1. Where is your rash located?
Face / eyelids
Hands / wrists
Feet / ankles
Neck / chest
Multiple areas
All over / scattered
2. How long have you had this rash?
Less than 2 weeks
2–6 weeks
More than 6 weeks
Comes and goes for months/years
3. Does your rash worsen with any of these?
Jewelry / metals
Cosmetics / skincare products
Fragrance / perfume
Rubber / latex gloves
Hair dye or hair products
Cleaning products
Not sure
4. Have you been diagnosed with eczema or atopic dermatitis?
5. Have you tried avoiding suspected products and noticed improvement?
Yes, definitely improved
Somewhat improved
No change
Haven't tried
6. Is the rash itchy?
Very itchy
Mildly itchy
More burning/stinging than itchy
Not really itchy