A practical resource · Two printable sheets
A clearer record.
A better conversation.
A skin exposure log and an exact-package label worksheet, ready for your own notes or a dermatology visit.
Write down what happened, preserve the label you actually used, and keep unanswered questions visible. You do not need an app, an account, or a confirmed allergy to use these sheets.
Use your browser’s Print command to print or save as PDF. The print layout contains just the two worksheets. Fill them in on paper or annotate your saved PDF. There are no entry fields, uploads, analytics, or advertising scripts on this page.
Before you begin
Record observations.
Leave room for uncertainty.
- Give each package a reference. Write a short code, such as A or B, on your notes and use it in both sheets. Keep photos of the front, full ingredient panel, and lot code with the same reference.
- Describe an ordinary day. Include products, work or hobby materials, gloves, washing, and other contact with the affected area. Record times as accurately as you can; write “approximate” when needed.
- Separate what you saw from what you suspect. “Itching noticed at 8 p.m.” is an observation. “This ingredient caused it” is a conclusion the log cannot establish. Include days with no symptoms if useful to your clinician.
- Take questions to the appointment. Bring the packaging and relevant clinical records. Ask the clinic what to bring and how to handle workplace materials; do not transport hazardous substances.
MySkinIQ · Sheet 1 of 2 · Keep with your own records
Skin exposure log
Record ordinary exposures and symptoms in your own words. A sequence of events does not establish a cause. Repeat this sheet as needed.
Date or date range
Body area being observed
01 Exposure or daily activity
Time · exact or approximate
Product or material · package reference
Contact · where, how long, rinsed off or left on
What you noticed · symptom or no symptom, time
02 Exposure or daily activity
Time · exact or approximate
Product or material · package reference
Contact · where, how long, rinsed off or left on
What you noticed · symptom or no symptom, time
03 Exposure or daily activity
Time · exact or approximate
Product or material · package reference
Contact · where, how long, rinsed off or left on
What you noticed · symptom or no symptom, time
Other context or changes
Washing, gloves, work or hobbies, existing treatment, and photo references. Record what happened without changing treatment for this log.
Bring this record to your clinician. Do not deliberately repeat a suspected exposure. This sheet cannot diagnose allergy or establish that a product is safe.
myskiniq.shop/resources/exposure-and-label-worksheet · October 24, 2026
MySkinIQ · Sheet 2 of 2 · One sheet per exact package
Product label worksheet
Document the package before interpreting it. This worksheet applies the U.S. cosmetic-label workflow; disclosure rules differ in other markets and for other product types.
Package reference · date recorded
Brand · full product name
Variant, shade, size · lot or batch if present
Country of sale · package or website source
1. Preserve the full declaration
Copy the list exactly or attach a readable photo. Include separate active and other ingredient panels when present. Note any missing or unreadable section; do not fill gaps from a different variant.
2. Write the name you are checking
Use your clinician’s exact allergen name and supplied label synonyms, if you have them. Otherwise write your question. Similar spelling alone does not establish a match.
3. Record the finding and the next question
Write the exact matching words, “not listed,” or “cannot resolve.” Note fragrance/flavor blends, incomplete labels, or conflicting package and website information. “Not listed” is not a safety verdict.
4. Keep any answer tied to this package
Who answered, when, what they confirmed, and what is still unknown? Save a manufacturer reply or clinician instruction with the package reference. Recheck a replacement package.
Label limits: U.S. cosmetic ingredients at 1% or less and color additives have ordering exceptions. Fragrance/flavor may be declared collectively. Ingredient position cannot provide an exact percentage or predict your reaction.
Label guidance: FDA Cosmetics Labeling Guide · fda.gov/cosmetics · October 24, 2026
Use the record with the guidance
What to do with the sheets
Keep both sheets with the original label photos. At a visit, ask which exposures fit the clinical history, whether any testing is appropriate, and which names belong on your personal label-checking list. An unanswered question should stay unanswered until you have evidence.
Sources and scope
Prepared by MySkinIQ, October 24, 2026. The worksheet structure is an organizational aid, not a validated diagnostic tool. The label reminders follow the FDA sources below; the clinical context follows the American Academy of Dermatology’s patient guidance.
- FDA: Cosmetics Labeling Guide — ingredient ordering exceptions and collective fragrance/flavor declarations.
- FDA: Cosmetic Ingredient Names — U.S. naming requirements and international names.
- American Academy of Dermatology: Patch testing can find what’s causing your rash — clinician-led investigation and treatment planning.
This educational resource does not replace medical care. Keep completed sheets and photos private and share them directly with your care team through the channel they recommend.