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It’s believed that about 7.5 million Americans have psoriasis and another 32 million or so have eczema. That combined population is likely used to experiencing dry and scaly patches, which is why it can be easy for the untrained eye to misidentify the two. “Eczema, or atopic dermatitis, and psoriasis are both very common skin conditions that are often confused by non-dermatologists,” says [Samer Jaber, MD](https://aedit.com/provider/samer-jaber-md-3882), a board certified dermatologist and founder of Washington Square Dermatology in New York City. “They are both red, dry, scaly and often itchy, so they can look similar to non-dermatologists.”

To the trained eye, however, that’s where the similarities between eczema and psoriasis usually end. In order to give your skin the care it needs, a proper diagnosis from a board certified dermatologist is key. To give us non-dermatologists a better understanding of the ins and outs of eczema and psoriasis, we’ve tapped two top physicians for their expert insight.  

## **Eczema & Psoriasis 101**
Both eczema and psoriasis are skin conditions that, in some instances, present similarly. According to [Marisa Garshick, MD](https://aedit.com/provider/marisa-garshick-md-313), a NYC-based board certified dermatologist, they can appear as “red patches and plaques” on the skin, but “the causes, triggers, appearance, and treatment may differ between the two conditions.” In terms of similarities, eczema and psoriasis “are both conditions that reflect inflammation in the skin,” she shares – though “they occur for different reasons and can appear differently on the skin.” In terms of visible differences, Dr. Jaber says “psoriasis is typically more thick and scaly than eczema,” while eczema is often itchier than psoriasis.

With that in mind, let’s take a closer look at each:

### **What Is Eczema?**
Also known as atopic dermatitis, [eczema](https://aedit.com/aedition/best-skincare-products-to-treat-eczema-flare-ups-in-the-winter) “describes a condition when the skin becomes red, itchy, dry, and, sometimes, flaky,” Dr. Garshick shares. It is often genetic in etiology (if your parents had eczema, you likely will, too), and it “commonly appears in babies or early childhood,” she adds. While Dr. Jaber says that it “can improve as you get older,” it is “often seen in patients that also have allergies and asthma.” 

Eczema can affect any part of the body, but Dr. Jaber says it is more common “on areas that rub” such as “the inner elbow, behind your knees, neck, and arms, and legs.” Generally speaking, eczema is due to inflammation of the skin and is often triggered by irritants and things that dry out it out like harsh soaps, detergents, chemicals, clothing with a rough texture (think: wool), and stress. While we might think of cold winter climates as a culprit, warmer weather can exacerbate the condition, too. “For some people, intense heat and humidity can also aggravate the skin,” Dr. Garshick says. That includes hot showers.

**Your Eczema Cheat Sheet**

### **Causes & Triggers:**
- Inflammation 
- Genetics
- Environmental factors
- Stress

### **What it looks like:**
- Dry, itchy areas of skin
- Patches of red, gray, brown, or purplish skin 
- Affected areas can also be bumpy or uneven

### **Associated conditions:**
- Seasonal allergies or hayfever
- Asthma
- Family history

### **Common treatments:**
- Moisturizing, fragrance-free beauty routine 
- Lifestyle changes (i.e. shorter showers, humidifiers, etc.)
- Biologic medications

No two eczema experiences are the same. In mild cases, there may be just a bit of redness or flaking. In more severe instances, the skin can thicken, be very red, and peel. At its worst, it can put the skin at risk for superficial infections. Treatment can range from over-the-counter skincare to prescription medication depending on the severity.

### **What Is Psoriasis?** 
[Psoriasis](https://aedit.com/aedition/what-its-like-to-live-with-and-treat-psoriasis) is “an inflammatory skin condition that is characterized by red, scaly, well-demarcated plaques with silvery scales that can occur anywhere on the body,” Dr. Garshick explains. Unlike eczema, “psoriasis usually starts in adulthood and rarely occurs in children,” Dr. Jaber notes. Studies show there may be a hereditary component, and it can be associated with diabetes and heart disease. The average age of onset generally occurs at two different peaks. According to Dr. Garshick, the first is 15 to 35 years old and the second is 55 to 60 years old. 

