Difference Between Psoriasis vs Eczema

Difference Between Psoriasis vs Eczema

Psoriasis and eczema are two of the most common rashes that dermatologists see in practice.  In most cases, these two conditions can be easily distinguished, but sometimes even the best dermatologist in Omaha can be challenged. Keep reading to learn more about the differences between psoriasis vs eczema.

Psoriasis vs Eczema: What’s the Difference?

Even though treatments can be very similar for mild cases of psoriasis and eczema, establishing a solid diagnosis and telling these two skin conditions apart can be very important when it comes to determining:

  • what the very best treatment is
  • the likelihood of the condition is to be chronic
  • to better know if any additional testing is needed

We want to give you some very simple things that you can look for to try to distinguish and tell if you have either psoriasis vs eczema.

What is Psoriasis?

Psoriasis is an autoimmune condition that speeds up the growth cycle of skin cells. In a normal skin cycle, cells grow deep in the skin and gradually rise to the surface, eventually falling off. This entire process usually takes about a month. However, in psoriasis, this process occurs in just a few days, leading to the buildup of thick, scaly patches on the skin’s surface.

The immune system plays a significant role in psoriasis. In individuals with psoriasis, the immune system mistakenly attacks healthy skin cells, triggering an inflammatory response that accelerates the production of new skin cells.

Psoriasis Types

Psoriasis can appear in various forms, common types of psoriasis include:

  • Plaque psoriasis – characterized by raised, red patches (called plaques) on the surface of the skin covered with silvery scales
  • Guttate psoriasis – small, dot-like lesions,
  • Pustular psoriasis – white pustules surrounded by red skin

Psoriasis can affect any part of the body, including the scalp, elbows, knees, and nails.

What is Eczema?

Eczema, also known as atopic dermatitis, is a chronic and inflammatory skin condition characterized by red, itchy, and inflamed skin. It often occurs in patches on the chin, cheeks, scalp, and chest, and can vary in severity. Eczema is a common skin condition that tends to run in families and is linked to other allergic conditions like asthma and hay fever.

The exact cause of eczema is not well understood, but it is believed to involve a combination of genetic, environmental, and immune system factors. People with eczema often have a malfunction in their skin barrier, allowing irritants and allergens to penetrate the skin more easily, leading to inflammation causing itchy skin.


First, the location of the rash can be very important.  Nearly any area of the body can be affected by both conditions, but psoriasis tends to favor certain specific areas most commonly.  These are usually pressure points, such as the

  • elbows
  • knees
  • buttocks
  • back of the scalp

The repetitive friction that tends to occur at these locations from our everyday activities can trigger psoriasis to develop in those areas in susceptible people.

We tend to see that psoriasis typically is often bilateral and symmetric. By that, we mean that if present in one area on one side of the body, it often is present in the same area on the other side of the body. Also, the appearance of the spot in the skin on one side of the body is often very similar to the appearance on the other side of the body.

For example, if a person has a skin plaque of psoriasis of a certain size on their left elbow, they will often have a very similar spot on the right elbow. This rule is not 100% but fits in many cases. In the case of eczema (atopic dermatitis), we tend to see that this rule is often broken.


When looking closely at the spots of psoriasis and eczema, they usually look somewhat different.  The classic appearance of spots of psoriasis is red bumps and plaques that have overlying scaling, which often is a shiny or silvery scale.   In the case of eczema, we usually see red areas, but these may have overlying blisters or yellow crusting dry skin.

Psoriasis vs Eczema Symptoms

Symptoms can also be helpful to separate eczema and psoriasis.  Most people with psoriasis have some symptoms with itching, but these are not very prominent. However, in the case of eczema, intense itching often occurs. It may even make falling asleep and staying asleep more difficult.

A person’s family history and personal history can also be another useful tool to get a better idea about whether you are dealing with eczema or psoriasis.  Those of us with eczema may have a family history of eczema, asthma, or seasonal allergies. And of course, folks with psoriasis may note a family history of psoriasis.   This factor, personal history/family history, is probably the least important factor when arriving at a diagnosis of eczema vs psoriasis. However, it still can be helpful.

Treatment Options

As we noted, treatments for mild eczema and mild psoriasis can be very similar. For both conditions, regular usage of a moisturizer can help. Additionally, steroid cream including over-the-counter ones can also reduce the intensity of the spots. For over-the-counter remedies, hydrocortisone 1% ointment, a topical corticosteroid is best to reduce inflammation.

We hope this helps you to make a better determination about whether you have psoriasis or eczema. If you or someone you know is still struggling with getting a diagnosis or treating their condition, please see us here at Advanced Dermatology of the Midlands where we have extensive experience in taking care of these problems for our patients daily.

Advanced Dermatology of the Midlands | Best Dermatologist in Omaha, NE & Council Bluffs, IA | Board Certified Dermatologists

Remember if you still have a concern, all of our dermatology providers here at Advanced Dermatology of the Midlands are here to help. For any information or to make an appointment please contact us today.