---
title: "Psoriasis vs. Eczema: How You Can Tell the Difference, and Why It Changes Your Treatment"
url: "https://bhskin.com/blog/psoriasis-vs-eczema/"
updated: "2026-10-27"
published: "2026-10-27"
author: "Don Mehrabi"
---

# Psoriasis vs. Eczema: How You Can Tell the Difference, and Why It Changes Your Treatment

Psoriasis and eczema are persistent skin conditions that tend to come and go. They have complex causes, though immune dysfunction and skin inflammation play important roles in their development. Both can look different from person to person, but they also share similarities that can make them difficult to tell apart. Knowing the difference is important because the wrong treatment may not help and could even worsen the symptoms.  What causes psoriasis and eczema? How do you manage these skin issues? Is it possible to have both? Keep reading to discover the answers and more.

## What Is Psoriasis?

 [Psoriasis](https://accessmedicine.mhmedical.com/content.aspx?bookid=2570&sectionid=210417798) is often described as an autoimmune condition, meaning your immune system turns against your healthy cells. However, its exact cause remains unclear, with heredity, environmental factors, and immune dysfunction all thought to contribute. Symptoms can begin at any age, but this disorder rarely develops in children younger than 10. The most recognizable feature of this skin condition is the psoriasis plaque, which appears as a raised, thickened patch covered by silvery scales. Removing the scales can lead to pinpoint bleeding on the skin beneath. Common sites for psoriasis lesions include the scalp, outside of the elbows and knees, and lower back, although other areas may also be affected.

### How Psoriasis Plaques Form

 Psoriasis arises when an overactive immune response makes your skin cells multiply too quickly. Instead of shedding normally, the cells accumulate on the surface, creating the characteristic thick, scaly skin plaques. Stress, infections like strep throat, traumatic skin injury, and certain drugs, including some blood pressure and pain medications, can trigger flares. Symptoms [may also worsen during cold, dry weather](https://pubmed.ncbi.nlm.nih.gov/40103264/), as low temperatures and humidity can lead to skin dryness, compromise the skin barrier, and promote inflammation. Carrying excess weight and smoking can increase your risk of more severe psoriasis.

### Other Psoriasis Symptoms

 Psoriasis plaques may cause [soreness, burning pain, and itching](https://www.mdpi.com/2075-1729/11/7/623) in the affected area. While itchiness is often associated with eczema, psoriasis can also produce intense itching, with research suggesting that it [can be as severe as that experienced with eczema](https://pubmed.ncbi.nlm.nih.gov/28522048/). Nail and scalp involvement may occur before or at the same time as the emergence of psoriasis patches. Your nails may show tiny dents, discoloration, thickening, or separation from the nail bed. Scalp psoriasis appears as thick, scaly spots that may extend beyond the hairline.

Different Forms of Psoriasis. Featured in these images are psoriasis vulgaris (a.k.a. plaque psoriasis), inverse psoriasis, guttate psoriasis, and erythrodermic psoriasis.

 Psoriasis has several subtypes, though a detailed discussion of each is beyond the scope of this article. Some forms, such as guttate psoriasis, cause small, scattered lesions. Severe types include erythrodermic psoriasis and generalized pustular psoriasis, which can produce widespread skin involvement and whole-body symptoms, such as fever and fatigue.

### Possible Complications

 Untreated or poorly controlled psoriasis can spill over to your joints and other aspects of your health. Psoriatic arthritis may lead to joint pain, stiffness, and swelling. Psoriasis is also associated with a higher risk of heart disease, blood sugar and cholesterol issues, and certain mental health conditions, including depression and anxiety. Your risk of developing skin cancer, particularly squamous cell carcinoma, may also be increased. This risk may be partly related to PUVA, a light treatment that combines UVA light with a light-sensitizing medication, rather than psoriasis itself.