Common areas that are affected by psoriasis include the scalp, elbows, knees, lower back, nails, hands, and feet. “Psoriasis tends to affect the extensor surfaces, such as the knee and elbow, and can be associated with joint pains and psoriatic arthritis,” Dr. Garshick shares. Flare-ups can be brought on by a variety of factors. “Psoriasis is often triggered by changes in the season, stress, alcohol, and skin trauma,” Dr. Jaber says. It can also be exacerbated in the aftermath of infections like strep throat, he adds. 

**Your Psoriasis Cheat Sheet**

### **Causes & Triggers:**
- Injury (think: insect bites, sunburn)
- Certain illnesses & medications
- Temperature changes
- Smoking & alcohol consumption 

### **What it looks like:**
- Red or pink plaques
- Raised rash with scales
- Clearly defined patches

### **Associated conditions:**
- Psoriatic arthritis
- Certain autoimmune conditions, including Crohn’s disease
- Type 2 diabetes

### **Common treatments:**
- Topical steroids
- Vitamin D analogs
- Narrowband phototherapy
- Lifestyle changes (i.e. diet, stress, etc.)

Eczema and psoriasis are similar in that every case is different. The condition usually manifests in unpredictable cycles that alternate between periods of few to no symptoms and more intense flare-ups. For some, psoriasis is a mostly cosmetic concern. But, for others, it can cause discomfort (physical and mental) and impact quality of life.

## **Diagnosing Eczema & Psoriasis**
If you are experiencing patches of scaly skin, the best way to determine whether you have eczema, psoriasis, or another skin condition is to schedule an appointment with your dermatologist. “In addition to the locations involved, associated symptoms, and the characteristic appearance, the most definitive way to distinguish the two is with a skin biopsy,” Dr. Garshick says. While the latter may be the most definitive, it’s not foolproof. “There are scenarios when even that is not conclusive to differentiate the two,” she admits.

When it comes to the physical exam, there are some specific indicators to keep an eye out for. “Eczema tends to be more ill-defined in the edges, while psoriasis is more well-demarcated,” Dr. Garshick explains. “Psoriasis is also known to experience the Koebner phenomenon, which is the appearance of new skin lesions in areas of skin trauma or injury in otherwise healthy appearing skin.”

Diagnosis may, however, be a little more nuanced on the face. Dr. Garshick says that it can sometimes be “challenging” to distinguish between eczema and psoriasis on the face – though “there are some hints based on location.” Because people with eczema tend to have more [sensitive skin](https://aedit.com/aedition/difference-between-sensitive-vs-sensitized-skin) in general, it “tends to favor the area around the eyes and mouth” and can be “more pronounced in areas of the face where the skin is thinner,” Dr. Garshick shares. This is not usually true of psoriasis. “On the face and scalp, some individuals can experience an overlap of psoriasis and seborrheic dermatitis (dandruff), which can affect the hairline, forehead, and eyebrows,” she adds.

## **Treating Eczema & Psoriasis**
Not only can a dermatologist diagnose your skin condition, but they can develop a treatment plan for it, too. “A dermatologist can help guide you on how to distinguish psoriasis from eczema as well as the specific treatment course,” Dr. Garshick says. This may include over-the-counter and prescription skincare, oral and injectable medications, and in-office procedures. “While the types of treatments may be similar – as both can be treated with topical creams as well as light therapy and oral or injectable medications – the specific ways and medications to treat the conditions can differ,” she notes. “It is always important to see a dermatologist to determine the best treatment options for you.”

### **How to Treat Eczema**
There are many ways to treat atopic dermatitis, and many of them require little to no professional intervention. “I always recommend starting out with simple lifestyle changes,” Dr. Jaber says. These modifications include:

- Using a [fragrance-free](https://aedit.com/aedition/fragrance-free-beauty-skincare-for-sensitive-skin) soap
- Taking shorter, cooler showers
- Patting (not rubbing) your skin dry
- [Moisturizing](https://aedit.com/aedition/best-body-creams-lotions-balms-for-every-skin-concern) twice a day 
- Running a [humidifier](https://aedit.com/aedition/humidifiers-facial-steamers-for-skincare-dry-skin-acne) at home
- Avoiding fragrance & skin irritants 

