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  5. Psoriasis Vs. Eczema - How To Diagnose Your Skin Condition Correctly?

Does your skin feel itchy or irritated most of the time? You might be wondering if you have a skin condition, or you’ve developed an allergic reaction to something you’ve eaten. This could be a sign of psoriasis or eczema.

Eczema and psoriasis might seem confusing to you, with their similar appearances. But deep down, they are fundamentally different. However, there are clues that can help you tell them apart.

Below we break down the key identifiers of psoriasis and eczema to help you correctly know, treat and manage your skin condition.

Identifying Eczema And Psoriasis

Psoriasis is a common chronic inflammatory skin disease, typically characterised by raised itchy skin plaques. These plaques are usually red, itchy, and covered with thick, silvery scales.

Psoriasis is most commonly found on your knees, elbows and scalp, but it can also affect your nails and legs.

In this skin condition, the life cycle of your skin cells speeds up. This builds up dead cells on the surface of your epidermis, causing red, inflamed and flaky patches of skin.

Eczema is also a chronic, non-contagious, inflammatory skin condition characterized by intense itching. Eczema can cause red, inflamed, or cracked skin. This may be accompanied by hay fever or asthma.

Eczema affects your skin’s ability to protect it from bacteria and allergens. This leads your skin to respond more forcibly to certain triggers such as dust, skin care products, detergents, animals etc.

Occurence Of Eczema And Psoriasis In The Body

Eczema:

It often appears on your face, arms, and legs. Babies can get it on their chin, cheeks, scalp, chest, back, arms, and legs.

1. Hand Eczema

young woman scratching the itch on her hands

Hand eczema or hand dermatitis, causes small, itchy blisters to appear on your palms. It might occur due to use of harsh chemicals as well as irritants. But if you are someone who has had eczema in childhood, or someone who has repeated contact with water, you can be prone to high risk.

Use a moisturizer to treat hand dermatitis. It will help repair your damaged outer skin and lock moisture inside the skin. Applying a moisturizer will also help you reduce the risk of secondary bacterial infection.

Choose to wear protective cotton-lined or rubber gloves at work and at home when in contact with irritating chemicals and water. You can also apply a barrier cream to your hands before exposure to irritants.

2. Facial Eczema

Facial eczema on the face is common in babies and toddlers, but it can appear in people of any age. It can cause inflammation and dryness, often resulting in flakes, and blisters.

Wash your face with lukewarm water, use a gentle cleanser, and look for skincare products with moisturizing ingredients to control the symptoms.

3. Eczema On Other Parts Of The Body

Eczema may also affect parts of a baby’s skin that comes in contact with diapers. This is because the material used to make diapers may irritate sensitive skin. Creams and other products used on babies may also cause trouble.

Adults may experience eczema on other body parts due to the detergent used to wash your clothes. You may want to change your laundry detergent in such ases.

Psoriasis:

It can occur on your elbows, knees, scalp and face, lower back, palms and soles. Psoriasis can lead to patches on your fingernails and toenail, mouth and lips, eyelids, ears, and skin folds.

young woman suffering from skin disease called psoriasis

1. Hand Psoriasis

Psoriasis can make an appearance on your hands and fingers. It can manifest as cracking, swelling, or blistering.

Psoriasis in hands might be triggered by your skin’s injury, an infection, or other skin conditions such as hand dermatitis. You can opt for treatments in pill form, injections, and UV therapy.

2. Facial Psoriasis

Facial psoriasis is a chronic skin condition in which there are one or more persistent and thickened red and dry patches on the face. It can cause mild to intense itch, soreness and skin sensitivity.

You can use gentle non-soap cleansers, moisturisers, sunscreens to treat facial psoriasis.

3. Psoriasis On Other Parts Of The Body

Inverse psoriasis and plaque psoriasis are two common types of psoriasis that you may experience in the genital area. Symptoms include red skin that is smooth (not scaly) and may look tight.

Did You Know?

Only 1% of babies experience Psoriasis. 2-6% of all psoriasis cases include children younger than 2 years of age.

