Spilanthes, particularly Spilanthes acmella (commonly known as "toothache plant"), has a long history of traditional use for treating external ulcerations and wounds. In various folk medicine systems, especially in South America, Africa, and Asia, the fresh leaves or extracts of Spilanthes are applied topically to ulcers, sores, and wounds to promote healing and reduce pain. The plant contains spilanthol and other bioactive compounds known for their local anesthetic, anti-inflammatory, and antimicrobial properties, which may contribute to its traditional use in external ulcer care.

However, despite this widespread ethnobotanical application, direct scientific validation in the form of controlled clinical trials is limited. Some in vitro and animal studies suggest Spilanthes extracts possess antimicrobial and wound-healing activities, but these findings are preliminary and not specific to human ulcerations. Thus, while traditional use is well documented, modern clinical evidence remains insufficient, and the current rating of evidence supporting its effectiveness for external ulcerations is modest.