Do You Have Rosacea, Psoriasis, or Eczema?

In This Article
Table of Contents

Rashes, bumps, redness, itching—these issues can indicate a number of skin conditions, including rosacea, psoriasis, and eczema. While the symptoms may seem generic and, perhaps in mild cases, not worth much attention, it's worth seeing a doctor 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—some of which may be severe.

This primer can help you sort out the differences between these three potential seem-alikes.

Rosacea

Rosacea is more common among those who are fair-skinned, and it strikes about three times as many women as men. This is believed to be due to hormonal issues, particularly those that occur around the time of menopause. Even so, rosacea can develop at any age, even during childhood.

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 of time when they are more severe and times when they are 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 spread to include the eyes, ears, chest, and back.

With the areas of redness on the face, tiny blood vessels, pimples, and/or pustules crop up, but no blackheads appear. This can help distinguish rosacea from acne.

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

It's worthy to note that about half of people with rosacea develop a problem called ocular rosacea, in which the eyes sting, burn, and feel gritty. If Ieft untreated, eye infections can 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 be helpful in treating rosacea, including:

Topical steroid creams can worsen rosacea and are not generally used. In cases when they are recommended, they should only be used for short bursts (no more than two weeks at a time) to decrease redness.

Laser treatment or electrodesiccation—use of 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.

Psoriasis

When you have psoriasis, your immune system treats your skin like a foreign invader, attacking and damaging it.

Psoriasis can develop at any age, even during childhood. It tends to run in families and waxes and wanes in severity over the course of a lifetime.

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, 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. 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 that is 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 smooth, red, and shiny. Unlike plaque psoriasis, the areas of skin affected by inverse psoriasis are usually skin folds like armpits, under the breasts, and/or 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 30% 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/or 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 (UV) light may improve symptoms, whether it's natural, outdoor sunlight, or a special lamp/light at a doctor'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. It usually begins before age 5. About 40% of children "grow out of" their eczema, but others experience flare-ups throughout their lives.

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

Symptoms of Eczema

Eczema is believed to be an allergic reaction that evolves into a cycle of redness and itching, as scratching and rubbing only aggravate the skin further. Affected areas may become cracked, discolored, blistered, crusty or scaly, and may weep clear fluid. People with eczema are at an increased risk for developing skin infections, especially with the bacteria 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 important 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. Topical prescription medications like Elidel (pimecrolimus) and Protopic (tacrolimus) can improve itching and redness, but should only be used for short periods of time. Oral antihistamines may also be helpful.

In severe cases of eczema, oral steroids—Trexall (methotrexate), Sandimmune (cyclosporine), or Imuran (azathioprine)—might be needed.

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 for these issues, your doctor will also consider other skin conditions that mimic these three. As some can be more serious, a professional evaluation is best.

Was this page helpful?

Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  • American Academy of Dermatology. Rosacea. Published 2017.

  • American Academy of Dermatology. Atopic Dermatitis. Published 2017.

  • American Academy of Dermatology. Psoriasis. Published 2017.

  • Sankowski AJ, Łebkowska UM, Ćwikła J, Walecka I, Walecki J. Psoriatic Arthritis. Pol J Radiol. 2013 Jan-Mar;78(1):7-17. doi:10.12659/PJR.883763

  • Ferri, Fred F. Ferri's Clinical Advisor 2008. 2008. Fred F. Ferri. Philadelphia: Mosby, 2008.