Itchy, dry, and scaly skin often leads many people to believe they have a single skin condition. However, these symptoms can be caused by two distinct conditions: psoriasis and eczema. While both are uncomfortable and disruptive, they have different causes, characteristics, and treatments. Understanding the difference between psoriasis and eczema is crucial to avoid making mistakes in treatment.
What Are Psoriasis and Eczema?
Psoriasis is a chronic autoimmune disease that causes skin cells to grow excessively. This results in thickened, dry, scaly skin, often causing itching and pain. This condition typically appears on the scalp, elbows, knees, or lower back. Psoriasis is not contagious, but it can recur and is influenced by genetic factors, stress, or certain health conditions.
Eczema is a skin inflammation that causes redness, itching, dryness, and even cracking. This condition is more common in children, but it can also affect adults. Eczema is generally caused by the immune system's reaction to certain irritants or allergens, such as dust, soap, food, or cold air. Unlike psoriasis, eczema is more often associated with allergies and skin sensitivities.
Causes of Psoriasis and Eczema
The main difference between psoriasis and eczema lies in their causative factors. Psoriasis is an autoimmune disease, meaning the immune system malfunctions and accelerates skin cell production. This causes skin cells to build up on the surface, becoming dry, scaly, and forming white plaques.
Meanwhile, eczema has more diverse and complex triggers. Heredity and environmental factors play a significant role in its development. In some sufferers, mutations in genes related to the formation of the skin's protective barrier have been found. As a result, the skin becomes more susceptible to irritation, allergies, and infections.
Here's the Difference Between Psoriasis and Eczema That You Need to Understand
Although both cause skin problems, psoriasis and eczema have distinct characteristics. These differences range from the sensations experienced, the appearance of the skin, the areas where they appear, and even the triggers. Understanding these differences is crucial to avoid misdiagnosing symptoms and choosing the right treatment.
1. Sensation on the skin
Eczema: causes intense itching, which can even lead to scratching until it bleeds. If the sores are open, there's a risk of secondary infection, such as pus, swelling, or fever.
Psoriasis: The itching is usually milder, but is often accompanied by a burning or stinging sensation, similar to a fire ant bite. The skin may also appear thickened and scaly, similar to dandruff.
2. Skin appearance
Eczema: the skin looks red, inflamed, and if scratched frequently can thicken.
Psoriasis: The skin also becomes red, but the thickening is more pronounced. Initially, small, spreading bumps appear, then become covered with silvery-white scales, making the skin appear dry, flaky, and peeling.
3. Location appears
Eczema: generally in the folds of the body, such as behind the knees, elbow folds, neck, and wrists.
Psoriasis: usually in non-folding areas, such as the outer elbows, knees, back, scalp, palms, soles, nails, ears, and eyelids.
4. Triggering factors
Eczema: often triggered by irritation or allergies, for example soap, detergent, dust, animal hair, humidity, temperature changes, and certain foods (cow's milk, eggs, nuts, soy, wheat).
Psoriasis: can flare up due to stress, infection, or medications, but some of the triggers are similar to eczema.
5. Age of the patient
Eczema: more common in babies and children, and in some cases can improve or disappear with age.
Psoriasis: usually appears in late adolescence to young adulthood (15–35 years).
6. Related conditions
Eczema: often experienced by people with sensitive skin, allergies, or a family history of eczema or asthma.
Psoriasis: is often associated with other chronic diseases such as diabetes, heart disease, obesity, and mental disorders such as depression.
By understanding the differences between psoriasis and eczema, we can be more aware of the symptoms that appear on our skin. If symptoms persist, worsen, or interfere with daily activities, consult a dermatologist immediately.
When Should You Consult a Doctor?
Both psoriasis and eczema require medical attention if symptoms worsen or do not improve with home treatment. Consult a doctor immediately if:
- The skin feels so itchy that it interferes with sleep or daily activities.
- Open wounds, pus, or signs of infection such as swelling and fever appear.
- The affected skin area is expanding or recurs frequently.
- The medication or cream used is no longer effective in relieving symptoms.
- Symptoms are accompanied by other complaints, such as joint pain in psoriasis or severe allergic reactions in eczema.
Although they may seem similar, psoriasis and eczema have important differences to recognize. By understanding the symptoms, causes, and when to seek medical attention, you can prevent the condition from worsening and receive appropriate treatment. Don't hesitate to consult a dermatologist for a clear diagnosis and tailored therapy to your needs.
Article written by Dr. Fiedya Wati Kusuma, Sp.DVE (Dermatologist and Venereologist at EMC Hospital, Tangerang)