Eczema vs psoriasis can be difficult to distinguish, as both conditions can cause dry, inflamed, itchy or flaky skin. If you are looking at eczema vs psoriasis images or trying to understand how to tell the difference between eczema and psoriasis, there are several characteristics that can help, including the appearance, location and symptoms of the affected skin.
Although eczema and psoriasis can sometimes look similar, they are different skin conditions that develop for different reasons and may require different approaches to treatment. Appearance alone is not always enough to identify the cause of a rash or skin change.
In this guide, we compare eczema and psoriasis, looking at their symptoms, appearance, common locations, possible triggers and treatment, as well as when it may be appropriate to see a dermatologist.
Jump To Section
What is eczema?
Eczema is a group of conditions that cause the skin to become dry, itchy and inflamed. The most common form is atopic eczema, also known as atopic dermatitis.
Eczema can affect people of any age, although atopic eczema commonly begins during childhood. Some people experience periods when their symptoms improve followed by flare-ups when they become more severe.
Symptoms can vary considerably from person to person and may include:
- Dry or very dry skin
- Itching
- Inflamed or discoloured patches
- Cracked or sore skin
- Thickened skin following repeated scratching
- Small areas that bleed or weep
Eczema can affect different areas of the body depending on factors including age and the type of eczema present.
What is psoriasis?
Psoriasis is an inflammatory skin condition associated with increased production of skin cells. Normally, skin cells are produced and replaced gradually. In psoriasis, this process happens much more quickly, causing cells to accumulate on the skin’s surface.
The most common form, plaque psoriasis, typically causes well-defined patches known as plaques. These may be covered with silvery-white scale.
Other symptoms can include:
- Dry or cracked skin
- Itching or discomfort
- Thickened or scaly patches
- Changes to the fingernails or toenails
Psoriasis can occur at any age and, like eczema, symptoms may fluctuate between periods of improvement and flare-ups.
Eczema vs psoriasis
When looking at how to tell the difference between eczema and psoriasis, there are several characteristics that can help differentiate the two conditions.
One of the main differences is the appearance of the affected skin. Eczema often causes intensely itchy, dry and inflamed skin. Psoriasis, particularly plaque psoriasis, tends to cause more clearly defined, thickened plaques with scale.
Their common locations can also differ. Eczema frequently affects skin folds, such as the insides of the elbows and backs of the knees, although it can occur elsewhere. Plaque psoriasis commonly affects areas including the elbows, knees, scalp and lower back.
However, these patterns are not absolute. Both conditions can affect different parts of the body and their appearance varies between individuals.
| Feature | Eczema | Psoriasis |
|---|---|---|
| Typical appearance | Dry, inflamed, cracked or sore skin | Well-defined, thickened plaques, often with scale |
| Itching | Often very itchy | Can be itchy, but severity varies |
| Common locations | Skin folds, hands and face | Elbows, knees, scalp and lower back |
| Typical onset | Often begins in childhood | Can develop at any age |
| Skin changes | May become cracked, weepy or thickened | May develop silvery-white scale |
| Nail changes | Can sometimes affect the nails | May cause pitting, thickening or other nail changes |
These differences can provide useful clues, but they should not be used to diagnose a skin condition without appropriate clinical assessment.
Eczema vs psoriasis images
[IMAGE: Eczema vs psoriasis images showing representative examples of each condition]
Looking at eczema vs psoriasis images can help when learning how to tell the difference between eczema and psoriasis, particularly when comparing features such as scaling, inflammation and the appearance of affected skin. However, photographs should not be relied upon for self-diagnosis.
Both eczema and psoriasis can vary considerably in appearance. The colour of inflammation can also appear differently depending on skin tone. On lighter skin, affected areas may appear pink or red, while inflammation on darker skin tones may appear purple, grey, dark brown or a different colour from the surrounding skin.
The type, severity and location of the condition can also affect its appearance. If you have an unexplained rash or persistent changes to your skin, a dermatologist can assess the area directly.
Where do they appear?
The location of a rash can provide useful clues when looking at how to tell the difference between eczema and psoriasis, although either condition can affect different areas of the body.
Eczema vs psoriasis images can also help illustrate these typical patterns of distribution, although the areas affected can vary from person to person.
Atopic eczema commonly affects areas including:
- Hands
- Face
- Insides of the elbows
- Backs of the knees
The areas affected can differ according to age.
Plaque psoriasis commonly develops on:
- Elbows
- Knees
- Scalp
- Back
Psoriasis can also affect other areas, including the nails and skin folds. There are several different types of psoriasis, so not everyone will develop the typical plaques associated with plaque psoriasis.
Which is more itchy?
