Japanese sophora (Sophora japonica), also known as Huai Hua in traditional Chinese medicine, has been used historically to treat various skin conditions, including external ulcerations. The flower buds and other parts of the plant are applied topically or prepared as washes or poultices for wounds, sores, and ulcers. This use is well documented in traditional East Asian pharmacopeias, where it is valued for its purported properties of cooling the blood, reducing inflammation, and stopping bleeding. The flavonoids and alkaloids present in Japanese sophora are believed to contribute to these effects, with some in vitro studies suggesting anti-inflammatory and antimicrobial properties; however, robust clinical trials specifically addressing the efficacy of Japanese sophora for external ulcerations are lacking. The historical use, coupled with preliminary pharmacological findings, provides some support for its application in traditional wound care, though modern evidence remains limited. Therefore, the justification for its use is primarily traditional, with some low-level scientific rationale but not enough to assign a higher evidence rating.