Background: Many drugs are available for the management of eczema but a quick and effective management is still the need of the time. Root bark of Karavira (Nerium oleander L.), a semi-poisonous drug of Ayurveda has been reported for its efficacy in skin disorder. Ayurveda considers Vicharchika (eczema) disease condition, under Kshudrakustha (group of minor skin diseases). Aim: To study and evaluate the efficacy of Rakta Karavira Taila in the treatment of Vicharchika (eczema) through an open-label clinical trial. Materials and methods: An open-label clinical trial was performed to assess the effect of Rakta Karavira Taila in Vicharchika. The trial drug was prepared by mixing root bark of red variety of Nerium oleander L. and Sarshapa Taila (mustard oil) following the recommended method of oil preparation in Ayurvedic Formulary of India (AFI). Total 30 patients, diagnosed as Vicharchika, were treated by applying required amount of Rakta Karavira Taila externally twice a day for 28 consecutive days. Response to the treatment in the recruited patients was recorded on a weekly basis and therapeutic effect was evaluated through symptomatic relief. Results: Rakta Karavira Taila, is an oil preparation, which is effective against all the major clinical symptoms of Vicharchika like Kandu (itching), Pidika (papular eruptions), Vaivarnyata (discoloration), Daha (burning sensation), Vedana (pain), and Rukshata (dryness). The study yields statistically significant results in symptoms like Kandu (itching) (p < 0.001), Vaivarnyata (discoloration) (p < 0.001), and Rukshata (dryness) (p < 0.001). Conclusion: Rakta Karavira Taila has proven to be effective in reducing the symptoms of Vicharchika, when applied for a period of 28 days.