What Can Flare Up Eczema And Psoriasis?

Eczema usually results from things that irritate your skin and elements that cause allergy like:

  • Soaps
  • Detergents
  • Disinfectants
  • Juices from produce or meats
  • Dust
  • Pets
  • Pollen
  • Mold
  • Dandruff
  • Infections
  • Excessive sweat
  • Stress
  • Heat
  • Hormonal changes

Psoriasis triggers vary from person to person. However, some of the common psoriasis triggers include:

  • Vaccines
  • Injury to skin like bug bites or scratches
  • Weather
  • Certain foods

How Does Age Affect Eczema And Psoriasis?

Eczema is commonly experienced by children under the age of 5. This type of skin condition can continue till adolescence or adulthood. There are less common cases of adults getting eczema, unless they have thyroid disease, hormone changes, or stress.

Symptoms of psoriasis often start between ages 15 and 25 among men and women. Children can have mild, moderate, or severe psoriasis.

Conditions linked to eczema and psoriasis

Eczema usually comes along with dry, sensitive skin. You might also experience it if any of your family members has eczema, asthma or hay fever.

Psoriasis is usually linked to stress. However you may also develop it in case you have diabetes or depression, any heart disease or infections.

You can always refer to a doctor to accurately spot the skin conditions and get it treated.

Similarities Between Eczema And Psoriasis?

Eczema and Psoriasis are similar in appearance. Both can lead to rashes, red and itchy skin. They can appear in the same places of the body, such as the hands and scalp. You may find it difficult to distinguish between these two skin conditions. Hence, you must talk to a dermatologist about getting the right diagnosis and treatment. Self-diagnosis can further aggravate the condition.

How To Treat Eczema And Psoriasis?

Both eczema and psoriasis have different treatments based on the severity and the symptoms. However, the key thing is to know the triggers.

Psoriasis Treatment:

Moisturizers

Use lotions, creams, and ointments to reduce scaling, dryness and irritation in your skin. You can choose emollients (moisturising treatments to soothe and hydrate skin) too. Emollients for psoriasis often contain liquid paraffin/white soft paraffin, antimicrobials, and lauromacrogols, which prevents itching.

What you should look for in a lotion if you have psoriasis:

  • Aloe vera
  • Jojoba
  • Zinc pyrithione
  • Capsaicin
  • Glycerin

Topical Corticosteroids:

These are one of the most widely used treatment modalities to soothe psoriasis symptoms. It helps to reduce inflammation and slow down cell-growth rate.

Corticosteroids form the basis of treatment, with the best success and fewest side effects. (1) They have been segregated based on their potency. Your doctor may recommend mild cvorticosteroids like hydrocortisone for sensitive areas such as your face. Stronger corticosteroid creams may be recommended for other areas. These include triamcinolone (Acetonide, Trianex), Clobetasol (Temovate) among others.

Topical corticosteroids are available in:

  • Creams
  • Lotions
  • Gels
  • Solutions
  • Ointments

Some of its side-effects include:

  • Itching
  • Burning
  • Irritation
  • Redness
  • Dryness

Long-term use can lead to loss of skin tone, and deterioration of skin cells. It can also increase the risk of infections. Consult a dermatologist for advice.

1. Vitamin D:

Use Vitamin D topical ointments (under medical advice) to treat psoriasis. Vitamin D is the main active ingredient in two medications - Vectical and Dovonex - used to treat psoriasis. Vitamin D can help in slowing down the growth rate of skin cells. Your doctor may prescribe it to be used in combination with corticosteroids.

2. Salicylic Acid:

It helps to soften and remove psoriasis scales. However, don’t use it over large areas of skin. It may cause your body to absorb too much of the medication, leading to side effects. Use it only after consulting a dermatologist.

3. Topical retinoids:

Topical retinoids are vitamin A derivatives. Examples include Tazorac and Avage. These are available in the form of gels or creams.

Note :

These are not recommended if you are breastfeeding or pregnant or trying to conceive.

