Psoriasis vs. Eczema in Black People and Darker Skin Tones: How to Tell the Difference (With Images)
Key takeaways:
Psoriasis and eczema are common rashes that can both cause itchy skin patches that appear violet, brown, or gray in Black people and those with darker skin tones.
Psoriasis usually causes thick patches that affect places like the scalp, elbows, and knees. Eczema causes dry patches that affect skin folds, like the neck, behind the knees, and inside the elbow.
Treatment for psoriasis and eczema is basically the same in all skin tones. However, some treatments — like phototherapy and scalp treatments — can affect people with darker skin tones differently.
Psoriasis and eczema are two common skin conditions that cause an itchy rash and can affect your mood and quality of life. But they are actually very different conditions.
Psoriasis is caused by an overactive immune system that causes skin cells to grow too fast. This leads to thick, scaly skin patches. Eczema is a group of skin conditions that lead to chronic skin inflammation and dry, itchy patches.
People with all skin tones can get both psoriasis and eczema. But, these two common conditions tend to look different on Black people and those with darker skin tones. Here, we’ll cover what they look like on darker skin tones (with pictures) and show you how to tell the difference between the two.
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What does psoriasis and eczema look like on darker skin tones?
Psoriasis and eczema both cause skin inflammation. On darker skin tones, this may not appear red like it does on lighter skin. Instead, it can appear violet, gray, or brown, and it may be harder to see.
Besides inflammation, there are some main differences between psoriasis and eczema. Here are some things to look for.
Psoriasis
Psoriasis patches are usually thick, covered in gray or white scales, and have well-defined borders. They can occur anywhere, but are common on areas like:
Scalp
Elbows
Knees
Lower back
Psoriasis also causes nail changes, like pitting (dents), thickening, and discoloration.
Eczema
Atopic dermatitis (the most common type of eczema) usually causes discolored bumps or patches that affect the following areas:
Skin folds
Neck
Inside the elbow folds
Behind the knees
Face
Hyperpigmentation on darker skin tones: Learn what causes this common condition and what you can do about it.
Hydroquinone for dark spots: Three women share their experience using this lightening cream to treat melasma and other dark spots.
Melasma in people of color: Read why this type of hyperpigmentation is often worse in people with darker skin tones.
Eczema patches may appear dry, thickened, or even cracked. And they usually don’t have well-defined borders.
Pictures of psoriasis and eczema on darker skin
Here are some pictures of psoriasis and eczema on darker skin tones to help you see the difference.
Psoriasis
Eczema (atopic dermatitis)
How do you diagnose psoriasis vs. eczema on darker skin tones?
Dermatologists and other trained healthcare professionals can usually diagnose psoriasis or eczema based on what your rash looks like and your symptoms. Sometimes, a skin biopsy is needed to confirm the diagnosis. This is an office procedure where a small skin sample is removed and sent to a lab for evaluation.
Here are some of the key differences that healthcare professionals look for to diagnose psoriasis versus eczema in people with darker skin tones.
| Psoriasis | Eczema | |
|---|---|---|
| What it looks like | Thick, sharply outlined patches covered with scale | Dry, flaky patches that can crack and ooze fluid |
| Where it appears | Common areas include:
|
Common areas include:
|
| What it feels like | Can be itchy, burn, or sting | Can be very itchy, dry, painful |
| When it begins | Usually between 20 and 30 years old or between 50 and 60 years old | Usually during childhood |
| Other common symptoms or associated conditions |
|
|
Treating psoriasis and eczema on darker skin tones
For the most part, treating psoriasis and eczema is the same on all skin tones. Treatment depends on a few factors, like how much of your skin is affected and how much it bothers you.
In general, mild psoriasis and eczema can be treated with medicated creams. More severe or widespread disease usually requires stronger treatments, like pills, phototherapy (light therapy), or biologics.
One thing to keep in mind is that some treatments can affect people with darker skin tones differently. Before starting treatment, here are some points to consider:
Phototherapy causes the skin to darken. This can make previous dark spots more noticeable in darker skin tones.
It’s important to take hair texture and styling into consideration when treating scalp psoriasis or eczema.
When psoriasis and eczema heal, they can also lead to light or dark skin patches (hyperpigmentation) that can take months to fade. If they bother you, your dermatologist can recommend treatment to help them fade faster.
When to get care for psoriasis or eczema
You may want to get care if you’re not sure whether your skin rash is psoriasis, eczema, or something else. Another good reason is if your skin isn’t getting better despite treatment.
When getting treatment, you may also want to find someone with experience in treating darker skin tones. One way to do this is by using the Skin of Color Society searchable database.
Frequently asked questions
Eczema and psoriasis can sometimes be mistaken for other types of rashes. Some common examples include:
If you’re not sure what rash you have, don’t try to figure it out on your own. Have the rash checked out by a healthcare professional instead.
No. Eczema is not a fungal infection, and it’s not contagious. Eczema can sometimes look like ringworm, a common fungal infection. But they are different conditions with their own unique causes and treatments.
Yes. Vaseline and other thick ointments can be very helpful in managing eczema. Because they are so thick, they can help lock in moisture, heal dry, cracked skin, and prevent eczema flares. They can be greasy to use, so sometimes they are easiest to apply at night.
The bottom line
Psoriasis and eczema are two common skin conditions that can look different in Black people and people with darker skin tones. Both conditions cause skin inflammation, which can appear violet, brown, or gray in darker skin tones. But psoriasis tends to cause thick, well-defined scaly patches, while eczema causes dry, itchy patches.
Psoriasis and eczema treatment is basically the same in all skin tones. However, some treatments — like phototherapy and scalp treatment — may affect people with darker skin tones differently. It’s a good idea to find a healthcare professional comfortable with treating these conditions in people with darker skin tones.
Why trust our experts?
Images used with permission from VisualDx (www.visualdx.com).
References
American Academy of Dermatology Association. (n.d.). Can you get psoriasis if you have skin of color?
American Osteopathic College of Dermatology. (n.d.). Biopsy.
Maloney, C. (2025). Is it eczema or psoriasis? National Eczema Association.
National Health Service. (2022). Psoriasis.
National Psoriasis Foundation. (2025). Phototherapy for psoriasis.