With your skincare routine, it’s all about preventing [dry skin](https://aedit.com/aedition/how-to-treat-prevent-dry-skin-face-body-hands) and irritation, but know that these changes may not be enough for everyone. “If, despite this, you still struggle with eczema, see a dermatologist for topical prescription medications,” Dr. Jaber says. “There are both steroid and non-steroid topical medications that work very well for mild to moderate eczema.” From a prescription perspective, Dr. Garshick points to non-steroid anti-inflammatory creams like Eucrisa® (crisaborole) and Elidel® (pimecrolimus) and injectable Dupixent® (dupilumab). For some patients, light therapy may also be effective. In the most severe cases, Dr. Jaber says there have been “some amazing advancements” in the treatment of eczema with biologic medications. 

### **How to Treat Psoriasis**
Psoriasis flare-ups can be unpredictable, and, as Dr. Garshick shares, “treatments do not provide a permanent cure” and “there’s always the chance it can come back.” Even so, there are some lifestyle adjustments that can help manage and maybe even prevent relapses. They include eating a [well-balanced diet](https://aedit.com/aedition/best-diet-for-healthy-beautiful-skin), maintaining a healthy body weight, keeping stress levels in check as much as possible, and many of the eczema-prevention tips outlined above. “Since psoriasis has been found to be associated with other medical conditions, such as an increased risk of heart disease, certain lifestyle modifications, such as weight loss and exercise, can be helpful for those with psoriasis and has been shown to improve psoriasis skin severity,” she notes.

From there, a multi-modal treatment plan often works best. Both of our experts agree that topical steroids and/or topical [vitamin D](https://aedit.com/aedition/guide-to-vitamin-d-in-skincare-wellness) analogs, like calcipotriene, can be effective – especially in the treatment of mild psoriasis. For moderate to severe cases, narrowband phototherapy and biologic medications are often a solution. As Dr. Garshick explains, the latter are “injections that target the immune system” and “have been a great advance” in the treatment of psoriasis because they allow patients to see results and clearer skin “relatively quickly.”

In terms of at-home skincare, Dr. Garshick says exfoliating acids can help to smooth scaly skin. “As some of the plaques can be thick, it can be helpful to use [salicylic acid](https://aedit.com/aedition/guide-to-beta-hydroxy-acids-salicylic-acid-in-skincare)-based creams on the plaques to help exfoliate and eliminate the dead skin cells,” she shares. Oh, and then there is this piece of advice that is true of psoriasis and pretty much every other skin concern: Don’t touch it. “You don’t want to manually pick off the scales in psoriasis, as that can trigger more scales,” she warns.

## **The Takeaway**
If you have red, rough patches of skin that are not responding to your usual hydrating skincare routine, it’s time to visit the experts to figure out the root cause. Even an article as comprehensive as this one cannot replace the expert eye of a [board certified dermatologist](https://aedit.com/aedition/skin-care-questions-for-your-dermatologist) when it comes to diagnosing and subsequently treating both eczema and psoriasis. Once you know what skin condition you are dealing with, you’ll be able to establish a treatment plan – including the necessary lifestyle adjustments – accordingly.

Expert Opinion

To the untrained eye, it can be difficult to distinguish between the red, scaly patches of skin. Here’s what you need to know about the common skin conditions.

Eczema vs. Psoriasis: What's The Difference Between The Skin Conditions?

Eczema vs. Psoriasis: What’s The Difference?

shutterstock 1348743422 (1)

If you’re one of the 32 million Americans who have eczema, you know that winter makes dealing with the affliction its own special project. The skin condition impacts children and adults alike and can crop up just about anywhere on the body. Eczema specifically refers to skin that has a damaged barrer, in addition to hydration loss and inflammation. In mild cases, there is just a bit of redness or flaking. In more severe instances, the skin can thicken, be significantly red, and peel. At its worst, it can put the skin at risk for superficial infections. 

The good news is that eczema is not contagious and flare ups usually come and go. Below, we caught up with top dermatologists and a star aesthetician to get their best tips and product recommendations for dealing with eczema in the winter months.  

