Psoriasis vs. Eczema in Salt Lake City, UT

A person scratching their forearm with eczema by Swinyer Woseth Dermatology

Understanding Psoriasis vs. Eczema: Diagnosis & Treatment Options in Salt Lake City

Have you ever looked at a red, itchy patch on your skin and wondered, “Is this eczema or something else?” You aren’t alone. Skin conditions often look remarkably similar to the untrained eye, leading to confusion and, unfortunately, ineffective home treatments. Two of the most common—and often confused—skin conditions are eczema and psoriasis. While they share features such as redness, inflammation, and itchiness, they are distinct diseases with different underlying causes and treatment paths. Understanding the nuances of psoriasis vs. eczema is critical for finding relief and managing your skin health long-term. At Swinyer Woseth Dermatology in Salt Lake City and South Jordan, UT, we see patients every day who struggle to differentiate between these two conditions. This guide will help you understand the key differences, symptoms, triggers, and treatment options so that you can have an informed conversation with your dermatologist.

Overview of Psoriasis & Eczema

Before diving into the visual differences, it helps to understand what is happening beneath the surface. Eczema (atopic dermatitis) is primarily a hypersensitivity reaction. It is often linked to a compromised skin barrier that allows moisture to escape and irritants to enter. This triggers an inflammatory response. Eczema is strongly associated with the “atopic triad,” which includes asthma and hay fever. If you have allergies, you are more likely to experience eczema. It is incredibly common in children, though many adults suffer from it as well. Psoriasis, on the other hand, is an autoimmune disease. In a healthy body, skin cells grow and shed in a cycle that takes about a month. In people with psoriasis, the immune system becomes overactive, speeding up the process and causing skin cells to multiply in just a few days. These cells accumulate on the surface, forming thick, scaly patches. While it involves inflammation, such as eczema, the root cause lies in the immune system attacking healthy skin cells.

Key Differences in Symptoms and Appearance

While both conditions cause rashes, a closer look reveals distinct characteristics.

Itch vs. Burn: The sensation is often a significant clue. Eczema is notoriously itchy—so much so that it is often called “the itch that rashes.” The itching can be intense, leading to scratching that causes the skin to bleed. Psoriasis can also be itchy, but patients often describe the sensation as burning or stinging, akin to being bitten by fire ants.
Texture and Color: Eczema rash vs. psoriasis plaques look different. Eczema typically presents as red, inflamed, and dry skin. It may feature small fluid-filled blisters that ooze and crust over. The borders of the rash are usually ill-defined. Psoriasis plaques are thicker and more raised. They are typically well-defined with sharp borders. A hallmark of plaque psoriasis is the silvery-white scale that covers the red patches.
Location: While both can appear anywhere, they have preferred spots. Eczema loves the “flexural” areas—the insides of the elbows and the backs of the knees. It also frequently appears on the neck, wrists, and ankles. Psoriasis favors the “extensor” surfaces—the outside of the elbows and knees. It is also very common on the scalp, lower back, and palms.
Eczema vs. psoriasis around the eyes: This is a tricky area. Eczema around the eyes is common and often presents as dry, flaky, red, and swollen eyelids. Psoriasis around the eyes is rarer but can occur. When it does, the scales may block vision or cause the lashes to fall out. Because the skin here is delicate, accurate diagnosis is vital to prevent eye damage.

Triggers and Risk Factors

Knowing what sets off a flare-up can help you manage your condition. While stress and weather changes can aggravate both, other triggers tend to be specific to the disease.

Common Eczema Triggers:
- Irritants: Soaps, detergents, shampoos, and disinfectants.
- Allergens: Dust mites, pets, pollens, and molds.
- Temperature: Extreme heat or cold, high humidity, or dry air.
- Fabrics: Wool and synthetic fibers.
- Foods: In some cases, dairy, eggs, nuts, or soy can trigger flares.
Common Psoriasis Triggers:
- Skin Injury: Cuts, scrapes, bug bites, or severe sunburns (known as the Koebner phenomenon).
- Infections: Strep throat is a well-known trigger for guttate psoriasis, a specific type of the disease.
- Medications: Certain drugs, including lithium, high blood pressure medications, and antimalarials.
- Lifestyle: Heavy alcohol consumption and smoking.

How Dermatologists Diagnose Each Condition

Because psoriasis vs. eczema symptoms can overlap, self-diagnosis is risky. A board-certified dermatologist uses specific diagnostic tools to get it right. Diagnosis typically begins with a thorough physical exam and medical history. Your doctor will ask about your family history, as both conditions have genetic components. They will examine the rash distribution and the appearance of the scales.

Dermoscopy: A dermatologist may use a specialized magnifier to examine the skin closely. Psoriasis often shows dilated blood vessels that appear as red dots (Auspitz sign) when scales are removed.
Biopsy: If the visual exam isn’t conclusive, a small skin sample (biopsy) may be taken. Under a microscope, eczema skin looks spongy and swollen, while psoriasis skin shows thickened layers of compacted cells.
Patch Testing: If eczema is suspected, specifically contact dermatitis, patch testing can identify allergic reactions to specific substances.

Treatment Options for Eczema Rash vs. Psoriasis

Although there is no cure for either condition, modern dermatology offers practical ways to manage symptoms and clear the skin. Eczema vs. psoriasis treatment plans differ significantly due to the underlying causes.

Treating Eczema

The goal is to repair the skin barrier and reduce inflammation.

Moisturizers: Heavy creams and ointments are essential to lock in hydration.
Topical Corticosteroids: These anti-inflammatory creams are the mainstay for calming flares.
Topical Calcineurin Inhibitors: Non-steroid creams that stop the immune system from reacting.
Biologics: For severe cases (like Dupixent), injectable medications target specific parts of the immune system involved in inflammation.
Antihistamines: These help control the severe itching, especially at night.

Treating Psoriasis

The goal is to slow down the rapid growth of skin cells and suppress the immune system.

Topical Treatments: Vitamin D analogues (like calcipotriene), retinoids, and coal tar are used alongside corticosteroids to slow cell growth.
Phototherapy: Controlled exposure to UV light can help slow the growth of affected skin cells.
Systemic Medications: Methotrexate or cyclosporine are oral drugs that work throughout the body to suppress the immune system.
Biologics: These are potent, targeted therapies that are injected or infused to block specific immune proteins (such as TNF-alpha or interleukins) that drive psoriasis.

When to Seek Specialized Dermatologic Care

Over-the-counter hydrocortisone might help a mild bug bite, but it rarely makes a dent in chronic eczema or psoriasis. You should schedule an appointment at Swinyer Woseth Dermatology if:

The condition covers a large area of your body.
The itch or pain disrupts your sleep or daily activities.
You see signs of infection, such as crusting, oozing, or red streaks.
Over-the-counter treatments aren’t working.
The rash appears in sensitive areas, such as the face or genitals.
You experience joint pain (a sign of psoriatic arthritis).

Managing Your Skin Health in Utah

Living with a chronic skin condition can be frustrating, but you don’t have to navigate it alone. Whether you are dealing with the dry mountain air of Salt Lake City aggravating your eczema or stress triggering a psoriasis flare in South Jordan, accurate diagnosis is the first step toward relief. Understanding the differences between psoriasis and eczema empowers you to seek the proper care. With a personalized treatment plan, you can minimize flares, reduce discomfort, and feel confident in your skin again. If you are struggling with a persistent rash, contact us today for treatment.