Objective To evaluate the clinical efficacy and safety of filiform needles combined with modified Zilan decoction in treating verruca plana in adolescents.Methods A total of 120 adolescents with verruca plana treated at the outpatient clinic of the Wuxi Ninth People's Hospital from March 2021 to March 2022 were randomly assigned to observation group and control group(n=60,each).The observation group received filiform needle treatment combined with oral administration of modified Zilan decoction,while the control group took pidotimod dispersible tablets plus external application of 0.1%tretinoin cream.After six weeks of treatment,the severity scores of verruca plana lesions,Dermatology Life Quality Index(DLQI)scores,treatment efficacy rates,serum levels of interleukin-10(IL-10)and interferon-γ(IFN-γ),as well as adverse reactions were compared between the two groups before and after treatment.Results Before treatment,there was no significant difference in the severity scores and DLQI scores of verruca plana lesions between the two groups(P>0.05).After treatment,both groups showed a significant decrease in the severity scores and DLQI scores of verruca plana lesions compared to those before treatment(P<0.01),with the observation group significantly lower than the control group(P<0.01).The overall treatment efficacy rate for the observation group was 95.00%,which was significantly higher than the control group's 77.00%(x2=12.987,P<0.01).Before treatment,there was no significant difference in serum IL-10 and IFN-γ levels between the two groups(P>0.05).After treatment,the serum IL-10 concentration in the observation group was significantly lower than that before treatment(P<0.01)and also significantly lower than that in the control group(P<0.01);the serum IFN-γ concentration in the observation group was significantly higher than that before treatment(P<0.01)and also significantly higher than that in the control group(P<0.01).No systemic adverse reactions occurred during the treatment process.Conclusion Filiform needles combined with modified Zilan decoction have shown significant therapeutic effects and high safety in treating verruca plana in adolescents.