## **What Causes Eczema**
Eczema is believed to develop due to a combination of genetic and environmental factors, and there is more than one type. While almost anyone can have dry skin, atopic dermatitis is genetic in etiology, says board certified dermatologist [Rita Linkner, MD](https://aedit.com/provider/rita-linkner-md-8907), of Spring Street Dermatology in New York City. “This means that if your parents had eczema, you would be likely to develop it,” she explains. “Childhood eczema is very common. In adults, eczema usually affects the hands.”  

Board certified dermatologist [Sejal Shah, MD](https://aedit.com/provider/sejal-shah-md-17984), of Manhattan’s SmarterSkin Dermatology says that atopic dermatitis is linked to an overactive immune system, while contact dermatitis is, as the name implies, caused by direct contact with an irritant (think: beauty products, jewelry, even plants). “Other factors such as dry skin, sweat, irritating skincare products, certain fabrics, excessive temperature extremes, and household products like cleaning products and detergents can exacerbate these types of eczema,” Dr. Shah says. 

Most common in the winter months is xerotic eczema, which develops as a result of excessively dry skin and often impacts people in cold, dry conditions. Dr. Shah says other types of eczema include nummular and stasis.

## **How to Treat Eczema**
Dr. Linkner says that eczema flare ups imply the body isn’t doing a good enough job manufacturing the lipids that keep the skin’s barrier intact. The good news is that humectifying topicals can help reestablish the barrier. Celebrity aesthetician and eponymous brand founder [Renée Rouleau](https://www.reneerouleau.com/) agrees, saying that “while there is not technically a known cure, you can definitely help improve the appearance of eczema by strengthening the skin’s barrier.”

### **1. Keep Showers Short** 
Dr. Shah says that, in addition to moisturizing, it’s important to avoid triggers. She recommends using a humidifier if the environment is dry, bathing with lukewarm water, keeping showers short, and using a sulfate-free gentle cleanser. Dr. Linker agrees that showers should be “all business, no pleasure.” “Quick, cool-water showers are best for not stripping the skin,” she explains. For a noruishing, suds-free wash try [Skinfix Eczema+ Foaming Oil Body Wash](https://www.sephora.com/product/eczema-foaming-oil-body-wash-P442847). 

### **2. Hydrate From Head to Toe**
As for moisturizing, Dr. Linkner recommends applying [Cetaphil Moisturizing Cream](https://www.ulta.com/moisturizing-cream?productId=6120&sku=5022058&cmpid=PS_Non!google!Product_Listing_Ads&cagpspn=pla&CATCI=aud-842462607482:pla-820687546282&CAAGID=80241971458&CAWELAID=305687948&CATARGETID=330000200001847063&CADevice=c&gclid=CjwKCAiAu9vwBRAEEiwAzvjq-yB--awpbEH7rpEGuqFcEa1dz7N-CIopeZEBiAXdPi4bBwd9SgD4FxoCLNMQAvD_BwE) post-shower and using [Aquaphor](https://www.target.com/p/unscented-aquaphor-jar-14oz/-/A-11014466?ref=tgt_adv_XS000000&AFID=google_pla_df&fndsrc=tgtao&CPNG=PLA_Beauty%2BPersonal+Care%2BShopping_Local&adgroup=SC_Health%2BBeauty&LID=700000001170770pgs&network=g&device=c&location=9067609&ds_rl=1246978&ds_rl=1247077&ds_rl=1246978&gclid=CjwKCAiAu9vwBRAEEiwAzvjq-50ONWqD2irubX5MTGxFR0xxF7ycdZ65-mY6U-CqTJIRLMmV-dB4wBoC66cQAvD_BwE&gclsrc=aw.ds) on the cuticles and lips. Dr. Shah likes [Vanicream Moisturizing Skin Cream](https://www.amazon.com/Vanicream-Moisturizing-Sensitive-Irritated-Dermatologist/dp/B000NWGCZ2) and [Avene XeraCalm A.D Lipid-Replenishing Cream](https://www.aveneusa.com/xeracalm-lipid-replenishing-cream). 