### Psoriasis Treatment Options

 The condition currently has no cure, but proper care and avoidance of triggers can help manage your symptoms. Psoriasis treatments [may be divided into several categories](https://www.aad.org/member/clinical-quality/guidelines/psoriasis). Each type is suited to different situations. Topical treatments are medications you can apply directly to the affected skin. Your dermatologist may recommend them alone for mild or limited disease, or combine them with other therapies for moderate-to-severe symptoms. The most common options include the following:

- Corticosteroids — Anti-inflammatory drugs that include triamcinolone and clobetasol, which alleviate redness, itching, and scaling.
- Vitamin D analogs — Vitamin D–like medications that include calcipotriene and calcitriol, which slow excessive skin-cell growth and ease inflammation.
- Topical retinoids — Vitamin A–like drugs, such as tazarotene and adapalene, which normalize skin-cell growth and reduce scaling.
- Calcineurin inhibitors — Examples include tacrolimus and pimecrolimus, which calm inflammation and limit prolonged corticosteroid use on areas like the face and skin folds, where steroids may cause skin thinning.
- Keratolytics — Examples include salicylic acid and urea, which loosen thick scales and help other medications penetrate the skin.
- Coal tar — Coal tar preparations slow excessive skin-cell growth and curb inflammation and scaling.

Psoriasis Before and After Treatment

- PDE-4 inhibitors — An example is roflumilast, which reduces inflammation by blocking PDE-4, an enzyme involved in inflammatory signaling.
- AhR agonists — An example is tapinarof, which activates AhR, a cell protein that helps regulate inflammatory responses and skin-cell growth.
- Emollients — Thick moisturizers, such as petrolatum, that soften and hydrate scaly, dry skin, helping relieve discomfort and support the skin barrier.

 Phototherapy uses controlled exposure to UV light to slow excessive skin-cell growth and calm inflammation. Several types are available, but [narrowband UVB](https://bhskin.com/medical/phototherapy/) is most widely used. Your dermatologist may recommend this treatment when your symptoms are hard to manage or when topical regimens aren’t enough. Systemic medications work throughout your body to control immune mechanisms that drive psoriasis. Systemic therapies are generally used for widespread lesions. Their broader effects can make them useful treatment options but may also increase the risk of side effects. There are two main types. Non-biologics are small-molecule drugs made through conventional chemical processes. They’re available in convenient forms, including oral pills, though some may cause significant side effects, including liver or kidney issues. Options include methotrexate, cyclosporine, acitretin, apremilast, deucravacitinib, and the recently FDA-approved [icotrokinra](https://www.aad.org/public/diseases/psoriasis/treatment/treatment). Biologics are derived from living sources rather than made through chemical methods. They’re usually given as injections or infusions and can be highly effective for moderate-to-severe psoriasis, with less risk of liver or kidney problems than some strong non-biologics. However, they may increase the risk of infections, requiring screening before treatment. The list of psoriasis biologics is long and includes adalimumab, etanercept, infliximab, and secukinumab.

## What Is Eczema?

 Eczema is otherwise referred to as "dermatitis," which means skin inflammation. Immune dysregulation is an important mechanism underlying eczema, but like psoriasis, it has complex causes and may be set off by environmental influences. Some forms also have a strong genetic component.  Severe itching is characteristic of eczema and may occur even before a rash appears. Eczema patches can begin as small, red bumps that may become fluid-filled lumps when inflammation persists. Scratching may cause skin breaks. Repeated rubbing and scratching can thicken the skin, creating a rough, leathery texture.

### Atopic Dermatitis and Other Eczema Subtypes

 Eczema comes in several forms, with [atopic dermatitis](https://accessmedicine.mhmedical.com/content.aspx?bookid=2570&sectionid=210417027) (or atopic eczema) being the most classic. If you have this condition, you may have inherited changes that affect your skin barrier and the way your immune system responds to allergens. Having atopic dermatitis can also make you more likely to have allergic disorders, such as hay fever and asthma. Atopic dermatitis usually starts in early childhood, often before age 5, and can come and go over the years. Many children improve by age 10, although symptoms may return beyond childhood. Seborrheic and contact dermatitis are eczema types that may also be seen in infants, though they can occur throughout life. Seborrheic dermatitis commonly manifests as cradle cap, appearing as scaly patches on the scalp. Contact dermatitis arises when the skin mounts a response to irritants or allergens. Other forms of eczema may first appear later in life. Nummular eczema causes itchy, coin-shaped patches. Dyshidrotic eczema characteristically affects the hands and feet. A full discussion of other eczema subtypes is beyond the scope of this article.

