Psoriasis vs. Eczema vs. Rosacea: What's the Difference?

All three are common skin problems with some shared symptoms

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Rashes, bumps, redness, and itching can indicate several skin conditions, including rosacea, psoriasis, and eczema. While the symptoms may seem generic—and perhaps in mild cases, not warrant much attention—it's worth seeing a healthcare provider to get a formal diagnosis, particularly if they persist.

While rosacea, psoriasis, and eczema tend to be chronic conditions, they're rarely life-threatening. However, they can lead to complications if left untreated.

This primer can help you distinguish psoriasis versus eczema versus rosacea.

Psoriasis vs. Eczema vs. Rosacea

Psoriasis, eczema, and rosacea can look alike. But, there are some ways to tell them apart.

Psoriasis Eczema Rosacea
Age it effects Childhood and up Childhood and up Most common 30 to 50
Location Elbows, knees, scalp Skin folds, cheeks, hands, arms, legs Face, ears, torso
Flushing No No Yes
Pimple-like rash No No Yes
Skin-thickening Yes Yes Yes
Pus-filled bumps Sometimes No Yes
Smooth rash Sometimes No No
Swelling Sometimes Sometimes Sometimes
Itching Yes Yes, severe Yes
Red rash Yes Yes Yes
Crusty, scaly rash Yes Yes No
Rash weeps fluid No Yes No

Rosacea

Rosacea is more common among 30- to 50-year-olds with fair skin. It's slightly more common in women versus men. Even so, rosacea can develop at any age, even during childhood.

Person with dark hair pulled back with rosacea rash on cheeks.

Ildar Abulkhanov / Getty Images

Symptoms of Rosacea

Rosacea primarily occurs on the face and causes symptoms like easy and severe blushing or flushing, hotness, redness, bumps, and swelling. These symptoms often come and go, with periods when they're more severe and times when they're milder.

In addition, the symptoms of rosacea typically follow a pattern. Initially, the central areas of the face are affected, with flushing spreading over time to the cheeks, forehead, chin, and nose. Rosacea can even extend to include the eyes, ears, chest, and back.

With the areas of redness on the face, tiny blood vessels, pimples, and pustules crop up. As such, rosacea is commonly mistaken for acne. However, with rosacea, no blackheads appear. Therefore, the absence of blackheads can help distinguish rosacea from acne.

Over time with rosacea, the blood vessels on a person's face become enlarged, making the redness more visible, albeit harmless.

It's worth noting that more than half of people with rosacea develop a problem called ocular rosacea, in which the eyes sting, burn, and feel gritty. Left untreated, this may lead to problems with vision.

Lastly, rosacea may eventually lead to thickening of the skin, most commonly of the nose (called rhinophyma). Rhinophyma tends to strike men who have had rosacea for years and may become disfiguring enough to require surgery.

Rosacea Triggers

Scientists are still trying to understand the underlying causes of rosacea, but common triggers include:

  • Temperature extremes or changes
  • Sunburn
  • Stress
  • Menstruation
  • Personal care products and cosmetics that contain alcohol
  • Scrubbing of the face
  • Hot beverages
  • Spicy foods
  • Caffeine
  • Alcohol
  • Certain medications

Rosacea Treatments

A variety of topical treatments may help treat rosacea, including:

Topical steroid creams can worsen rosacea and are not generally used. However, in cases when healthcare providers recommend them, you should only use them for short bursts (no more than two weeks at a time) to decrease redness.

Laser treatment or electrodesiccation—using a tiny needle that delivers electricity to the blood vessel to destroy it—may also improve symptoms.

Lastly, blood pressure medications like beta-blockers and Catapres (clonidine) are sometimes helpful in reducing flushing associated with rosacea.

Rosacea vs. Eczema

One distinguishing difference between rosacea and eczema is that it is not uncommon to see blood vessels beneath the skin with rosacea. In addition, the location of the rash can help identify the culprit: A rosacea rash is more common on the cheeks, whereas facial eczema is more common around the eyes and lips.

Psoriasis

Autoimmune disease is the root cause of psoriasis. That means your immune system treats your skin like a foreign invader, attacking and damaging it.

Psoriasis can develop at any age, even during childhood. However, it tends to run in families and waxes and wanes in severity throughout a lifetime.

Psoriasis on a person's skin.

RUTH JENKINSON / Getty Images

Symptoms of Psoriasis

The most common form of psoriasis is called plaque psoriasis, in which areas of the skin become covered by thick, red patches (the so-called plaques), topped by a silvery-white scale. It can occur anywhere on the skin but usually affects the elbows, knees, and scalp. The areas where plaques form can be itchy and tender.

Plaque psoriasis can also affect the scalp, causing it to become very scaly, resembling dandruff. Nails, too, may be targeted, and if so, they may become pitted, ridged, and loose.

