WWarts on hands and feet are the most common types of warts seen and treated in the dermatologist’s practice of Dr. Schnitzler in Zurich Enge.

They can be treated with the most modern methods.

Warze in mikroskopischer Aufnahme

Microscopic image of a wart @auntspray AdobeStock

Table of contents

FOOT WARTS

Probably the most common way people get a wart is through infection on the foot, almost as often, in the form of plantar warts on the soles of their feet (Latin plantaris, relating to the ‘sole’). These warts typically appear as hard rough patches with small, closed blood vessels at the surface resembling tiny black dots.

How do plantar warts develop?

In the human papillomavirus family HPV, subtypes 1or 4 are the most common trigger of warts on feet or soles of feet.

A wart occurs when the person becomes infected with the virus through small open wounds. Since these micro-lesions do not hurt, they usually go unnoticed. These infections are often contracted by walking barefoot on damp surfaces. These can be for example, communal showers in sports clubs, fitness studios, swimming pools, saunas, or whirlpools.

If the virus infects the upper layer of the skin on the feet, it infiltrates its genetic material into that of the healthy skin cells causing rapid growth and wart cells are formed.

After varying lengths of time, the wart begins to grow. This can be after a few days, weeks or even months or years. Why this is so different cannot be explained to this day.

Fusswarze

Warts on the soles of feet can be painful.
@srisakorn – AdobeStock

Mosaikwarzen können auch erfolgreich behandelt werden.

Mosaic warts on the ball of the foot – these can be successfully treated. @XXX – AdobeStock

Do warts multiply on the soles of feet?

Warts can spread as more areas of the skin become infected with the virus. If a wart has been on the foot sole for a long time, there are often several other warts.

Flat or multiple warts clustered together on the soles of feet are called mosaic warts.

Special features of plantar warts!

Why are warts on the soles of feet flat and like a hard bump on the hands?

It is assumed that this is due to the mechanical load. Since the sole of feet continuously carry our weight, the wart grows inwards verses the outward growth on fingers and hands. Due to the “inward” growth of plantar warts, they are usually more painful than warts on hands or other locations.

Hand warts

Developing a wart on the hand or even multiple warts is also very common. The presence of warts on the hands is almost as prevalent as warts on the soles of feet.

How do warts develop on hands?

As with plantar warts, the skin on the hand becomes infected with an HPV. This is usually the subtype HPV2, but again as with plantar warts, subtype HPV4 can also be responsible for warts on hands.

This as well, happens when the virus enters the skins surface through tiny wounds or scratches that mostly go unnoticed.
This infection usually occurs through skin-to-skin contact or contact with objects that are touched by persons already infected such as hand towels, especially after this skin has been softened by water or sweating.

This is followed by the development of the wart, causing rapid cell growth and formation of wart cells in the same way as described above.

Handwarzen

Warts on hands are unsightly.
@muro – AdobeStock

Warzen am Fingernagel sind sehr unangenehm.

Warts around the fingernails are very uncomfortable. @medarko – AdobeStock

Features of hand warts!

A very uncomfortable but not common wart on the hand is the subungual wart. Here the virus has infected the skin around the nail. Injuries to the skin layer are very common in these areas. The wart spreads along the nail bed and under the fingernail.

Treatment for Warts

Different methods are possible!

Unfortunately, there is no miracle method to treat warts. Removing warts on hands and soles of feet is sometimes difficult. They are often very resistant to therapy or respond poorly to therapies.

The NEW innovative method from CellFX is very promising.

CellFX Process

One of the most modern and most promising methods to successfully remove warts with minimal treatments is the CellFX wart treatment. This method, highly acclaimed in America for successfully treating warts and other benign skin tumors, is now available in Europe.

CellFX Warzen Behandlung an der Ferse.

Dr. med. Hero Schnitzler – CellFX wart treatment on the heel.

This wart therapy which is also successfully being used at derma competence center in Zurich Enge, is based on making the wart destroy itself.

CellFX Applikation auf die Warze an der Ferse.

CellFX application on a wart

The CellFX-process uses an innovative technology which works directly on the wart cells. This is achieved by using very fast energy pulses, Nano-Pulse Stimulation.

CellFX Impulse öffnen Calciumkanäle

CellFX impulses open calcium channels

The Nano-Pulse Stimulation delivers ultra-fast energy pulses targeting the wart cells.

Durch offene Kanäle strömt Calcium in die Zelle

Calcium flows into the cell through open channels

These pulses of energy cause tiny pores to form, which allow ions (small, charged particles) such as calcium to enter the cell and promote growth of healthy skin cells.