### How Eczema Rashes Form

 Eczema inflammation activates nerve endings, causing intense itchiness. Scratching damages the skin barrier, creating an itch-scratch cycle that perpetuates inflammation. A new eczema rash may appear red, swollen, and bumpy, with or without fluid, usually on the face, scalp, hands, arms, legs, or body folds, depending on your age. Older lesions may become scaly, cracked, or thickened from repeated scratching and rubbing, making them look like psoriasis plaques to the untrained eye. If you have a dark skin tone, eczema may leave areas of altered pigmentation after inflammation subsides. Flares may be triggered by irritants, allergens, stress, sweating, infections, and changes in temperature or humidity. Seasonal effects vary by type, with some forms worsening in winter and others during hot, humid weather.

Eczema in Babies. The images feature atopic dermatitis, seborrheic dermatitis, and irritant contact dermatitis.

### Other Eczema Symptoms

 Eczema can affect the nails and scalp, although these areas are less characteristically involved than in psoriasis. Nail changes may include brittleness, ridging, or thickening. The scalp may show dryness, scaling, or flaking. Eczema can reduce your quality of life, especially when itching disrupts sleep or daily activities. Visible rashes may also affect your confidence, mood, and relationships. Atopic dermatitis can involve the skin around your eyes, causing redness, dryness, itching, and swelling.

### Possible Complications

 Scratching itchy patches can damage the skin barrier and increase the risk of infections. Pus may form when the skin bacterium *Staphylococcus aureus* infects an eczema lesion. Herpes simplex virus may cause eczema herpeticum, characterized by painful blisters that later become punched-out sores. Rarely, these microbes can trigger exfoliative dermatitis, a potentially life-threatening condition marked by widespread skin redness, scaling, weeping, and crusting. In atopic dermatitis, repeated eye rubbing and inflammation can damage the cornea, potentially resulting in corneal scarring and vision problems. In seborrheic dermatitis, an abnormal response to the skin fungus *Malassezia* can contribute to the formation of greasy, flaky patches, particularly on the scalp and face. As with psoriasis, having atopic dermatitis [may increase your risk of developing certain skin cancers](https://pubmed.ncbi.nlm.nih.gov/35430723/). The reasons aren't fully understood, but this risk may be related to chronic or longstanding inflammation, immune changes, or regimens used for more severe disease.

### Eczema Treatment Options

 Beyond avoiding triggers, eczema is managed differently from psoriasis because these conditions have different treatment goals. For eczema, relieving itchy skin and preventing the condition from worsening are key. Eczema therapies also vary by subtype. For atopic dermatitis, treatments fall into [several categories](https://pubmed.ncbi.nlm.nih.gov/38108679/), each serving a different purpose. Skin-applied therapies are often used for mild lesions, but you may also combine them with other regimens when your symptoms are more extensive. Among topical treatment options, corticosteroids are the most important for controlling eczema symptoms. Topical corticosteroids, such as hydrocortisone, triamcinolone, and mometasone, are strongly recommended because they can quickly dampen inflammation and relieve itching during eczema flares.

