Eczema and psoriasis are both common inflammatory skin conditions that cause redness and itching — but they’re entirely different diseases with different causes and different treatments. Getting the right diagnosis is essential for effective management.

Eczema (Atopic Dermatitis)

Eczema is driven by an impaired skin barrier combined with an overactive Th2 immune response. The hallmarks: intensely itchy skin, dry and flaky texture, erythematous (red) or erythematous-brown plaques depending on skin tone. In infants, typically affects cheeks and scalp; in older children and adults, it involves the flexural areas (inside elbows, behind knees, wrists, ankles, neck). Weeping and crusting suggests secondary infection (usually Staphylococcus aureus). The itch is the defining feature — it’s severe enough to disrupt sleep. Triggers are individual but commonly include wool, synthetic fabrics, soaps, fragrances, heat, sweating, stress, and certain foods (in young children).

Psoriasis

Psoriasis is a chronic autoimmune condition causing rapid, abnormal skin cell turnover. Skin cells are produced in 3–5 days instead of the normal 28 days, accumulating as thick, silvery-white scaly plaques on a red base. Plaques are typically well-defined, with a “punched-out” appearance. Most commonly affects elbows, knees, scalp and lower back — the extensor surfaces, unlike eczema which favours flexural areas. Itch is present but often less intense than eczema. The Koebner phenomenon — new plaques appearing at sites of skin trauma — is characteristic. Psoriasis is associated with psoriatic arthritis in ~30% of cases and with increased cardiovascular risk.

OTC Management of Eczema

Emollients are the cornerstone — liberal and frequent application of a thick moisturiser (Aveeno, Doublebase, Diprobase) to reduce barrier loss and prevent flares. Hydrocortisone 1% cream for mild flares on body skin (not face). Avoid known triggers. Antihistamine (chlorphenamine) at night for itch-scratch cycle management.

OTC Management of Psoriasis

Moisturisers to reduce scaling and discomfort. Coal tar preparations (shampoos, creams, ointments) — reduce cell turnover and have anti-inflammatory effects. Salicylic acid preparations soften and remove scale. Mild corticosteroids for limited flares. Psoriasis affecting more than 10% of body surface or resistant to OTC treatment should be assessed by a GP or dermatologist for prescription treatments (vitamin D analogues, stronger steroids, biologics).

Browse Skin Conditions products at Huncoat Pharmacy. Related: Sensitive Skin Guide.