Das Calcium in der Zelle bewirkt das Absterben der Warze

The calcium in the cell causes the wart to die off

This disturbance of the equilibrium triggers a mechanism in the cell that leads to the controlled demise of the wart cells. This procedure only targets (wart) cell tissue. There is practically no effect on the surrounding skin. The CellFX process works without heat or cold. This reduces the risk of scarring.

Already after one CellFX treatment the wart is cured.

The wart is healed after just one CellFX treatment.

  • Up to 80% removal for common / flat warts *
  • 41% of the treated warts were persistent (resistant to previous treatments) *

* Lain E.A. Prospective, Non-Randomized, Multicenter Pivotal Study of Nano-Pulse Stimulation (NPS) for the Treatment of Cutaneous Non-Genital Warts. Presented at the 2020 American Society for Dermatologic Surgery (ASDS) Annual Conference, October 2020.

CellFX is one of the most modern and most promising treatment methods to remove warts with one or a few treatments. This method, established in America for successfully treating warts and other benign skin tumors, is now also available in Europe.

Laser

Spider veins - laser - Dr. Schnitzler Zurich-Enge

The use of lasers causes the wart to «starve».

With repeated laser treatments blood vessel supplying the wart are closed off. The wart is «starved out».

Topical Formic Acid

Ameisensäure wird auf die Warze appliziert.

Formic Acid is applied to the wart.

Multiple application of high-concentrate formic acid can dry out hand and plantar warts.

Freezing

Vereisung eines Hautumors.

Freezing warts using liquid nitrogen kill the wart cells.

Warts and wart beds are frozen with liquid nitrogen to kill the wart.

Scraping (Mechanical Removal)

Scraping allows for an immediate reduction in pain.

With use of a sharp spoon-like knife or curette the wart is cut to reduce the size. Pain caused by strain (e.g., walking) is quickly reduced.

Tinctures

Antiviral tinctures help prevent cells from spreading and re-infecting.

Wart treatment with salicylic acid patches or tinctures: This chemical substance softens the wart and makes it easier to remove.

Frequently Asked Questions on Wart Treatment

What can be expected after a wart treatment?

Almost all treatments for warts on the soles of feet or on the hands can lead to blisters, bruises, crusts, pigmentation, and slight pain after the treatment. If a wart on the sole of the foot has been treated, these undesirable side effects can temporarily limit the patient’s ability to walk.

How often do you have to treat warts to heal completely?

Most warts need a variety of different or combinations of the above treatments and multiple treatment sessions. Even then, healing is not guaranteed. This is extremely frustrating for both the patient and the treating dermatologist.

It is gratifying that with the new CellFX technology, it usually only takes one session, rarely two or three for stubborn cases, to successfully treat plantar warts and warts on the hands.

What treatments for warts are not recommended?

Cutting warts out surgically or with a laser is no longer a frequent procedure. It has been recognized that the resulting large wounds took a long time to heal, were considerably painful for the patient and severely restricted daily life. A higher recurrence of the warts was also observed.

Are there alternative or natural wart treatments?

Both the internet and the medicine cabinet are full of natural alternative treatments or home remedies to treat warts. The latter ranges from your own urine, snail slime, onion juice, tea tree oil to talking to the wart, to name just a few.

These practices can sometimes lead to the desired result in children; in adults, these remedies, especially in the case of the hard-to-treat plantar and hand warts are rarely successful.

Furthermore, one should also bear in mind that “home remedies” can sometimes lead to undesirable side effects.

OVERVIEW OF WART TREATMENTS

Treatments for warts and their specifics in summary

CellFX

  • 15-20 minutes
  • Seldom more than 1 treatment necessary
  • 80% removal of common warts*
  • 41% healing of stubborn warts (resistant to previous treatments)*
  • use of local anesthesia
  • uncomplicated healing from within

Laser

  • 15-20 minutes
  • usually 2-4 treatments required
  • non-invasive, no wounds, possible small blisters
  • painful

Acid

  • 10-15 minutes
  • frequent repetition
  • frequent repetition
  • blood blisters and wounds are possible

Freezing

  • 10-15 minutes
  • no chemicals
  • frequent repetition
  • blood blisters and wounds are possible

Scraping

  • up to 45 minutes
  • mostly painless
  • immediate relief of discomfort and pressure
  • only the keratinization is removed, diseased
  • cells are not therapied

Tinctures

  • a few minutes
  • very frequent repetition
  • can be done at home
  • chance of success only if consequently applied


Autor - Dr. med. Hero P. D. Schnitzler

I am Dr. Hero P. D. Schnitzler and founded the derma competence center in Zurich Enge in 2015, which I have been managing with heart, soul and professional competence ever since.

I am a member of various Swiss and international professional societies and a long-time lecturer for aesthetic laser medicine (D.A.L.M.) at the University of Greifswald, and for the Swiss skills program FMCH laser treatments of the skin.