The use of Ajuga (commonly known as bugleweed) for external ulcerations is rooted primarily in traditional herbal medicine. Historical records from European herbalists and folk medicine indicate that Ajuga species, particularly Ajuga reptans, have been applied topically to wounds, ulcers, and other skin afflictions to promote healing and reduce inflammation. Herbal texts from the 16th to 19th centuries often mention its use as a vulnerary—an agent that aids in wound healing—applied as poultices or infused washes.

Despite its long-standing traditional use, there is limited scientific research specifically validating Ajuga's effectiveness for external ulcerations. Some laboratory studies have identified anti-inflammatory and antimicrobial compounds in Ajuga species, such as iridoid glycosides and phenolic acids, which could plausibly contribute to wound healing. However, these findings are preliminary and have not been directly linked to clinical outcomes in the treatment of human skin ulcerations.

In summary, Ajuga’s use for external ulcerations is primarily justified by traditional practices rather than robust scientific evidence. While phytochemical studies suggest potential mechanisms of action, clinical evidence is sparse, and the traditional rating reflects the current state of knowledge.