Eczema Flare Before and After Treatment

 Your dermatologist may recommend tacrolimus, pimecrolimus, roflumilast, or tapinarof if topical corticosteroids are unsuitable, ineffective, or inappropriate for prolonged use. As with psoriasis, these medications can help reduce reliance on topical corticosteroids and lower the risk of side effects, such as skin thinning, particularly in sensitive areas. Dryness can worsen eczema symptoms by weakening your skin barrier and increasing your skin's sensitivity to irritants. So, you may also be advised to use emollients to keep your skin moisturized and strengthen its protective barrier. You may be prescribed a topical JAK inhibitor, such as ruxolitinib cream, when other topical therapies aren’t enough. JAK inhibitors suppress inflammatory processes that promote eczema. If an infection develops, you may also need antimicrobial creams or pills appropriate to the type of infection. Biologics may be recommended if you have moderate-to-severe atopic dermatitis that isn’t controlled adequately with topical treatments. Examples recommended specifically for atopic dermatitis include dupilumab, tralokinumab, lebrikizumab, and nemolizumab. Non-biologic systemic treatments may be considered when biologics aren’t suitable, aren’t tolerated, or don’t sufficiently control your eczema. Options include methotrexate, cyclosporine, azathioprine, and mycophenolate mofetil. Narrowband UVB phototherapy may be advised when topical medications aren’t enough. Your dermatologist may use it alone or alongside other regimens. Supportive treatments can go with your main eczema therapies. Bathing helps hydrate your skin and remove debris and microbes that can worsen eczema. Dilute bleach baths involve soaking in water containing a small amount of household bleach to help reduce microbes. Wet-wrap therapy covers treated lesions with damp and dry layers of bandages or clothing to hydrate your skin, improve medication absorption, and minimize scratching. If you have a relevant allergy, allergen immunotherapy can gradually desensitize you through repeated allergen exposure. However, its benefit for eczema remains uncertain, so it’s not recommended routinely. Managing other forms of eczema follows similar principles: avoiding aggravating factors, limiting inflammation, relieving symptoms, and supporting the skin barrier. But the approach depends on the subtype and its specific triggers.  For example, contact dermatitis may resolve once you identify and avoid the offending substance, while seborrheic dermatitis often requires antifungal therapy. That said, consultation with a [dermatology specialist](https://bhskin.com/about-us/) is crucial to ensure you get the optimal eczema treatment.

## Can You Have Both Psoriasis and Eczema?

 Yes, you may experience both psoriasis and eczema, either at the same time or at different points in your life. But studies show that [the odds of having both are low](https://pmc.ncbi.nlm.nih.gov/articles/PMC9060081/).

## Can Eczema Turn into Psoriasis?

 No, eczema doesn't transform into psoriasis. But you may develop both conditions at different times, and their similar appearance can sometimes make the initial diagnosis difficult.

## What This Means for You

 Psoriasis and eczema are common skin conditions that may occasionally have similar symptoms. Psoriasis can cause thick, raised, scaly patches that may resemble eczema rashes. Accurate diagnosis is important because early treatment can help prevent complications in both cases. Identifying the disease correctly also helps ensure you receive the appropriate remedy while avoiding aggressive therapies with potentially harmful side effects. Finally, chronic skin conditions that affect your quality of life or confidence deserve expert care, not guesswork. To give yourself the best chance of getting lasting results, entrust your skin’s health only to a [board-certified dermatologist](https://bhskin.com/about-us/).

## Trading Itchy Skin for Healthy Skin? Get Only LA’s Trusted

 Psoriasis and eczema may share similar symptoms but require different treatments. At BHSkin Dermatology, our skincare experts routinely help patients manage these conditions effectively and safely, allowing them to look and feel their best. Take your first step toward healthier skin. Visit us at our Glendale or Encino clinic, or [use our telederm portal](https://bhskin.com/blog/online-dermatologist-visit-faq/) for your [initial consultation](https://bhskin.com/blog/what-to-expect-dermatologist-appointment/). [Book your appointment](https://www.zocdoc.com/practice/bhskin-dermatology-4445?referrerType=widget&utm_term=jsmigration&dd_referrer=https%3A%2F%2Fbhskin.com%2F) today! **References:**

