Objective To explore the effect of Shenbai Zhiyang lotion on symptom severity in eczema patients with damp-heat type. Methods A total of 80 eczema patients with damp-heat type who were treated in Nanjing Lishui District Hospital of Traditional Chinese Medicine from December 2024 to March 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 40 patients in each group. The control group received conventional treatment, and the observation group received Shenbai Zhiyang lotion on the basis of the control group. The Eczema Area and Severity Index (EASI), treatment effect and adverse reaction rate were compared between the two groups. Results After 1, 2, 3 and 4 weeks of treatment, the EASI scores of the two groups were lower than those of the control group (P <0.05). The total effective rate of treatment in the observation group (95.00%) was higher than that in the control group (80.00%) (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion The symptom severity of eczema patients with damp-heat type is effectively reduced after treatment with Shenbai Zhiyang lotion, with ideal treatment effect, no increase in the incidence of adverse reactions, and good application safety.