Psoriasis vs. Eczema: what are they and how do they differ?

As we battle through winter, when skin is especially sensitive, it’s important we keep an eye on any changes to the body. Below, we break down the key characteristics of each condition and how to go about treating outbreaks.

The average person probably couldn’t tell the difference between psoriasis and eczema. What’s understood is that both skin conditions are uncomfortable and visually unpleasant for those who suffer from them. Generally speaking, they look similar—red, rash-like, and inflamed—however, the symptoms and treatment options differ.

Psoriasis

According to Dr. Kirk Barber, a certified dermatologist practicing in Calgary, Alberta, psoriasis affects approximately one million Canadians and 125 million people worldwide. Although it manifests on the surface of the skin, its impact is profound. Dr. Barber says that about 30% of people with the condition will develop an arthritis related to their psoriasis. Psoriasis has been linked to other chronic diseases like diabetes and cardiovascular disease. Most patients have their first episode in adulthood, yet it still affects about one per cent of children.

While the exact cause remains unknown, researchers believe it to be a combination of genetic, environmental, and immune factors.

Signs and symptoms
Psoriasis speeds up the production of skin cells, which results in itchy and sometimes painful lesions. These patches are well-defined, red, and elevated, often with flaking silvery scales. Affected areas look dry, cracked, and inflamed. The most common sites for psoriasis are the elbows, knees, scalp, chest, and lower back. Outbreaks can be triggered with increased stress, infection, injury to the skin, smoking or heavy drinking, and certain medications. Depending on the patient, an episode of psoriasis often subsides within a few weeks or months.

Treatment options
There are a variety of treatment options available to patients with psoriasis. These vary based on the level of severity, how large the lesions are, and patient preferences. For mild to moderate cases, creams or ointments, such as corticosteroids, vitamin D or vitamin A derivatives, or coal tar may be helpful. When the affected area is large, and it is not practical to apply creams or creams have not been effective then light therapy, oral medications or injections may be recommended.

Quick tips:

  • Exercise frequently and manage your stress
  • Avoid extreme temperatures
  • Moisturize every day, particularly after bathing/showering and hand-washing

How bad is your psoriasis?

  • Mild: Affects less than 3% of skin
  • Moderate: Affects 3 to 10% of skin
  • Severe: Affects more than 10% of skin

For more information about psoriasis, visit the Canadian Dermatology Association’s website.

Eczema

Approximately 15 to 20% of Canadians suffer from eczema. Around 17% are diagnosed with the most common type, atopic dermatitis (AD). AD is hereditary and is often linked to asthma and/ or hay fever. While most cases of AD occur before the age of five, some experience their first outbreak in adulthood, which is known as adult-onset atopic eczema.

The other common form of eczema is known as contact dermatitis, and it comes in two forms: allergic and irritant. Allergic is caused by a delayed immune reaction, whereas irritant is caused by repeated exposure to substances that damage the skin.

Like psoriasis, the cause of eczema is unclear; patients either develop or are born with an impaired skin barrier function, which means they’re more susceptible to external allergens and bacteria. Again, there are a variety of genetic, environmental, and immune factors at play.

Signs and symptoms
Eczema consists of dry skin and inflammation, and is generally more itchy than psoriasis. Infected areas look red and swollen, sometimes with fluid-filled bumps. Whatever the state, eczema is not contagious. Flare-ups may occur in different areas of the body based on one’s age. For instance, babies tend to experience eczema on their scalp and face, whereas adolescents tend to have flares in the crooks of the knees and elbows. In addition, everyone, adults included, may also find patches on the ankles, wrists, neck and hands.

Treatment options
Eczema is kept under control by a variety of remedies. Treatment is primarily based around minimizing recognizable irritants, like soaps and detergent based body washes and avoiding them. Coarse fabrics and wool clothing may cause significant irritation. In severe cases, and especially when infection is present, certified dermatologists will recommend antibiotics, corticosteroids, topical calcineurin inhibitors, or light therapy. Regardless of its state, moisturizing is essential and will minimize itchiness, which can be the most aggravating symptom of all.

Quick tips:

  • Avoid harsh products and fabrics that cause irritation
  • Bathe daily or every other day (or even less frequently, depending on what works best for you), using lukewarm water
  • Moisturize every day, particularly after bathing/showering and hand-washing

Other types of eczema:

  • Dyshidrotic Eczema
  • Lichen Simplex Chronicus
  • Nummular Eczema
  • Seborrheic Eczema
  • Stasis Dermatitis

For more information about eczema, visit the Canadian Dermatology Association’s website.

The skin is the body’s largest organ, and as such, it’s important we protect and take care of it, regardless of genetics or skin condition. In some circumstances, like those noted above, skin requires a little extra care. Book regular appointments with your certified dermatologist to minimize discomfort and damage to the skin.

 

The Canadian Dermatology Association along with Novartis and the Canadian Association of Psoriasis Patients developed a public service announcement to raise awareness of psoriasis and the emotional and physical impact it has on the 1 million Canadians who live with it.

The information in this article has been reviewed by a certified dermatologist.