A guided worksheet to help you track your hives and swelling, understand how urticaria is affecting your life, and walk into your next appointment ready to make treatment decisions together with your clinician — not for them.
If you ever have swelling of the tongue, throat tightness, difficulty breathing or swallowing, dizziness, or fainting, this may be a sign of a severe angioedema or anaphylaxis emergency. If you think this is anaphylaxis, use your prescribed adrenaline auto-injector if you have one and call 999 for an ambulance. This tool is for tracking and conversation preparation only — it does not replace urgent medical care.
Chronic urticaria (CU) is the recurrence of itchy hives (wheals), angioedema (deeper swelling), or both, on most days for six weeks or longer. It's grouped into chronic spontaneous urticaria (CSU), which has no identifiable trigger, and chronic inducible urticaria (CIndU), brought on by a specific physical trigger such as cold, pressure, heat, or exercise. Many people live with a mix of both.
Current international guidance (EAACI/GA²LEN and related consensus updates) recommends a stepped approach: starting with a standard-dose second-generation antihistamine, then updosing up to four times the standard dose if hives persist, before moving to add-on therapy. For years, omalizumab (an anti-IgE biologic) and cyclosporine were the main third-line options. Since 2025, that landscape has widened: the FDA approved remibrutinib, the first oral BTK-inhibitor for CSU, as a needle-free option for people who remain symptomatic on antihistamines, and trial data on dupilumab continues to build. A 2025 treatment comparison found omalizumab and remibrutinib to be among the most effective options for antihistamine-refractory disease, while dupilumab also reduces hive activity, with less evidence so far specific to angioedema. This is exactly the kind of decision — daily pill vs. injection, speed of relief vs. long-term data, side-effect trade-offs — where your priorities should help guide the choice.
Fill this in daily, ideally at the same time each evening, thinking back over the last 24 hours. This mirrors the UAS7 (Urticaria Activity Score over 7 days), the tool clinicians use most often to measure hive activity, plus a simplified angioedema tracker.
| Day | Number of wheals (hives) | Itch severity |
|---|
A quick daily check for swelling episodes. This is a simplified adaptation for self-tracking — it is not the full validated Angioedema Activity Score (AAS), which your clinician may also use.
| Day | Angioedema severity |
|---|
Urticaria's impact reaches far beyond skin. Rate each area for the past week — this helps your clinician see the whole picture, not just the wheal count.
Check everything you've tried and how it went. This creates a clear record so you and your clinician aren't retrying — or unnecessarily avoiding — options.
Treatment decisions in chronic urticaria almost always involve trade-offs. Use the arrows to rank these from most (1) to least important to you right now. There's no wrong order — it's about naming what matters to you.
Tap a suggestion to add it, or write your own. A short, specific list is more useful in a 15-minute visit than a long one.
This pulls together everything above into one page. Print it, save it as a PDF, or read it out loud at the start of your visit.