What is the difference between eczema, dermatitis and psoriasis?

For millions of Australians, the battle against itchy, inflamed skin is a daily reality. One of its causes is rated in the top five causes of non-fatal disease burden. Three common culprits behind this struggle are eczema, dermatitis, and psoriasis. 

These terms are often interchangeable in general discussion, but they are completely different & represent distinct skin conditions with varying characteristics and management strategies. If you’re experiencing itchy and inflamed skin, you must understand the differences to seek appropriate treatment and improve your quality of life. 

Eczema vs psoriasis vs dermatitis: the differences

Eczema

Appearance

Eczema, also known as atopic dermatitis, typically manifests as red, dry, itchy patches of skin with fine scaling. Blisters, oozing, and crusting can occur in severe cases.

The skin may also appear discoloured, with shades varying from pink to brown, depending on your skin tone.

Sensation

Eczema is notorious for its intense itching, often worse at night and with scratching. The sensation can be relentless and even disrupt sleep.

Location

It typically affects the inner elbows, back of the knees, face, and neck. However, it can appear on any part of the body. In infants, eczema tends to affect the cheeks and scalp.

Triggers

Numerous factors can trigger eczema flares, including stress, dry air, harsh soaps, allergies, and certain fabrics. Identifying individual triggers is crucial for effective management.

Onset

Most commonly, eczema develops in infanthood between ages 0 and 6 months. According to a study, more than half of surveys indicated that the condition was diagnosed around that age. Many children outgrow the condition, but for 52% of eczema sufferers, it continues into adulthood.

Treatment options

Treatment for eczema involves a combination of moisturising creams to hydrate the skin, topical steroids to reduce inflammation during flare-ups, and avoiding known triggers. In severe cases, doctors may prescribe systemic treatments or immunosuppressant medications. They may also recommend phototherapy.

Psoriasis

Psoriasis is multi-system disease that can affect the joints, heart, lung and bowels and is not often well understood. 

Appearance

Psoriasis presents as thick, red, raised patches of skin covered with silvery-white scales. These plaques are distinctive and can cover large areas of the body.

Sensation

Psoriasis typically causes less intense itching than eczema, but burning, stinging, and tenderness are common. If psoriasis affects joints, it can lead to painful cracking and bleeding of the skin.

Location

Common areas for psoriasis include the scalp, elbows, knees, and lower back, but it can develop anywhere, including the nails and joints.

Triggers

Hormones, stress, infections, physical injury to the skin, certain medications, and weather changes can trigger psoriasis flares. But unlike eczema, psoriasis is more closely linked to the immune system, and these triggers can prompt an autoimmune response.

Onset

Psoriasis can start at any age, with two common onset periods: one in late adolescence and another in middle age. This is especially true for hormone-caused psoriasis because it’s associated with puberty and menopause.

Treatment options

The severity and extent of the condition can vary significantly from person to person, so treatment of psoriasis also varies. It ranges from topical creams and ointments to help reduce inflammation and slow skin cell growth to phototherapy. For more severe cases, systemic medications and biologic drugs target specific parts of the immune system.

Dermatitis

Dermatitis encompasses a broad category of skin conditions, each with diverse presentations. So, the specific appearance, sensation, location, and triggers can vary depending on the type of dermatitis. Here are some of them:

• Atopic dermatitis. This is another term for eczema, which we covered in detail above.
• Contact dermatitis. This skin problem presents as a red, swollen rash. It may also blister, ooze, or develop crusts. The sensation is often intense itching or burning, especially when the skin comes into contact with allergens or irritants. Common locations include areas directly exposed to the irritant or allergen, such as hands, face, neck, or legs. Triggers range from allergic reactions to substances like nickel, latex, or certain cosmetics to irritants such as soaps, detergents, or chemicals. Contact dermatitis typically occurs soon after exposure to the trigger.
• Seborrheic dermatitis. It’s characterised by oily, scaly patches on the skin, often appearing with a yellowish or reddish tinge. It can be itchy and slightly sore. This usually occurs on the scalp, face (particularly around the nose and eyebrows), ears, and chest. The exact causes are unclear, but stress, hormonal changes, cold and dry weather, and yeast living on the skin are potential triggers. It is common in infants (as cradle cap) and adults.

Managing dermatitis involves avoiding known triggers, using emollients to moisten the skin, and applying topical steroids during flare-ups. In some cases, antihistamines are prescribed to control itching.

Have your skin checked at ENRICH

If you’re worried you have one of these skin conditions and need help with diagnosis or treatment, contact us.