Other forms of psoriasis have other notable features:

  • Guttate psoriasis: This type of psoriasis causes small, tear-drop-shaped, salmon-pink spots to appear on the skin. The spots most often form on the trunk, arms, and legs but can also cover the entire body.
  • Pustular psoriasis: With this type of psoriasis, a person develops inflamed, red skin covered with pus-filled bumps often found on the palms of the hands and soles of the feet.
  • Inverse psoriasis: Like the name, this type of psoriasis causes lesions that are not scaly but instead are smooth, red, and shiny. Unlike plaque psoriasis, the areas affected by inverse psoriasis are usually areas of skin folds, such as armpits, under the breasts, and the groin area.
  • Erythrodermic psoriasis: This is a rare, potentially severe form of psoriasis that causes widespread redness, swelling, and itching all over the body. In extreme cases, complications like dehydration, overwhelming infection, and congestive heart failure may cause this condition to become life-threatening.

A form of arthritis called psoriatic arthritis is a potentially debilitating complication that develops in about 10% to 20% of people with psoriasis. While this joint condition affects people uniquely, a few classic symptoms include prolonged morning stiffness, fatigue, and sausage-shaped fingers and toes (called dactylitis).

Psoriasis Triggers 

You may be surprised to learn that infections are frequent triggers of psoriasis flares, especially strep infections, which are highly correlated with guttate psoriasis.

Other possible triggers for psoriasis include:

  • Skin injury
  • Severely dry skin
  • Stress
  • Taking certain medications, like lithium or an interferon

Psoriasis Treatments

A variety of topical treatments may help improve symptoms of psoriasis, including:

Exposure to ultraviolet light may improve symptoms, whether natural, outdoor sunlight or a special lamp/light at a healthcare provider's office.

Severe psoriasis may require treatment with powerful medications that suppress your immune system, such as:

Eczema

Eczema (also known as atopic dermatitis) can develop at any age, even during infancy. However, it usually begins before age 5. About 50% of children will still experience eczema in adulthood, but it typically gets milder with age.

Eczema tends to run in families, especially in those prone to allergies and asthma.

Close-up side view of baby with eczema on cheek

Engdao Wichitpunya / EyeEm / Getty Images

Symptoms of Eczema

Experts believe eczema results from excessive inflammation that evolves into a cycle of redness and itching, as scratching and rubbing aggravate the skin further. Affected areas may become cracked, discolored, blistered, crusty, or scaly and may weep clear fluid. People with eczema are at increased risk of developing skin infections, especially with Staphylococcus aureus.

Eczema can crop up anywhere, although common areas are in skin folds and on the cheeks, backs of the hands, tops of the arms, and fronts of the legs.

Eczema Triggers

Triggers for eczema include:

  • Temperature changes
  • Dry skin
  • Irritants (for example, wool, dyes, cosmetics, perfumes, and soaps)
  • Foods, especially the major allergens (i.e., eggs, peanuts, fish, soy, wheat, and dairy)
  • Stress
  • Dust mites
  • Pollen
  • Animal dander

Eczema Treatments

When you have eczema, it's essential to keep your skin clean and well-moisturized. Take short, warm (not hot) showers, and use a non-soap cleanser. Applying a moisturizer to the entire body within three minutes of getting out of the shower can go a long way in protecting your skin's barrier.

When skincare is not enough, topical steroids can improve redness and itching, but you should only use them for short periods. Topical prescription medications like Elidel (pimecrolimus) and Protopic (tacrolimus) can improve itching and redness. Oral antihistamines may also be helpful.

For moderate to severe cases of eczema that are not well managed with topical prescription treatments or for which topical treatments aren't advised, Dupixent (dupilumab) and Adbry (tralokinumab-ldrm), biologic medications given by injection, are other treatment options.

In severe cases of eczema, you might need immunosuppressants such as Trexall (methotrexate), Sandimmune (cyclosporine), or Imuran (azathioprine).

Eczema vs. Psoriasis

One of the most significant differences between eczema and psoriasis is the level of itching. While both skin conditions can cause itching, the itch associated with eczema is intense, causing some people to scratch their skin until it bleeds, often in their sleep. In addition, the borders of psoriasis are more well-defined than those of eczema.

A Word From Verywell

Rosacea, psoriasis, and eczema are common skin problems with some shared—and some unique—symptoms, triggers, and treatments. Aside from evaluating these issues, your healthcare provider will also consider other skin conditions that mimic these three. As some can be more serious, a professional evaluation is best.

Frequently Asked Questions

  • Can eczema turn into psoriasis?

    Eczema and psoriasis are unrelated skin conditions. One can not progress to the other. Experts believe environmental and genetic factors cause eczema. Psoriasis is an autoimmune disease, which is when the immune system attacks the body.

  • Can you have psoriasis and rosacea?

    Yes. One does not cause the other, but it is possible to have both at the same time. Both can be worsened by some shared triggers.

  • How can you tell the difference between seborrheic dermatitis and rosacea?

    One distinction is that rosacea is more common on the cheeks, whereas seborrheic dermatitis—a skin rash sometimes caused by yeast overgrowth—is usually on the nose, forehead, and ear canal.

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13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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