The use of neem (Azadirachta indica) for eczema is supported by both traditional use and emerging scientific evidence, though the scientific validation is still limited. In traditional Ayurvedic and Unani medicine, neem leaves and oil have long been applied to various skin conditions, including eczema, due to their reputed anti-inflammatory, antimicrobial, and wound-healing properties.

Modern scientific studies have begun to investigate these claims. Neem contains bioactive compounds such as nimbidin, nimbin, and azadirachtin, which exhibit anti-inflammatory, antibacterial, and antifungal activities. Several laboratory studies and small clinical trials suggest that neem extracts can reduce inflammation and inhibit the growth of skin pathogens that may exacerbate eczema symptoms. One randomized controlled trial (2013) found that a neem-based cream offered improvement in symptoms for patients with eczema compared to a placebo, though the sample size was small and methodology limitations exist.

Despite these promising findings, high-quality, large-scale clinical trials are lacking, and most current evidence is preclinical or anecdotal. The American Academy of Dermatology does not currently endorse neem as a standard eczema treatment due to insufficient robust data. However, neem remains a popular complementary option, especially in regions where traditional medicine is practiced. More rigorous research is needed to confirm its efficacy and safety in eczema management.