer

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If you just have mild psoriasis, you may be able to treat it by keeping the area moisturized, using salicylic acid, or even getting a little sun.However, if your psoriasis is really itchy and painful, or if it's visible and you're embarrassed, see a dermatologist. Also, if you have psoriatic arthritis, where it affects your joints, you should have that treated right away, because it's a destructive arthritis.