Eczema vs. psoriasis

Both eczema and psoriasis are skin conditions, with similar symptoms such as inflammation and pruritis, however they differ on the way they are both treated. But, how can we differentiate them between each other? Here are the main differences.

Eczema

Eczema appears as red dry scaly patches on the skin. Sometimes it can become swollen and quite inflamed. Similar to psoriasis, eczema can be quite itchy and uncomfortable. It mainly appears on areas such as elbows, knees, wrist or ankles and sometimes even on face or hands. It can be caused by certain irritants or allergens, stress or genetic origin.

Which are the main treatments?

• Emollients

  Emollients are very effective products which help to smoothen out the skin, hence reducing the dryness and scales associated with eczema.

  Most of them are paraffin based, which is quite a strong moisturiser such as Epimax, Cetraben, Epaderm etc.

  There are also certain emollients which contain specific ingredients such as:

  • urea which is a keratin softener and very hydrating such as Balneum Plus, Eucerin Intensive, Hydromol Intensive, or E45 Itch relief

  • lauromacrogols which have anaesthetic properties to relieve itching such as Balneum Plus or E45 Itch relief

  • lanolin or lanolin derivatives which have hydrating properties such as Oilatum emollient bath additive, E45 cream

  • antiseptics which include chlorhexidine dihydrochloride or benzalkonium chloride which help to keep the area of inflammation clean and prevent any infection such as Dermol 500 lotion, Oilatum Plus bath additive

• Topical corticosteroids

  Topical corticosteroids are a type of steroids which help to reduce the inflammation and irritation of the skin. They come into 4 different potencies: mildly potent, moderately potent, potent and very potent. 

  The ones which can be sold without a prescription are hydrocortisone 1% cream/ointment 15 g (mildly potent)  or clobetasone 0.05% cream 15 g  (moderately potent).

  These topical corticosteroids are recommended to be applied very thinly twice daily for 7 days. If no improvement after 7 days, you need to speak to your doctor. It also shouldn't be applied to face or genitals.

• Oral antihistamines

  Oral antihistamines are not recommended for regular use when having eczema. They are recommended to be used only in severe cases of itching. Usually non drowsy antihistamines such as loratadine, cetirizine, or fexofenadine can be considered.

Psoriasis

Psoriasis is a skin autoimmune disease characterised by well-defined layered scaly patches of skin which overlies redness. The patches can be silvery in colour and much thicker and more inflamed in nature than eczema. It is also characterised by itching.

Compared to eczema, psoriasis can appear everywhere in the body, and genetics tend to be a major cause for this skin condition.

Which are the main treatments?

• Emollients

  Same to eczema, same emollients can be used for psoriasis to hydrate and moisturise the skin.

• Vitamin D preparations

  Vitamin D preparations such as calcipotriol or calcitriol can only be supplied by prescription. They work by slowing down the build up of the skin cells which reduces inflammation and thickness of the skin patches.

• Salicylic acid containing products for scalp

  Salicylic acid containing products such Sebco or Cocois sclap ointment or Capasal shampoo are used in cases of psoriasis spread in scalp. The salicylic acid has antibacterial properties and helps to get rid of the scales and flaky dead skins. It is recommended to read patient information leaflet to check any allergies and dosage instructions.

• Coal tar products

  Coal tar has anti-inflammatory and anti-scaling properties. Some products used for scalp psoriasis include: Alphosyl 2 in 1 shampoo, Capasal shampoo, T-Gel shampoo etc. Products used for psoriasis in trunk and limbs include Exorex lotion or Psoriderm cream. Please consult with a pharmacist or read patient information leaflet before use.

• Topical corticosteroids

  Same as eczema, topical corticosteroids are recommended to help reduce inflammation and redness of the skin.

• Phototherapy

  Phototherapy uses artificial and natural light to treat psoriasis. It is usually done under the supervision of a dermatologist.