Free template · PDF · US Letter
Free Printable Itch Diary (PDF) — Eczema Itch & Scratch Log
| Date | Time of day | Itch (0–10) | Where | Scratched / sleep lost | What was happening | Notes |
|---|---|---|---|---|---|---|
Why log itch separately from flares
Visible eczema and itch do not always move together. Itch often spikes in the evening and at night, after exercise, or during stressful weeks, while the skin looks the same. A diary that only records how the skin looked misses the pattern. Scoring itch on a simple 0–10 scale at a few fixed points — morning, afternoon, evening, night — turns 'it has been bad lately' into a line your dermatologist can read, and shows whether a change in routine actually helped.
Record the context without judging it. 'Wool sweater', 'hot shower', 'gym', 'deadline', 'new detergent' are observations. Over two or three weeks, the ones that keep appearing beside high scores are worth discussing with your clinician; the sheet does not decide what they mean.
Scoring and what to note
Anchors for the 0–10 column, and the context most people find worth writing down. Use whatever words fit — consistency matters more than the exact number.
| Score | What it feels like | Context worth noting |
|---|---|---|
| 0 | No itch | — |
| 1–3 | Noticeable but easy to ignore; no scratching needed | Time of day, what you were wearing |
| 4–6 | Hard to ignore; you scratch or rub, can still concentrate | Heat, sweat, fabric, bathing, a new product |
| 7–9 | Dominates attention; scratching is hard to stop; disturbs sleep | Stress, illness, missed routine, sleep lost (hours) |
| 10 | Worst imaginable; cannot sleep or function | Everything above — and tell your clinician |
Scales like this are commonly used in dermatology for patient-reported itch; your clinician may prefer a specific one. The sheet works with any of them.
How to use this sheet
- Print the PDF and keep it by the bed — night is when itch is usually worst and least remembered.
- Score itch 0–10 at fixed points (morning, afternoon, evening, bedtime) and whenever an episode stands out.
- Note where on the body it was and whether you scratched, and estimate sleep lost in hours.
- In What was happening, write the plain facts: heat, sweat, wool, hot shower, stress, new detergent, missed moisturizer.
- After two to three weeks, bring the sheets to your dermatologist appointment.
Questions
Is this sheet really free?
Yes. The PDF is free to download and print — no sign-up, no email, no watermark.
Is this a medical form?
No. It is a personal record sheet to help you describe symptoms accurately. It does not diagnose, and it does not replace advice from a dermatologist or doctor.
How often should I fill it in?
A few fixed times a day works better than 'whenever it itches', because it captures the quiet days too. Add extra rows for episodes that stand out.
Should I log itch if my skin looks clear?
Yes — that is one of the most useful things the sheet records. Itch without visible flare is common and worth telling your clinician about.
Is there an app version?
Yes — Skinote for iPhone logs flares, itch, triggers, and routine, and shows which factors cluster before your worse days. Core is free, no account needed, and your data stays on your device.
Want the log to analyze itself?
Skinote for iPhone tracks the same things in seconds and shows you the patterns — free core, no account, and everything stays on your device.