1. AAAAI/ACAAI JTF Atopic Dermatitis Guideline Panel, Chu, D. K., Schneider, L., Asiniwasis, R. N., Boguniewicz, M., De Benedetto, A., Ellison, K., Frazier, W. T., Greenhawt, M., Huynh, J., Kim, E., LeBovidge, J., Lind, M. L., Lio, P., Martin, S. A., O'Brien, M., Ong, P. Y., Silverberg, J. I., Spergel, J. M., Wang, J., … Chu, D. K. (2024). Atopic Dermatitis (Eczema) Guidelines: 2023 American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters GRADE- and Institute of Medicine-Based Recommendations. *Annals of Allergy, Asthma & Immunology. 132*(3), 274–312. [https://pubmed.ncbi.nlm.nih.gov/38108679/](https://pubmed.ncbi.nlm.nih.gov/38108679/)
2. American Academy of Dermatology. (n.d.). *Psoriasis Clinical Guideline*. Retrieved October 5, 2026, from [https://www.aad.org/member/clinical-quality/guidelines/psoriasis](https://www.aad.org/member/clinical-quality/guidelines/psoriasis)
3. American Academy of Dermatology. (2026). *Psoriasis: Diagnosis and Treatment.* Retrieved October 5, 2026, from [https://www.aad.org/public/diseases/psoriasis/treatment/treatment](https://www.aad.org/public/diseases/psoriasis/treatment/treatment)
4. Cunliffe, A., Gran, S., Ali, U., Grindlay, D., Lax, S. J., Williams, H. C., & Burden-Teh, E. (2021). Can Atopic Eczema and Psoriasis Coexist? A Systematic Review and Meta-analysis. *Skin Health and Disease. 1*(2), e29. [https://pmc.ncbi.nlm.nih.gov/articles/PMC9060081/](https://pmc.ncbi.nlm.nih.gov/articles/PMC9060081/)
5. Gudjonsson, J. E., & Elder, J. T. (2019). Chapter 28: Psoriasis. *Fitzpatrick's Dermatology, 9th ed*. [https://accessmedicine.mhmedical.com/content.aspx?bookid=2570&sectionid=210417798](https://accessmedicine.mhmedical.com/content.aspx?bookid=2570&sectionid=210417798)
6. Jaworecka, K., Kwiatkowska, D., Marek, L., Tamer, F., Stefaniak, A., Szczegielniak, M., Chojnacka-Purpurowicz, J., Matławska, M., Gulekon, A., Szepietowski, J. C., Narbutt, J., Owczarczyk-Saczonek, A., & Reich, A. (2021). Characteristics of Pruritus in Various Clinical Variants of Psoriasis: Results of the Multinational, Multicenter, Cross-Sectional Study. *Life. 11*(7), 623. [https://www.mdpi.com/2075-1729/11/7/623](https://www.mdpi.com/2075-1729/11/7/623)
7. Shahwan, K. T., & Kimball, A. B. (2017). Itch Intensity in Moderate-to-Severe Plaque Psoriasis Versus Atopic Dermatitis: A Meta-Analysis. *Journal of the American Academy of Dermatology. 76*(6), 1198–1200.e1. [https://pubmed.ncbi.nlm.nih.gov/28522048/](https://pubmed.ncbi.nlm.nih.gov/28522048/)
8. Simpson, E. L., Leung, D. Y. M., Eichenfield, L. F., & Boguniewicz, M. (2019). Chapter 22: Atopic Dermatitis. *Fitzpatrick's Dermatology, 9th ed*. [https://accessmedicine.mhmedical.com/content.aspx?bookid=2570&sectionid=210417027](https://accessmedicine.mhmedical.com/content.aspx?bookid=2570&sectionid=210417027)
9. Yang, J., Li, G., Yue, L., Dang, E., & Qiao, P. (2025). The Impacts of Seasonal Factors on Psoriasis. *Experimental Dermatology. 34*(3), e70078. [https://pubmed.ncbi.nlm.nih.gov/40103264/](https://pubmed.ncbi.nlm.nih.gov/40103264/)
10. Zhu, Y., Wang, H., He, J., Yang, L., Zhou, X., Li, Z., Zhou, H., Zhao, H., & Li, Y. (2022). Atopic Dermatitis and Skin Cancer Risk: A Systematic Review. *Dermatology and Therapy. 12*(5), 1167–1179. [https://pubmed.ncbi.nlm.nih.gov/35430723/](https://pubmed.ncbi.nlm.nih.gov/35430723/)