How bad is the itch?
Put a number on it. This is the 0–10 itch scale dermatology trials use as a primary endpoint — rate your worst and average itch over the last 24 hours, see what the score means, and log it daily so the trend does the talking. Everything stays on this device.
Your single worst moment, even a brief one. This is the primary score.
The whole day taken together — background level, not the spikes.
Your itch log
The 5-D Itch Scale
The 0–10 scale above is your quick daily pulse — one number, intensity only. The 5-D Itch Scale is the deeper instrument chronic-itch studies use: five questions covering how long you itch each day, how intense it is, which way it’s trending, how it affects sleep, work, and daily life, and how much of your body it covers. Each domain scores 1–5 for a total of 5–25. It asks about the past two weeks and was built to detect change over time — so take it about once a week, and keep the daily scale for the days in between.
Take the 5-D assessment
1 · Duration
—During the past 2 weeks, how many hours a day have you been itching?
2 · Degree
—Please rate the intensity of your itching over the past 2 weeks.
3 · Direction
—Over the past 2 weeks, has your itching gotten better or worse compared with the previous month?
4 · Disability
—Rate the impact of your itching on each activity over the last 2 weeks. The domain score is the highest of the four — mark “Not applicable” where an activity doesn’t apply.
5 · Distribution
—Mark each body part affected by itching over the last 2 weeks. If a part is not listed, choose the closest one.
The domain scores by how many areas are marked: 1–2 areas → 1 · 3–5 → 2 · 6–10 → 3 · 11–13 → 4 · 14–16 → 5.
Your 5-D log
Instrument: Elman S, Hynan LS, Gabriel V, Mayo MJ. The 5-D itch scale: a new measure of pruritus. British Journal of Dermatology. 2010;162(3):587–593. Item wording and 1–5 scoring reproduced from the published scale.
Bring the numbers with you: your log can ride along on the printable Derm Visit Prep sheet. It also pairs well with the Skin Flare Diary for tracking triggers, and — if eczema is the culprit — the POEM eczema severity score.
Saved only on this device — and browsers erase site data. A history clear, a private window, or Safari's automatic deletion after seven days without a visit will take this log with it. The fix is a free Dermington account: it backs this up automatically and puts it on every device you sign in to — details in how storage works.
- Eczema & DermatitisOne Drug Keeps Collecting Diseases That Were Never Supposed to Be RelatedBlistering in the elderly and hives that last for years now answer to the same eczema injection — which says something uncomfortable about how dermatology names things.
- Measuring Skin DiseaseYou Remember Your Worst Day as Typical. That's What the Diary Is For.Fluctuating skin disease defeats memory in a direction researchers have actually measured — and most diaries fail because they record the wrong five things.
- Measuring Skin DiseaseItch Is a Number in Every Trial and a Shrug in Most AppointmentsThe symptom that does the most damage to daily life is the one patients describe with an adjective — and a four-second daily score is the difference between a vague complaint and a chart a clinician has to act on.
- Hives & UrticariaHives Lasting More Than Six Weeks Are a Different DiseaseAcute hives are a reaction and usually have a culprit. Past six weeks they are a mast-cell disorder that usually has none — which is why the exhaustive allergy hunt so many patients are put through is the wrong investigation entirely.
How the itch scale works
The 0–10 itch Numeric Rating Scale is the same instrument dermatology trials use as a primary endpoint when testing eczema, psoriasis, and chronic-pruritus treatments — not a quiz invented for the internet. The primary question is the validated Peak Pruritus NRS: your worst itch in the past 24 hours, anchored at 0 (no itch) and 10 (worst itch imaginable). Validation work by Yosipovitch and colleagues mapped the scores to severity bands — 0 none, 1–3 mild, 4–6 moderate, 7–8 severe, 9–10 very severe — and those cutpoints are exactly what this tool uses to read your number back to you in plain English.
A single number matters far less than the trend. Itch fluctuates day to day, so researchers judge treatments by change over time — a drop of roughly 3 points is the accepted benchmark for improvement you can genuinely feel when itch starts at moderate or worse. Log your score daily through a flare and the bar chart shows whether a new routine is actually moving the needle; the Dermington database of dermatologist-informed product reviews can then point you to fragrance-free barrier repair worth trying, and the log rides along on our printable derm-visit sheet when it’s time to get professional help.
Common questions
Why does this tool ask for my worst itch instead of just the average?
Peak itch is the number dermatology research trusts most — the validated Peak Pruritus NRS asks for your worst moment in the past 24 hours because people recall their worst moment far more reliably than a mental average of an entire day. Eczema and psoriasis drug trials use that worst-itch score as a primary endpoint. We still ask for the average, because the gap between the two tells you whether your itch is constant background noise or sharp, spiky flares.
What counts as a meaningful improvement on a 0–10 itch scale?
Research on the itch NRS puts the clinically meaningful change at roughly 2–4 points, with about a 3-point drop as the working rule of thumb for moderate-or-worse itch. Going from an 8 to a 7 is day-to-day wobble; going from an 8 to a 5 is a treatment genuinely working. That’s why a log kept over days beats judging any single number.
When is itch by itself a reason to see a dermatologist?
Three patterns earn professional eyes regardless of the cause: itch that wakes you at night or steals sleep, itch that has lasted more than six weeks (the definition of chronic pruritus), and whole-body itch with no visible rash — that last one can occasionally point to an internal cause a doctor should rule out. A log of daily 7-plus scores is exactly the record that makes the appointment productive.
Scratching feels amazing — why does everyone say not to do it?
The relief is real, but it’s rented. Scratching damages the skin barrier and triggers inflammation, which sensitizes the very nerve fibers that carry itch signals — so the itch comes back stronger, in what dermatologists call the itch-scratch cycle. A cold compress, a firm press of the palm, or moisturizer breaks the loop and buys similar relief without the rebound.
Where do my itch scores go — is any of this shared?
Nowhere. Every number you log lives in your own browser’s local storage on your device — nothing is sent to a server, there’s no account, and we can’t see your scores. Clearing your browser data (or tapping Clear History) erases the log permanently, so print your numbers onto the Derm Visit Prep sheet if you want a copy that survives.
What’s the difference between the 0–10 scale and the 5-D Itch Scale further down the page?
The 0–10 NRS is your quick daily pulse — one number for intensity, ten seconds, every day. The 5-D Itch Scale (Elman et al., Br J Dermatol 2010) is the deeper instrument chronic-itch studies use: five domains — duration, degree, direction, disability, and distribution — each scored 1–5 for a total of 5 to 25, capturing what a single intensity number misses, like lost sleep, disrupted work, and how much of your body is involved. Do the 5-D about once a week and keep rating the NRS daily; the two logs are stored separately.
How often should I repeat the 5-D Itch Scale, and what does the total mean?
About once a week is the sweet spot — the questions ask about the past two weeks and the scale was designed to detect change over time, so daily retakes mostly repeat themselves. Totals run from 5 (no itch in any domain) to 25 (maximal in all five); published groupings read 6–11 as mild, 12–17 as moderate, and 18–25 as severe. A total that falls week over week is a treatment working; one that plateaus high is exactly the record to bring to a dermatologist.