The initial phase of infestation is asymptomatic. Subsequently, the disease manifests with intense itching especially at night or while taking a hot water bath. The itching is due to allergic reaction to the mites and their excreta or deposit in skin burrows. The skin lesion includes red rashes and raised spots. Due to scratching the skin may become crusty or scaly as the infection progresses. Secondary skin infection with Streptococcus bacteria can sometimes lead to acute glomerulonephritis which is a serious complication of scabies.
Curing scabies needs several precautions and effort. A local application made from Gandhaka described in classical texts of Ayurveda can check the infection and reduce the spread of scabies.
Gandhaka ointment (ointment of sulphur) - Gandhaka ointment is an effective preparation made form Gandhaka (sulphur), Tila oil (sesame oil) and Siktha (bee wax). Both internal and external use of purified Gandhaka is mentioned in Ayurvedic classics as well as the Ayurvedic Formulary of India.
Tila consists of dried seeds of Sesamum indicum Linn. a herb extensively cultivated throughout the plains of India. Tila oil extracted from sesame seeds is used in skin diseases such as erysipelas, vitiligo, haemorrhoids, gout, gonorrhea, alopecia, dental disease, burn, etc.Bee wax is obtained from the honey comb of the bees. In pharmaceuticals, it is an ingredient of paraffin ointment.
In plastic surgery too bee wax extracts are used for improved wound healing and reduced scar tissue development.
Composition - Gandhaka ointment comprises of Gandhaka, Tila oil and Siktha.
| Name | English Name | Latin Name | Family |
| Gandhaka | Sulphur | Sulphur | Sulphur |
| Siktha | Bee Wax | Obtained from bees Apis mellifera | Apidae |
| Tila oil | Sesame oil | Sesamum indicum Linn. | Pedaliaceae |
Main chemical constituents -
(a) Gandhaka: Sulphur .
(b) Tila Taila: Fixed oil, natural lipids, glycolipids, phospholipids.
(c) Siktha: Myricin, free cerotic acid, small quantity of melissic acid and aromatic substance cerolin.
Dosage form - The preparation has ointment-like consistency with light-yellow colour and a peculiar strong smell.
Therapeutic properties - Gandhaka ointment has parasiticidal, fungicidal, and antiseptic properties.
Indications and uses - Gandhaka ointment is useful in fungal infections of skin, scabies, eczema, and for application over chronic infective lesions.
Dose and mode of administration -
(1) Gandhaka ointment is applied externally on the affected parts of the body once or twice daily and left on the lesions for an hour or so.
(2) Thereafter, the lesions should be cleaned with warm water.
(3) Repeat the procedure daily for 7 to 10 days or till all the lesions disappear
Precautions and safety aspects -
(1) Gandhaka should not be used in formulations without subjecting it to purification.
(2) Persons sensitive to sulphur should not use this application.
(3) If the skin lesions do not heal within a few days of application, proper medical guidance should be sought.
(4) Gandhaka ointment should not be used on open wounds and lesions.
(5) Persons with scabies having secondary bacterial infection should avoid the use of Gandhaka ointment.
(6) Persons known to have scabies should avoid having close skinto-skin contact until they have been cured.
(7) If a member of a family has scabies, all other household members, sexual partners and close contacts should be treated simultaneously.
(8) Use gloves and gowns when treating others with a suspicious rash and itching.
(9) Wash all clothing, towels and bed linens that were used in the last three days by the affected person, with hot water.
(10) Use the dryer at high heat rather than air drying. Since the mites cannot survive on nonliving objects for several days, therefore place the objects that are not machine-washable such as coats and stuffed toys into a bag and store for a week.
(11) Cut nails and clean them thoroughly to remove any mites or eggs. (12) Try to avoid scratching and keep all open sores clean and aseptic.