Is My Skin Condition Eczema Or Something Else?

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Let’s face it: Skin conditions are not fun to deal with. Maybe they’re issues you have been treating for a while, but sometimes they can appear on the skin seemingly out of nowhere. It’s easy to misdiagnose yourself, because to the untrained eye, different rashes and discolorations can look similar. To make things more complicated, some conditions can overlap with others. For example, did you know that rosacea is actually an adult form of acne?

Here, Jungho Kwon, M.D., a dermatologist with Henry Ford Health System, shares the defining characteristics of several skin conditions, how to tell them apart, and how to treat them. 

Eczema

What it is: An itchy skin rash that’s part of the “atopic triad,” meaning those with eczema often also have allergies and asthma, says Dr. Kwon.

What it looks like: Scaly patches of skin that can appear on any part of the body during infancy, but in children and adults, eczema often favors the inner wrists and elbows, behind the knees, and neck. In people with darker skin tones, these patches can look hyperpigmented and brown, or they can look pink or red. In people with lighter skin tones, they can look red or pink. 

Who is prone to getting it: People with eczema are more susceptible to sensitivities, and it typically appears in infancy. “Most kids tend to outgrow it by five years old, and if not by five, then by ten years old. If they don’t outgrow it by ten, they’ll usually have it throughout adulthood,” says Dr. Kwon.  

How to treat it: First of all, don’t scratch—doing so can worsen eczema. “The mainstay treatment is a topical steroid, along with an antihistamine like Benadryl to decrease itching,” says Dr. Kwon. To prevent flare-ups, use hypoallergenic skincare products, avoid fragrances, and moisturize regularly to prevent dryness.

Tinea Versicolor

What it is: An overgrowth of yeast living on the skin. “We all have microscopic organisms on our skin, including a fungi called Malassezia. Some people have a predisposition to overgrowing it, and this is what causes tinea versicolor,” says Dr. Kwon.  

What it looks like: Patches of discoloration that usually appear on the neck, shoulders and chest. “Some people have light patches, others have dark patches,” says Dr. Kwon. It’s not itchy and doesn’t cause complications.

Who is prone to getting it: It presents during the teenage and young adult years, when oil glands are most active. “It flares up when you’re sweating throughout the spring and summer, and can dissipate on its own in the fall and winter,” says Dr. Kwon. “It’s most prevalent in humid climates.”        

How to treat it: Use a selenium sulfide shampoo as a body wash every day for two weeks, and then once or twice a week to prevent flare-ups. “Selenium sulfide shampoo is a mild antimicrobial used for dandruff, but it can also treat tinea versicolor,” says Dr. Kwon. Anti-fungal creams may also work. See your dermatologist to find the best treatment for you.   

Rosacea

What it is: An adult form of acne thought to be caused by skin mites. “Everyone has tiny mites on their faces, but those with rosacea have more than others. It’s thought that their skin reacts differently to the mites, triggering an inflammatory response,” says Dr. Kwon.

What it looks like: Red, flushed skin (typically limited to the face) with broken capillaries and small, red bumps that look like tiny pimples. In some men, rosacea can appear as thickened skin or a buildup of tissue on and around the nose.

Who is prone to getting it: Rosacea typically begins to affect people in their late 20s and into their 30s, 40s, and 50s. "While there's a genetic component, rosacea is most common in fair-skinned individuals with accumulative sun damage. It's not as common in those with dark skin," says Dr. Kwon.

How to treat it: Avoid spicy foods, alcohol, hot beverages, hot weather and cold weather (when possible)—because anything that naturally causes your skin to flush can trigger rosacea. “Use hypoallergenic products and wear mineral sunscreen daily, as ultraviolet rays can also worsen rosacea,” says Dr. Kwon.      

Acne

What it is: Pimples, whiteheads and blackheads that are caused by hair follicles becoming plugged with oil. A specific type of bacteria on the skin, called P. acnes, can also contribute to breakouts

What it looks like: Raised bumps on the skin. Acne cysts are large bumps, while whiteheads are small bumps with a white surface, and blackheads are small bumps with a dark surface.   

Who is prone to getting it: There is a genetic predisposition for acne, but it usually first appears during the teenage years because of fluctuating hormones and increased oil production. For some people, it can continue throughout adulthood. “Genetics, hormones and bacteria are the main triggers for acne,” says Dr. Kwon.  

How to treat it: Antibacterial soaps like benzoyl peroxide help eliminate bacteria-causing acne, and salicylic acid treatments unclog pores. Retinol (a derivative of vitamin A) is an over-the-counter treatment that helps prevent blackheads and whiteheads by increasing cell turnover.

Psoriasis

What it is: An inflammatory immune disorder that also affects other areas of the body. (It's not just a skin disorder.) “We used to think psoriasis was similar to eczema, but we now know it’s much more complex," says Dr. Kwon.

What it looks like: Defined, raised patches of skin that have a thick scale. In people with darker skin tones, these patches can look hyperpigmented and brown, or red or pink with a thick white scale. In people with light skin tones, they can look red or pink with a thick white scale. Any part of the body can be affected, but psoriasis typically appears on the elbows, knees and torso. Some people have guttate psoriasis, meaning they have small raindrop-like spots all over the body.

Who is prone to getting it: Those who have psoriasis are prone to inflammatory disorders like heart disease and insulin resistance (which increases the risk of developing diabetes). “We’ll work with the patient’s primary care provider to ensure other conditions they’re at risk for are being monitored,” says Dr. Kwon. Psoriasis can present at any age, but traditionally tends to manifest during the 20s, 30s, or 40s.

How to treat it: “We'll start with a topical steroid,” says Dr. Kwon. “But for more severe cases, we'll use immune-suppressing medications.” Talk to your dermatologist to see what is right for you. 


To find a doctor or dermatologist at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936). Learn about our virtual care options available for primary care visits, as well as dermatology and many other specialty services. 

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Dr. Jungho Kwon is a senior staff dermatologist and sees patients at Henry Ford Medical Centers in Troy and West Bloomfield (on Farmington Road). 

Categories: FeelWell