Eczema vs Psoriasis and How to Tell the Two Apart
If you have patches of itchy, irritated skin that keep coming back, you may be wondering whether it is eczema or psoriasis. The two are easy to confuse. Both are long-lasting conditions linked to the immune system, both come and go in flare-ups, and neither is contagious[1][2][3]. Knowing the signs of eczema vs psoriasis helps you understand which treatment fits.
In general, eczema is driven by itch and dry, easily irritated skin, while psoriasis builds thick, raised patches with a silvery scale[1][4]. The treatment overlaps more than you might expect. A steroid cream is used for both, and some non-steroid creams are used for eczema[5][6]. If you already know which one you have and are having a flare-up, Starfish.com can help. A licensed clinician reviews your answers and, if treatment is right for you, sends a prescription to your pharmacy, usually within 1 to 2 hours.
Eczema vs Psoriasis at a Glance
| Eczema (atopic dermatitis) | Psoriasis | |
|---|---|---|
| How it looks | Dry, discolored patches that may ooze or bleed. On darker skin they can look dark brown, purple or grayish[1][7] | Raised, thick patches called plaques, often covered by a dry, silvery-white scale[4] |
| How it feels | Itch is the main symptom, and it can be severe[1] | Plaques often itch too, but the thickness and scale stand out more[4] |
| Where it shows up in adults | Often the hands, and around the eyes. In children, the creases of the elbows and knees[7] | Usually the scalp, elbows, knees or lower back. Nails may get tiny dents or crumble[4] |
| Linked conditions | Asthma, allergies, depression or anxiety, and poor sleep[1] | Psoriatic arthritis (swollen, stiff joints), heart disease, diabetes and depression[2] |
| When it starts | Usually in childhood, and more likely if family members have eczema, hay fever or asthma[1] | More common in adults than in children[2] |
| Common prescription creams | Steroid creams such as triamcinolone, and non-steroid creams such as pimecrolimus[5] | Steroid creams such as triamcinolone, plus vitamin D-based and other creams[6] |
What Eczema Is
Eczema, or atopic dermatitis, is a long-lasting condition that inflames the skin and causes intense itching[1]. Changes in the skin let it dry out, so it becomes easily irritated[1]. Over time, scratching can leave patches of skin thicker and itchier[7]. In adults, eczema often settles on the hands, and the hands may be the only place it appears[7].
What Psoriasis Is
Psoriasis happens when the immune system becomes overactive and skin cells grow too quickly[2]. The extra cells pile up on the surface and form plaques. Common triggers include stress, skin injuries such as a cut or bad sunburn, infections such as strep throat, cold and dry weather, smoking and heavy drinking[3]. Psoriasis is also linked to joint disease, called psoriatic arthritis, and to heart disease and diabetes[2].
Treatment for an Eczema Flare-Up
Answer a short questionnaire about your skin. A licensed clinician reviews it and, if treatment is right for you, sends a prescription to your pharmacy.
How Each Is Treated
Eczema. Daily moisturizing helps restore the skin barrier. For flare-ups, steroid creams calm the inflammation. Non-steroid creams called topical calcineurin inhibitors also reduce inflammation[5]. We offer both kinds for eczema: triamcinolone acetonide 0.1% cream, a steroid cream, and pimecrolimus cream, a non-steroid cream. Pimecrolimus is meant for mild to moderate eczema when other prescription creams have not worked well enough or are not a good fit[8].
Psoriasis. Mild psoriasis is usually treated with creams and ointments, especially steroid creams. Vitamin D-based creams are another option. Moderate to severe psoriasis may need light treatment, pills or injections[6]. For a flare-up of mild psoriasis, we offer psoriasis treatment with a prescription steroid cream.
Both conditions are long-lasting, so treatment aims to calm a flare-up and keep your skin comfortable. Once a clinician approves your request, the prescription goes to the pharmacy you chose. You pay for the medication at the pharmacy, the same way you would with a prescription from your own doctor.
When Online Treatment Fits, and When It Does Not
A questionnaire cannot examine your skin. Online treatment suits you best if a doctor has already diagnosed your eczema or psoriasis and you are having a familiar flare-up. When the diagnosis is not clear, a doctor may need to examine your skin, scalp and nails, and sometimes take a small skin sample[5][6]. See a clinician in person if:
- you have never been diagnosed and are not sure what the rash is
- a rash keeps getting worse, or a treatment you used before no longer helps
- you have swollen, tender joints or morning stiffness, which can be a sign of psoriatic arthritis[4]
- you are pregnant, as we do not treat anyone who is pregnant
Signs That Need Care Right Away
Some skin changes are emergencies, not flare-ups. Get medical care right away if:
- skin on most of your body looks burnt, with chills or fever. This can be a serious form of psoriasis that needs immediate care[4].
- you have eczema and develop painful, dome-shaped blisters with a fever or feeling unwell. This can be a herpes infection of the skin called eczema herpeticum[7].
If you have eczema and notice golden or yellow crusts, contact a clinician soon, as this can be a skin infection[7].
FAQ
Can stress cause a psoriasis flare-up?
Yes. Emotional strain is one of the common psoriasis triggers, along with skin injuries, infections such as strep throat, and cold, dry weather[3].
Is eczema or psoriasis contagious?
No. You cannot catch eczema or psoriasis from another person[1][3].
Which itches more, eczema or psoriasis?
Itch is the main symptom of eczema and can be constant[1][7]. Psoriasis plaques often itch too, but scratching can make the patches thicker[4].
Can Starfish.com prescribe pimecrolimus for psoriasis?
Pimecrolimus is approved for eczema (atopic dermatitis), not psoriasis[8]. For psoriasis, we offer a steroid cream. If you have both conditions, mention it in your questionnaire.
Get a Prescription Cream for Your Flare-Up
A licensed clinician reviews your answers and, if treatment is right for you, sends the prescription to your pharmacy within 1 to 2 hours.
References
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. “Atopic Dermatitis: Symptoms and Causes.” National Institutes of Health. https://www.niams.nih.gov/health-topics/atopic-dermatitis/basics/symptoms-causes
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. “Psoriasis.” National Institutes of Health. https://www.niams.nih.gov/health-topics/psoriasis
- American Academy of Dermatology. “Psoriasis: Causes.” https://www.aad.org/public/diseases/psoriasis/what/causes
- American Academy of Dermatology. “Psoriasis: Signs and Symptoms.” https://www.aad.org/public/diseases/psoriasis/what/symptoms
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. “Atopic Dermatitis: Diagnosis, Treatment, and Steps to Take.” National Institutes of Health. https://www.niams.nih.gov/health-topics/atopic-dermatitis/diagnosis-treatment-and-steps-to-take
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. “Psoriasis: Diagnosis, Treatment, and Steps to Take.” National Institutes of Health. https://www.niams.nih.gov/health-topics/psoriasis/diagnosis-treatment-and-steps-to-take
- American Academy of Dermatology. “Atopic Dermatitis: Signs and Symptoms.” https://www.aad.org/public/diseases/eczema/types/atopic-dermatitis/symptoms
- U.S. National Library of Medicine, DailyMed. “Pimecrolimus cream, 1%.” Human prescription drug label. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d5b0403a-065f-42e3-96d6-7dcb9ab127d3
