Eczema and Psoriasis: Which Do You Have?

Dry, itchy, inflamed skin can interrupt your life — especially when it shows up in patches on your elbows, knees, scalp, or face. Two common causes of these symptoms are eczema (also known as atopic dermatitis) and psoriasis. Both can leave you feeling uncomfortable and self-conscious, but they have different underlying causes and treatments.

At Holladay Dermatology & Aesthetics, Dr. Robert Topham and our team help people just like you figure out what’s behind their symptoms and find the right path to lasting relief — whether that’s with medical treatment, lifestyle adjustments, or targeted therapies like those described on our dermatology services page.

Let’s walk through the key differences so you can better understand what your skin might be trying to tell you.

What eczema feels and looks like

Eczema is an inflammatory skin condition rooted in an over-reactive immune response and a weakened skin barrier. Many people first experience it in childhood, though it can show up at any age. Eczema tends to come and go in “flares,” often triggered by stress, temperature changes, irritants, or dry skin.

Common features of eczema include:

• Itchy, sore patches that may ooze or crust
• Skin that feels dry, rough, or scaly
• Redness that spreads beyond a central area
• Flares that worsen with scratching or irritation

Itching is often the dominant symptom with eczema, so much so that the urge to scratch can make irritation worse and lead to thickened, leathery patches over time.

What psoriasis looks and feels like

Psoriasis is an immune-mediated condition that causes skin cells to reproduce too quickly. Instead of shedding normally, new cells pile up on the surface, creating thick, raised patches of flaky skin.

Psoriasis often appears as:

• Silvery, scaly plaques with clearly defined edges
• Symmetrical patches on both sides of the body
• Involvement of the scalp, elbows, knees, or lower back
• Less intense itching than eczema, though it can be uncomfortable

Some people also experience psoriatic arthritis, where inflammation affects the joints along with the skin. That’s one reason early diagnosis and treatment are so valuable.

How to tell them apart

Because both conditions can cause red, irritated patches, it’s easy to confuse them — especially if you’re looking at photos online. Here are a few key distinctions:

Pattern and appearance

Eczema: Often red, raw, and very itchy; patches can spread and may ooze.
Psoriasis: Typically thicker, silvery scales with sharper borders.

Location

Eczema: Common in skin folds (behind knees, inside elbows), face, neck, hands.
Psoriasis: Common on extensor surfaces (elbows, knees), scalp, lower back.

Itch vs. scale

Eczema usually itches first. Psoriasis often scales first and may itch or burn later.

Triggers also differ: eczema flares often follow exposure to irritants or allergens, while psoriasis can flare with stress, infections, medications, or changes in weather.

Because these conditions overlap in some people, there are rare cases where a dermatologist needs a biopsy or other exam to be certain. That’s why a professional evaluation — like the ones we offer at Holladay Dermatology & Aesthetics — can make all the difference.

How we help you feel better

Whether your symptoms point more toward eczema or psoriasis, effective treatment begins with an accurate diagnosis. We offer a range of options tailored to your condition, severity, and lifestyle.

Topical therapies work wonders for many patients with both conditions — soothing inflammation and restoring a healthier skin barrier. For more persistent or widespread disease, we may recommend advanced treatments, including prescription-strength medications or light-based therapies.

If your diagnosis points to psoriasis, we also consider systemic options and biologic medicines when appropriate, especially in moderate-to-severe cases. For eczema, we focus on barrier repair, itch control, and triggers so flares are less frequent and less intense.

Every treatment plan at Holladay starts with you — your symptoms, your goals, and your day-to-day life.

Call Holladay Dermatology & Aesthetics in Holladay, Utah, and let’s figure this out together — so you can get back to feeling comfortable and confident in your own skin.