What Is the Difference Between Eczema, Psoriasis, and Rosacea?

Eczema, psoriasis, and rosacea are 3 of the most common skin conditions. While it is easy to confuse them, each condition is distinct.¹

All 3 can lead to skin that looks red and irritated. And all 3 are chronic, meaning they occur or reoccur over a long time. But they each have important differences.¹

What is eczema?

The term “eczema” refers to rashes that can be triggered by allergies or contact with irritating substances. Eczema is often worse in people who have dry or sensitive skin.^1,2

Symptoms of eczema

A dry, itchy, bumpy rash is the hallmark of eczema. It can also cause the skin to have a leathery texture. Patches of eczema may flake, scale, or crust. On people with darker skin tones, eczema may appear purple, gray, or brown. On lighter skin, it can look pink, red, or purple.^1,2

Eczema can show up anywhere on the body, such as the:²

• Hands
• Neck
• Elbows
• Knees
• Feet
• Face
• Ears
• Lips

Many people with eczema show signs of it before they turn 5 years old. But it is also common for older children and adults to develop it.³

Causes of eczema

Eczema weakens the barrier your skin provides against germs and irritants. When this barrier is weakened, it is harder for your skin to keep the moisture it needs. Further drying out then worsens the eczema.²

Allergic eczema is driven by an abnormal immune response to normal irritants or allergens. This response causes inflammation. Your genes also play a role, which means eczema can run in families.^2,3

Substances in your environment that can be irritating, like harsh cleansers or certain fabrics, can also trigger eczema. And emotions such as stress also can bring on an eczema flare.²

Treatments for eczema

The first step in managing eczema is to know your triggers and avoid them. You also can use gentle moisturizers to increase the moisture in your skin. You may need to apply it several times a day. Applying a moisturizer after bathing helps to seal in moisture.²

When you have a flare-up, your doctor may prescribe medicine to apply directly to your skin. Your doctor may also prescribe drugs that are injected or swallowed. For some people, light therapy (phototherapy) can help manage eczema symptoms.²

What is psoriasis?

Psoriasis is an autoimmune disorder. This means that the body’s own immune system attacks the skin. Psoriasis causes thick, scaly patches on the skin. Like eczema, it is a chronic condition.⁴

Eczema and psoriasis can look similar. But people with psoriasis tend to have thick plaques covered in scales.⁴

Symptoms of psoriasis

Psoriasis commonly appears on the:⁴

• Knees and elbows
• Face
• Inside of the mouth
• Scalp
• Lower back
• Palms and feet
• Fingernails and toenails
• Genitals

Symptoms of psoriasis include:⁴

• Itchy skin
• Cracked or dry skin
• Pain in the skin or joints
• Pitted or cracked nails

Causes of psoriasis

Like eczema, psoriasis is caused by an unusual immune response. However, the immune processes involved in these 2 conditions are different.^4,5

In healthy skin, cells are replaced every 30 days. But in skin affected by psoriasis, this timeline is turbocharged – skin cells are replaced every 3 or 4 days. This causes scales to develop.^4,5

Things that may trigger psoriasis include:⁴

• Emotional stress
• Infection
• Skin injuries, like cuts and scrapes
• Some medicines, like lithium and beta blockers
• Body temperature changes

Treatments for psoriasis

Treatment depends on how severe your psoriasis is. It also depends on your age and where flare-ups occur on your body.⁴

Your doctor may suggest or prescribe:⁴

• Medicated topical treatments, like steroid creams, medicated lotions, or shampoos
• Medicines that slow skin cell production
• Vitamin D3 or vitamin A creams
• Phototherapy
• Psoralen plus ultraviolet light
• Immune therapy
• Methotrexate
• Cyclosporine

What is rosacea?

Rosacea is an inflammatory skin condition that causes persistent redness. It can look and feel like a sunburn that will not go away.⁶

Symptoms of rosacea

People with rosacea may experience:⁶

• Frequent flushing or blushing
• Bumps and pimples
• Visible blood vessels
• Eye irritation
• Burning or stinging
• Facial swelling
• Dryness in the middle of the face

Sometimes, rosacea also causes skin to thicken. This most typically happens around the nose.⁶

Causes of rosacea

Rosacea is a complex condition that experts do not fully understand. They think it is caused by a breakdown of both nerves and vessels. This may activate the immune system. Microscopic face mites also may play a role.⁶

People with rosacea often have triggers that directly cause a flare-up. Triggers may include emotional stress, certain foods, or too much sun.⁶

Treatments for rosacea

Your doctor will tailor your treatment to your particular symptoms. A wide variety of topical and oral medicines can help manage symptoms. Some control the redness, while others control the bumps and pimples. Some people with rosacea also need to use a long-term anti-inflammatory therapy.⁶

Talk to your doctor

If you think you have eczema, psoriasis, or rosacea, talk to your doctor. If your symptoms are affecting how you feel about yourself or your activities, seek a diagnosis so you can begin the correct treatment and feel better.