Itching is particularly characteristic of eczema and can sometimes be severe. Repeated scratching may further damage the skin, contributing to soreness, bleeding, thickening or an increased risk of infection.
Psoriasis can also itch, but not everyone experiences the same symptoms. Some people instead describe soreness, discomfort or a burning sensation.
The severity of itching alone therefore cannot reliably determine whether you have eczema or psoriasis.
What causes them?
Eczema and psoriasis are both complex conditions, and there is no single cause for either.
Atopic eczema is associated with problems with the skin barrier and an overactive immune response. Genetics can play an important role, and people with atopic eczema may also have other atopic conditions such as asthma or hay fever.
Psoriasis is an immune-mediated inflammatory condition. The accelerated production of skin cells associated with psoriasis results from changes involving the immune system. Genetics also play a role.
Neither condition is contagious, so you cannot catch eczema or psoriasis from another person.
What triggers flare-ups?
Both eczema and psoriasis can go through periods when symptoms become more noticeable.
Eczema triggers vary between individuals but may include irritants such as soaps or detergents, certain fabrics, environmental factors, heat and skin infections.
Psoriasis can also be affected by a variety of factors. Potential triggers include stress, skin injury, some infections and certain medicines.
Identifying personal triggers can sometimes form part of managing either condition.
Can you have both?
It is possible for a person to have features of both eczema and psoriasis, although this is less common than having either condition independently.
There are also many other skin conditions that can produce symptoms resembling eczema or psoriasis. This is one reason why persistent, unusual or difficult-to-manage rashes may benefit from assessment by a dermatologist rather than relying on photographs or symptom lists alone.
How are they diagnosed?
There isn’t a single rule for how to tell the difference between eczema and psoriasis.
A dermatologist will usually examine the affected skin and consider factors such as:
- What the rash looks and feels like
- Where it appears
- When symptoms started
- How symptoms have changed
- Whether symptoms come and go
- Your medical and family history
- Treatments you have already tried
In many cases, a dermatologist can make a diagnosis through clinical assessment. Occasionally, further investigation may be appropriate if the diagnosis is uncertain.
How are they treated?
Treatment depends on the diagnosis, severity and extent of the condition, as well as the areas of skin affected and how symptoms are affecting you.
Eczema management often includes regular use of emollients alongside treatments intended to control inflammation during flare-ups. Identifying and avoiding relevant triggers may also help.
Psoriasis treatment can include topical treatments applied directly to the skin. Depending on the type and severity of psoriasis, other treatments such as phototherapy or systemic medicines may be considered.
Because eczema and psoriasis are different conditions, getting the correct diagnosis is important when deciding on an appropriate treatment plan.
When to see a dermatologist
Consider seeking medical advice if you have a rash or skin problem that:
- Persists or repeatedly returns
- Is particularly itchy, painful or uncomfortable
- Is affecting your sleep or daily life
- Covers a significant area
- Has not improved with previous treatment
- Has become infected, weepy or increasingly sore
- Has an uncertain diagnosis
You may also benefit from seeing a dermatologist if you have previously been told you have eczema or psoriasis but your symptoms are not responding as expected.
At Freyja Medical, our consultant dermatologists assess and treat a wide range of inflammatory skin conditions, including eczema and psoriasis. A dermatology consultation allows your skin to be examined properly, your symptoms and history to be discussed and an appropriate management plan to be considered.
Private dermatology consultations are available at our clinics in Wrexham, Nantwich, Chester and Shrewsbury, and you do not need a GP referral to book.
Eczema vs psoriasis FAQs
Is eczema the same as psoriasis?
No. Eczema and psoriasis are separate skin conditions. Although they can produce some similar symptoms, they develop differently and may require different approaches to treatment.
Which is worse, eczema or psoriasis?
Neither condition is inherently worse than the other. Severity varies significantly between individuals. Mild eczema may have little effect on everyday life, while severe eczema can be extremely disruptive, and the same is true of psoriasis.
Is eczema or psoriasis contagious?
No. Neither eczema nor psoriasis is contagious, and they cannot be passed from one person to another through physical contact.
Can eczema turn into psoriasis?
Eczema does not simply turn into psoriasis. They are separate conditions. However, the appearance of a skin condition can change over time, and it is possible for a previous diagnosis to need reassessment if symptoms change.
How to book a dermatology consultation
If you are unsure whether you have eczema, psoriasis or another skin condition, our consultant dermatologists can assess your skin, discuss your symptoms and recommend an appropriate treatment or management plan.
Freyja Medical offers private dermatology consultations in Wrexham, Nantwich, Chester and Shrewsbury, with no GP referral required.