Seborrheic keratosis (SK), also known as seborrheic warts or basal cell papilloma, is a common benign epidermal tumor typically seen in middle-aged and older adults. SK is one of the most frequently encountered skin lesions by primary care physicians and dermatologists in outpatient settings. Traditionally, cryosurgery and electrocautery have been the primary treatment options for SK. While both approaches are effective, these methods can result in unwanted side effects that may affect the cosmetic appearance of patients and can be quite costly, deterring some individuals from seeking treatment. Siddha external medicine provides a viable, cost-effective, and well-tolerated alternative. A 73-year-old female patient presented with black papules featuring fissures and ridges on a verrucous surface. The lesions, with a waxy "stuck-on" appearance, were located on the prominence of the concha of her left ear, measuring 1.5 cm in length and 6 mm in thickness. Though asymptomatic, the lesions raised significant cosmetic concerns. The diagnosis was confirmed through a thorough clinical evaluation. The Siddha formulation Pachaieruvai was applied externally for seven consecutive days. After one week of treatment, a significant reduction in both lesion thickness and pigmentation was observed. At the follow-up appointment, one week after the last treatment, the SK lesions were completely eradicated. No adverse symptoms or recurrence were noted. This research highlights the effectiveness of the Siddha approach to managing SK. Based on the findings, Siddha medicine proves to be an effective treatment for SK.