Six Things You Should Know about Eczema and Psoriasis

1. Eczema and psoriasis are different conditions with different causes.

Eczema and psoriasis are often confused because both cause dry, itchy skin that can be red and uncomfortable. However, these are two distinct conditions with different underlying causes and treatments.

Eczema appears as red, inflamed patches that can become scaly, crusty, or even ooze. The skin often looks irritated and may have small bumps. Environmental factors like harsh soaps, allergens, stress, or weather changes typically trigger flare-ups. Eczema frequently runs in families alongside allergies or asthma. You can actually have several different types of eczema simultaneously, and the condition stems from a faulty skin barrier that allows moisture to escape while letting irritants penetrate deeper into the skin.

Psoriasis shows up as thick, raised patches covered with silvery-white scales. These plaques feel rough and may crack or bleed. Unlike eczema, psoriasis develops when your immune system mistakenly accelerates skin cell production, causing cells to build up rapidly on the skin's surface instead of shedding normally. The result is those characteristic thick, scaly patches that can feel tight, burning, or stinging.

2. Location matters for diagnosis.

While eczema and psoriasis can flare anywhere on your body, they show distinct preferences for different areas.

Eczema favors the "creases" where your body bends. You'll often find it in the folds of your elbows, behind your knees, on your wrists, ankles, and neck. It also commonly appears on hands and feet. In babies, eczema frequently shows up on the cheeks and the scalp, though it can move to the typical crease areas as children grow older.

Psoriasis prefers the "outsides" of things. It typically develops on the outer surfaces of elbows and knees, the scalp, lower back, and sometimes the face. Unlike eczema, psoriasis can also affect your fingernails and toenails, causing pitting, discoloration, or thickening.

Psoriasis has another unique characteristic called the Koebner phenomenon - it can develop in areas of repeated trauma or pressure. For example, you might notice psoriasis patches where your belt sits, under bra straps, or where you frequently scratch. Even something like a tattoo or surgical scar can trigger psoriasis in that spot.

These location patterns help doctors distinguish between the two conditions, though some people can have both eczema and psoriasis simultaneously in different areas.

3. Triggers are personal -- and worth tracking.

Both eczema and psoriasis have triggers that spark flare-ups, but these vary significantly from person to person. What bothers one person might not affect another at all.

Eczema triggers often include everyday items like harsh soaps, detergents, or skincare products with fragrances. Certain fabrics, particularly wool or synthetic materials, can irritate sensitive skin. Stress plays a major role, as does sweating from exercise or hot weather. Some people notice their eczema worsens after eating specific foods, though food triggers are less common than many people think.

Psoriasis triggers include stress, which can cause flares or make existing patches worse. Skin injuries like cuts, scrapes, bug bites, or even sunburns can trigger new psoriasis patches through the Koebner phenomenon. Certain medications, including some blood pressure drugs and lithium, may worsen psoriasis. Infections, particularly strep throat, can trigger sudden flares. Cold, dry weather often makes psoriasis worse, while some people find their symptoms improve with moderate sun exposure.

Keeping a symptom journal helps identify your personal triggers. Note when flares happen, what you were doing, eating, or experiencing stress-wise in the days before. Include details like new products you tried, changes in routine, or even shifts in weather.

When you track your symptoms, you might discover patterns you hadn't noticed before. For example, your skin may flare after using a particular laundry detergent or during high-stress periods at work. This detective work takes time, but it helps you avoid your specific triggers and manage your condition more effectively. Many people find that identifying and avoiding just two or three key triggers significantly reduces their flare-ups.

4. Both eczema and psoriasis can affect more than your skin.

Yes, eczema and psoriasis are itchy and uncomfortable, and they can cause cosmetic concerns that affect your confidence. But these conditions can lead to complications beyond what you see on the surface.

Skin infections represent the most common complication for both conditions. When you scratch itchy patches, you create tiny breaks in your skin that allow bacteria to enter. These infections can cause increased redness, warmth, swelling, and sometimes pus or yellow crusting. Infections require antibiotic treatment and can make your underlying condition worse.

Psoriatic arthritis affects about 30% of people with psoriasis, causing joint pain, stiffness, and swelling. This can develop in your fingers, toes, wrists, knees, or spine. Unlike regular arthritis, psoriatic arthritis can cause permanent joint damage if left untreated, making early diagnosis and treatment important.

Both conditions can also impact your mental health. The visible nature of these skin conditions, combined with chronic itching and discomfort, can lead to anxiety, depression, or social isolation. Sleep disruption from nighttime itching affects your overall well-being and can worsen stress levels. People with moderate to severe psoriasis also face higher risks of heart disease, diabetes, and other inflammatory conditions.

5. You don't have to live with the itch.

Your primary care doctor can help diagnose and treat mild to moderate cases of both eczema and psoriasis. They can prescribe treatments that offer real relief and help you develop a management plan tailored to your specific needs.

Eczema treatments focus on repairing and protecting your skin barrier. This includes using gentle, fragrance-free moisturizers multiple times daily, switching to mild cleansers that won't strip your skin, and identifying and avoiding your personal triggers. When flares happen, prescription topical medications like corticosteroids can reduce inflammation and control symptoms.

Psoriasis treatments often start with topical corticosteroids to reduce inflammation and slow the rapid skin cell production. Your doctor might also prescribe medications containing vitamin D analogues or retinoids that help normalize skin cell turnover. For thicker plaques, treatments that soften and remove scales can improve the effectiveness of other medications.

For more stubborn cases, other treatments include oral medications that work throughout your body to control inflammation, or phototherapy using specific wavelengths of light to slow skin cell growth.

When your condition doesn't respond well to initial treatments, affects large areas of your body, or significantly impacts your quality of life, your primary care doctor can refer you to a dermatologist. These specialists have access to newer treatments and can provide more intensive management for complex cases.

6. Treatment for eczema and psoriasis works best when you stick with it.

Both eczema and psoriasis require consistent care, even when your skin looks and feels better. These are chronic conditions that need ongoing management rather than just treatment during flare-ups.

Keep up with your daily care routine and prescribed treatments, even during times when your skin is clear. For eczema, this means continuing to moisturize regularly and using gentle cleansers. For psoriasis, it might mean applying maintenance treatments to prevent new plaques from forming. Stopping treatment when your skin improves may result in more frequent and more severe flare-ups.

Pay attention to changes in your condition and document them. Notice if patches are getting larger, smaller, or changing appearance. Track what seems to help or make things worse. Some treatments take weeks or months to show full results, so patience pays off.

Stay connected with your healthcare provider through regular follow-up appointments, even when things are going well. Your primary care doctor or dermatologist can adjust treatments as needed, catch problems early, and help you navigate insurance requirements for medications. They can also spot signs of complications like infections or, in the case of psoriasis, joint involvement.

If you have a rash or skin discomfort that won't go away, it's time to see your primary care doctor. They can properly diagnose your condition, rule out other skin problems, and start you on an effective treatment plan. Early diagnosis and treatment often lead to better outcomes and fewer complications.

If you don't have a primary care doctor, you can also visit MedHelp urgent care clinics in Birmingham. Our urgent care providers can evaluate your skin condition, provide initial treatment, and help you understand the next steps for ongoing care.