4. Oral Retinoids:

Retinoids are a form of Vitamin A that slow down your skin’s cell growth and reduce redness and swelling. Acitretin is the only oral retinoid used to treat severe psoriasis in adults. However, it can cause serious side effects. Because of this, your doctor may only prescribe this medication for a short time.

Some of the side-effects are:

  • Chapped lips and skin dryness
  • Headache
  • Irritated skin
  • Hair loss
  • Dry mouth
  • Decreased night vision
  • Peeling of the skin
  • Aggressive thoughts

5. Methotrexate:

Methotrexate medicine can be used to treat adults with psoriasis if no other medications have shown results. You can usually take methotrexate once per week as an oral tablet or injectable solution.

Methotrexate may cause fatal liver damage or seizures. Before taking methotrexate for the first time, check with your doctor.

6. Cyclosporin:

It is an oral medicine that curbs your immune system and slows your skin’s cell growth. Use Cyclosporine only if you are diagnosed with severe psoriasis.

But remember, Cyclosporine can cause major risks like kidney problems, high blood pressure, and high cholesterol.

7. Light Therapy:

UV therapy such as UVB phototherapy and psoralen plus ultraviolet A (PUVA) can effectively reduce psoriasis symptoms.

However, the radiation can dry out your skin and cause itching. Go for light therapy only under a doctor’s supervision.

Note :

Exposing your skin to any tanning beds can damage it. UV light may contribute to skin damage.

8. Biologics:

These medicines interfere with the disease cycle and improve symptoms within a few weeks. Scientists have come up with several options in this category like etanercept (Enbrel), infliximab (Remicade), ixekizumab (Taltz) and secukinumab (Cosentyx).

Eczema Treatment:

1. Corticosteroid Creams:

Corticosteroid creams, solutions, gels, foams, and ointments are formulated with hydrocortisone steroids. Hydrocortisone is a mild corticosteroid prescribed for symptoms that are associated with eczema. It is usually prescribed in 1 percent concentrations. They can quickly relieve itching and reduce inflammation. (2)

They come in different strengths, from mild over-the-counter (OTC) treatments to stronger prescription medicines.

Topical corticosteroids are prescribed based on their potency. 

2. Antibiotics:

Antibiotics fight the bacteria that cause infections (3). If your flare-up has been triggered due to a bacterial infection, you can choose to go for an antibiotic to relieve your skin from inflammation and redness.

Your dermatologist may prescribe oral antibiotics if you have an extensive area of infected eczema. Flucloxacillin is one of the most common antibiotics usually recommended by the doctor.

3. Antifungal Creams:

Such creams made with hydrocortisone steroids can quickly relieve itching and reduce inflammation.

4. Systemic Corticosteroids:

Systemic steroids (Prednisone) are synthetic derivatives of the natural steroid, cortisol, produced by the adrenal glands. They have profound anti-inflammatory effects. (4). Systemic corticosteroids can be given to you in the form of oral medicines or by intramuscular injection.

Note :

These shouldn’t be taken as a long-term remedy as they can be damaging for your body.

5. Phototherapy:

This involves the usage of narrowband ultraviolet B (NB-UVB) light to treat moderate eczema (5). Light therapy usually involves 2-6 sessions per week in a specialized dermatological practice or hospital.

However, this is linked to skin cancer. You must consult your doctor before undergoing this treatment for eczema.

6. Dupilumab:

Dupilumab is a biologic that targets and interferes with the disease cycle. It was licensed in the UK in the year 2018. It has shown suppression of eczema-related symptoms after using it for 16 weeks. If you don’t see an improvement, talk to your doctor. Side effects include sores and eye inflammation. Dupilumab is not recommended for those below the age of 12.

Note :

If you are pregnant or breastfeeding, avoid taking dupilumab.

Wrapping Up

Remember that not all skin rashes are psoriasis or eczema. Even between psoriasis and eczema, it can be hard to tell the difference.There are effective treatments for both psoriasisand eczema, and severe cases may require medication. Be mindful to discuss your symptoms with your dermatologist to help them determine the best course of treatment for you.

Begin By Knowing Your Skin

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