The skin may not appear to be as vital as the heart or the brain, but, nevertheless, a healthy skin is essential for life and a skin disease can make life unbearable. A person with an apparent skin disease avoids meeting people, while others keep away due to the fear of infection. In the last few years, in India, like in the west, a multicrore rupee industry has come up to manufacture skin care preparations, so much so that some years ago the Indian Parliament had to amend the Drugs Act of 1940 to the Drugs and Cosmetics Act to include cosmetics in the Act, the use of which has been growing at a very rapid rate.

Scabies

Scabies is a contagious disease caused by a mite (Sarcoptes scabiei). This mite lays eggs in the burrows of the skin. The disease spreads through contact with infected individuals, clothing, bedding, or furniture. The commonly affected parts are the finger webs, the palm, wrist, front of the arm, the soles, areas around the nipples, and the groin and inner upper legs causing severe itching (pruritus), specially at night. A person suffering from itching in these areas and not suffering from allergy or pruritus (severe itching of the skin) can be suspected of scabies. This infection may cause small papules and there may be a rash.

The incubation period for the mite is long - about a month - and it can easily be transferred by normal social contact among a group of people living together.

All members of the house, whether afflicted or not, should be treated. The clothes, linen, towels, and so on, should be thoroughly washed and ironed.

Gamma Benzene Hexachloride (Emscab, Gammaderm, Gab, Lorexane, Scarab)

It is also called lindane and is the drug of choice for scabies and lice infestation. In adults single application of its 1 % lotion or 2% cream may be necessary to provide a complete cure. If needed it may be repeated after one week.

Adverse Effects: It is an irritant to the eyes and mucosa. It may cause skin irritation if used excessively or for a prolonged period. Such overuse may cause the adverse effect of irritating the brain. In rare cases due to excessive use resulting in absorption into the body, convulsions may occur.

Precautions

Do not apply it on the eyes and cuts on the skin as it may cause irritation.

Do not apply it repeatedly without consulting a doctor.

If skin irritation occurs, which may be due to an allergy, wash it off and don't apply again.

Do not apply more than 3 g of the lotion or cream at a time.

Wash the body thoroughly after an overnight (8 to 12 hours) application.

Avoid its use during pregnancy and in infants.

If skin is broken due to scratches or ulcers do not apply either the lotion or cream.

Permethrin (Perlife, Permite)

A 5% cream and 1% lotion is considered to be highly effective and safe. It has to be applied only once and if need, repeated after one week. It can be used in children also.

Crotamiton (Crotorax)

It is less effective than gamma benzene hexachloride as it has to be applied for 2-4 night heights. Its irritant effect is, however, less than gamma benzene hexachloride. It is available as 10% cream and lotion. It reduces itching.

Benzylbenzoate (Scabalcid lotion, Scabindon ointment)

Its irritant effect on the skin is more than that of gamma benzene hexachloride and may cause a burning or stinging sensation on the area of application. It is applied for 2 days. Itching may continue for a few days. This drug is used in difficult cases only.

Sulphur Ointment

This is messy, but an inexpensive remedy. It has a bad odour, and stains clothes, but is very safe. It is preferred in infants, young children, and pregnant women. A 5% sulfur cream (Persol Forte) contains benzoyl peroxide 10%.

Lice Infestation

This is also called pediculosis as it is caused by common lice - pediculus capitis (head louse). Although lice infestation is not injurious to health, it is very annoying due to the itching sensation caused by it. Excessive scratching and excoriation may lead to secondary bacterial infection. The itching is caused by the saliva of the parasite deposited on the skin. If eye lashes are involved, plain vaseline is applied twice a day for about a week.

Permethrin 1% is applied to the scalp and hair and left for 30 minutes to 8 hours before a rinse.

Gamma Benzene Hexachloride (Emscab, Gammaderm, Gab, Lorexane, Scarab)

Malathion

A 1% lotion is very effective and takes 8-12 hours time to kill the lice. However, it has been banned in the USA due to its slow action and toxicity to nerves. It should be applied in a very well ventilated area, lest the vapours be inhaled.