If you're looking for a facial moisturizer with a tight ingredient list (think: 10 or less!), we're fans of the [Chanel La Solution 10](https://www.chanel.com/us/skincare/la-solution-10-de-chanel/c/6x2x4/?gclid=CjwKCAiAu9vwBRAEEiwAzvjq-wrbUK55Px7EtjLuJ9FUEJ2YRSmMiGd7WhfiLzwdQWsyq5NWUghA-RoC1mAQAvD_BwE). For one that is just as good on the face as it is on the body but doesn't irritate sensitive, eczema-prone skin, we like [First Aid Beauty Ultra Repair Cream Intense Hydration](https://www.sephora.com/product/ultra-repair-cream-intense-hydration-P248407). 

For facial eczema sufferers who still want to wear makeup, Dr. Linkner likes the [Armani Maestro](https://www.giorgioarmanibeauty-usa.com/makeup/foundation/liquid-foundation/maestro-fusion-makeup/A300.html) collection, as it doesn’t have many preservatives or allergen-prime ingredients. Dr. Shah is partial to cosmetics from [VMV Hypoallergenics](https://www.vmvhypoallergenics.com/). 

### **3. Look for Products With These Ingredients**
“Moisturizers will be beneficial for repairing your skin’s moisture barrier when it’s damaged, but it’s important that you look for specific ingredients that mimic the natural lipids found in your skin,” Rouleau shares. “Just because a moisturizer feels rich and greasy on the skin doesn’t necessarily mean that it will offer repair.”

To repair a damaged moisture barrier, Rouleau likes a range of ingredients including carrot, evening primrose, sweet almond, jojoba, and cranberry oils, ceramides, squalane, non-exfoliating linoleic and linolenic acids, and shea butter. While these ingredients may call to mind products with heavy, occlusive textures, Rouleau says that the components can be blended into lightweight formulas that don’t clog pores. “It simply depends on the percentages used and the oil-to-water ratio within the formula,” she explains. 

Her [Sheer Moisture Lotion](https://www.reneerouleau.com/products/sheer-moisture-lotion) is “excellent for repairing the barrier for those with oily, combination and breakout-prone skin” because “it’s very lightweight,” she says. Her [Phytolipid Comfort Creme](https://www.reneerouleau.com/products/phytolipid-comfort-creme), meanwhile, is formulated for those who want a richer texture. For something in the middle, her [Hydraboost Rescue Creme](https://www.reneerouleau.com/products/hydraboost-rescue-creme) offers a good balance. 

Dr. Linkner says eczema-prone patients should look for ingredient lists containing lipids, cholesterol, and colloidal oatmeal, as they are all humectifying (read: moisture preserving) actives. Dr. Shah recommends products with ceramides, niacinamide, hyaluronic acid, glycerin, chamomile, shea butter, and plant oils that soothe and hydrate the skin, while helping to repair the skin barrier.

### **4. Avoid Products With These Ingredients**
Just as there are good-for-you actives to stock up on, there are ingredients the eczema afflicted should avoid. Dr. Linkner says to steer clear of anything that strips the skin, like vitamin A or vitamin C, while Rouleau says that sulfates — specifically, sodium lauryl sulfate — are harmful to the skin when used in high concentrations. She says that it can cause eczema to flare up and severely damage the skin’s protective barrier resulting in extreme water and moisture loss. 

Additionally, Dr. Shah says to be cautious about fragrances, formaldehyde (and formaldehyde-releasing ingredients), dyes, phthalates, parabens, and alcohol. Oh, and just because something is ‘clean’ or ‘natural’ doesn’t mean it’s right for sensitive skin. “Use caution with essential oils and botanical ingredients as they can be potentially irritating,” she notes. 

## **The Takeaway**
As with any eczema flare up, treating the condition in the winter requires patience, care, and the right combination of skincare ingredients. Finding products that both hydrate the skin and heal its damaged barrier can keep eczema in check, as can taking shorter showers and investing in a humidifier to counteract the season’s cold, arid air.

*All products featured are independently selected by our editors, however, AEDIT may receive a commission on items purchased through our links.*

If you’re one of the 32 million Americans who have eczema, you know that cold, dry air makes dealing with the skin condition its own special project. Here, dermatologists and aestheticians share tips for dealing with eczema in the winter months. 

The AEDITION

Eczema