Korean Medicine Treatments for Verruca Plana: A Systematic Review and Meta-Analysis

Objectives: To systematically evaluate the efficacy and safety of Korean medicine (KM) interventions for verruca plana and to quantify their comparative effects versus conventional controls.Methods: Following PRISMA guideline, nine databases were searched through July 2025 for randomized controlled trials (RCTs) of KM interventions for verruca plana versus conventional controls. Two reviewers independently screened, extracted data, and assessed risk of bias. Meta-analyses used total effective rate as the primary outcome; recurrence, adverse events (AEs), quality of life (QoL), and immune markers were secondary outcomes.Results: Seventeen RCTs met inclusion. Fire-needle showed a significant advantage (2 RCTs; n =697; Risk Ratio [RR] 1.09, 95% Confidence Interval [CI]: 1.02,1.15; I² = 0%), as did herbal medicines (3 RCTs; n = 262; RR 1.37, 95% CI: 1.22,1.57; I² = 1%). Several trials signaled lower 6–12-month recurrence, QoL improvement, and favorable cytokine shifts, with mostly mild AEs. Overall risk of bias was moderate.Conclusions: Herbal medicine and fire-needle may improve short-term clinical response in flat warts with acceptable safety, but heterogeneity and methodological limitations warrant cautious, conditional recommendations. Larger multicenter RCTs with ≥12-month follow-up, standardized protocols, and mechanistic substudies are needed.