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What is the Difference Between Eczema and Psoriasis?

One of the most common consultations a pharmacist will have during the working day is to take a look at a rash, lump, bump, or spot on a patient - sometimes you get them all on the one patient! Skin conditions are incredibly common, normally self limiting, and can randomly appear. As hard as it can be, try to avoid Google searching your symptoms, as this will always point you in the direction of a rare disease you’ve never heard of, or more often than not tell you you have weeks to live.. In this article I take a look at eczema and psoriasis, two common but similar conditions. We take a look at the causes, symptoms, treatments, and general advice around both conditions and how you can help identify one condition over another.

What Are The Symptoms of Eczema?

Eczema can cause a very intense itch. It makes your skin very red and inflamed, which can result in the skin looking dry or crusty. Inflamed skin can become red on lighter skin, and darker brown, purple or grey on darker skin. Although atopic eczema can affect any part of the body, it most often affects the hands, insides of the elbows, backs of the knees and the face and scalp in children. Eczema can also have periods of time where the symptoms are not as noticeable, and will have periods where the symptoms have worsened – these are known as flare ups.

What Are The Symptoms of Psoriasis?

Psoriasis is a skin condition with the same symptoms of red, flaky, crusty patches of skin. However the main tell tale symptom that differentiates the two is that with psoriasis the skin is covered with silvery scales. These patches normally appear on your elbows, knees, scalp and lower back, but can appear anywhere on your body. With psoriasis, the skin normally is thicker and more inflamed than people with eczema.

What Causes Eczema?

The exact cause of atopic eczema is unknown, but it's clear it is not down to one single thing. Atopic eczema often occurs in people who get hayfever, asthma, and allergies. "Atopic" means sensitivity to allergens. Eczema often has certain triggers, such as soaps, detergents, stress and the weather. Sometimes food allergies can play a part, especially in young children with severe eczema. A food diary to try to determine whether a specific food makes your symptoms worse.

What Causes Psoriasis?

The cause of psoriasis is known however. Psoriasis is the result of increased skin cell production. The cells are normally made and replaced every 4 weeks, but in psoriasis this process only takes about 3 to 7 days. The resulting build-up of skin cells is what creates the patches associated with psoriasis. Although the process is not fully understood, it's thought to be related to a problem with the immune system. Many people's psoriasis symptoms start or become worse because of a certain event, known as a trigger. Possible triggers of psoriasis include an injury to your skin, throat infections and using certain medicines.

What Age Am I Likely to Get Eczema?

Eczema is more common in children, often developing before their first birthday. But it may also develop for the first time in adults. It's usually a long-term (chronic) condition, although it can improve significantly, or even clear completely, in some children as they get older.

What Age Am I Likely to Get Psoriasis?

Psoriasis can start at any age, but most often develops in adults under 35 years old, and affects men and women equally. It currently affects 2% of the UK population.

How Do I Treat Eczema?

Treatment for eczema involves managing symptom control and providing relief. However, there is currently no cure for eczema. To reduce patient symptoms some medications can be used. Emollients such as Dermol, are used as a daily moisturiser to help with dry skin, topical corticosteroids such as hydrocortisone and mometasone can be used to help reduce the swelling, redness, and itchiness a patient experiences during a flare up. Self help counselling such as using a food diary to see if any certain foods cause a flare up, avoid scratching the skin, and try to avoid triggers as much as possible. If your eczema is more severe, an immunosuppressant drug like methotrexate or azathioprine may be prescribed.

How Do I Treat Psoriasis?

With psoriasis, there is also no cure. So treatment options are to help symptom control. For most patients, the first treatment used will be a topical treatment, such as topical corticosteroids. Topical treatments are creams and ointments applied to the skin. In severe cases, where the above treatments are ineffective, systemic treatments may be used. These are oral or injected medicines that work throughout the whole body. Methotrexate is an immunosuppressant used in the treatment of psoriasis. Newer drugs used in the systemic treatment of psoriasis include biologic medicines such as adalimumab and infliximab.

If you feel like you have any of these symptoms then please visit your local pharmacist and they will be more than happy to help you. They will be able to look at your skin and provide professional advice on your next steps to a healthier you.

 

Author Matt Jennings

MRPharmS

Clinically Reviewed By:

Ibrahim Nakib BSc(Hons) MRPharmS

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