Skin Conditions

Eczema and psoriasis can be very uncomfortable and frustrating, if you are a sufferer. Both skin conditions are most often confused for each other because of the similar symptoms.

What is eczema?

Eczema is a form of dermatitis, or inflammation of the upper layers of the skin. It is a term that is broadly applied to a range of persistent or recurring skin rashes characterized by redness, skin edema, itching and dryness, with possible crusting, flaking, blistering, cracking, oozing or bleeding. Areas of temporary skin discoloration sometimes characterize healed lesions, though scarring is rare. Some of the common symptoms are:

  • Moderate-to-severely itching skin (this symptom separates eczema from other skin rashes)
  • Recurring rash - dry, red, patchy or cracked skin (in infants and toddlers, the rash usually appears on the face, elbows or knees. In older children and adults, the rash appears less often on the face, and more commonly on the hands, neck, inner elbows, backs of the knees and ankles) 
  • Skin weeping watery fluid
  • Rough, “leathery,” thick skin
  • Lesions which may be infected by bacteria or viruses

What causes eczema?

Although the exact cause of eczema is unknown, it appears to be linked to the following internal and external factors:

  • A family history of eczema, asthma or hay fever (the strongest predictor) - if both parents have eczema, there is an 80 per cent chance that their children will, too
  • Particular food and alcohol (dairy and wheat products, citrus fruits, eggs, nuts, seafood, chemical food additives, preservatives and colorings)
  • Stress

What is psoriasis?

Psoriasis is a non-contagious skin disorder that affects 7.5 million (2.2%) of Americans (National Psoriasis Foundation, U.S.A)

Newly-produced skin cells normally mature over a period of three to four weeks while traveling to the skin’s surface to be shed. However, in skin affected by psoriasis, this process is accelerated and new skin cells reach the surface within 2–6 days. The rapidly-matured new cells mix with the old cells on the skin surface resulting in raised, inflamed, scaly, red skin lesions, known as plaques, which can often be inflamed, itchy and painful and can crack and bleed.

Although psoriasis most commonly appears on the scalp, knees, elbows, lower back, hands and feet, it can in fact develop anywhere on the skin, including genital areas, fingernails and toenails. The most common form of psoriasis is chronic stable plaque psoriasis (also known as psoriasis vulgaris) affecting 85%–90% of people with psoriasis. Once a person develops psoriasis, it usually continues throughout their life, although it may get better or worse and even disappear for periods of time (Australasian College of Dermatologists).

What causes psoriasis?

Psoriasis is an autoimmune disease, meaning that it is caused by over activity of the immune system in the skin. White immune cells (leukocytes) accumulate and produce a range of chemicals, which act as if they are fighting infection or healing a wound and lead to an abnormally rapid rate of skin cell multiplication and formation of psoriasis plaques.

Although normal skin contains notable numbers of immune cells, in psoriatic skin, the leukocyte number is greatly increased and immune processes are activated. The over-produced cells in the outermost layer of the skin stack abnormally, leading to the formation of silvery white scales waiting to be shed. Blood vessels are enlarged to support the increase in cell production, leading to the redness associated with psoriasis plaques. 

What are the treatment options for eczema and psoriasis?

Eczema

  • Topical corticosteroids that help reduce inflammation and itchiness. This is the most common form of eczema treatment. Most topical corticosteroids are available by prescription. However some milder strengths and non-steroidal options are available in the pharmacy.
  • Using intense moisturizers in-between the steroid treatments
  • Sedating antihistamines that induce sleep and reduce itchiness
  • Wet bandaging that soothes the skin, reduces itchiness and helps heal lesions
  • Antibiotics that treat secondary infections
  • Allergy testing (prick or blood tests) that may help establish trigger factors and
  • Diet modification, including seeking the advice of a dietician

Psoriasis

  • Phototherapy therapy
  • Systemic medications
  • Topical treatments are creams, lotions, ointments, mousse or gels that are rubbed directly into the skin and are typically given when psoriasis is mild to moderate. The different types of topical treatments are (The Psoriasis Association):
    • Vitamin D analogues
    • Coal tar preparations
    • Tropical steroids
    • Dithranol
    • Vitamin A analogues

Environmental factors like hot and cold weather, exposure to pollutants and harsh detergents are some examples that contribute to dry skin. There is also the possibility of medical conditions causing severely dry skin.

What causes Dry Skin?

Dry Air
Dry air is probably the most common cause of dry skin, especially during the winter. It draws moisture right out of the skin.

Long, Hot Showers & Baths
Prolonged exposure to water, especially hot water, can wash away the natural oils that protect your skin. Lukewarm, rather than hot water, is better for your skin.

Soap
Soap can quickly strip away your skin’s protective oils, and we tend to use way too much of it. Ironically, in the quest to rid ourselves of germs, excessive hand washing can dry out the skin and cause it to crack and bleed, making infection much more likely.

Itchy Clothing
Some people prefer fashion over comfort and will wear clothing they find itchy.  But no matter how much you might love the look of a sweater, it’s not worth it if it’s uncomfortable.

Medical Conditions

  • Changes in hormone levels: Dry skin often develops when people get older, especially in women. Changes in hormone levels can cause dry skin as we age. As many as 75% of people over 64 have dry skin. 
  • Skin conditions, like eczema and psoriasis: While they usually need direct treatment, careful use of moisturizers often helps.
  • Diabetes: fluctuations in glucose levels can lead to dehydration, and that dries the skin out.  Given that diabetes can also slow healing and increase the risk of infections, it’s especially important for people with this condition to keep their skin healthy.
  • Hypothyroidism: low levels of thyroid hormone can reduce the amount of oil produced by your skin.  As a result, skin becomes dry and rough, where moisturizer is unlikely to help. 
  • Malnutrition:  not getting the nutrients you need can leave your skin dried out.

Tips to prevent and treat Dry Skin?

Cleansing

  • Use a soap-free, sulfate-free wash in the bath or shower. It is less likely to strip the natural oils from your skin
  • Select a cleanser that is clinically proven to be non-irritating

Moisturizing

  • Use a concentrated moisturizer clinically proven to hydrate your skin. Make sure it is free from fragrances & petrochemicals
  • Select a moisturizer that is non-greasy and absorbs well
  • Select a moisturizer that provides 24 hours of moisturization

When the skin on the feet is very dry, it can be accompanied by itching, which can be severe and interfere with sleep and other daily activities. Repeated rubbing and scratching can produce areas of thickened, rough skin that can cause painful cracks in the skin.

What happens when feet are very dry?

The skin appears dull, flaky and scaly, feels rough and itchy and fine lines in the skin become visible when very dry. When the skin on the feet is very dry, it can be accompanied by itching, which can be severe and interfere with sleep and other daily activities. Repeated rubbing and scratching can produce areas of thickened, rough skin that can cause painful cracks in the skin. Rough, dry, cracked heels can be caused by varying factors such as environmental conditions, poor foot care, prolonged pressure on the heel, decreased sebum production with age or as a side effect of diabetes. Dry feet are characterized by:

  • Heels that are visibly scaly & coarse
  • Skin that is rough, dry to touch
  • Cracks & fissures

How to treat dry and cracked feet?

The best treatment for dry and cracked feet is to moisturize. However using the right type of moisturizer is crucial to seeing results and eventually healing the skin. Use a product specifically for feet with ingredients like urea and lanolin. These ingredients help the skin to hold water and seal in the moisture.