It is very difficult to differentiate the arsenical manifestation in stages. A person without external manifestations may face serious consequences of arsenicosis leading to cancer or acute renal failure. This is very simple to classify the arsenicosis as subclinical and clinical form. Clinically the earliest sign in the skin may be the melanosis then the keratosis and others. The systemic involvement is variable and may appear before and after the melanosis or keratosis.
Subclinical cases deserve early identification and follow-up.
The use of arsenic free water may probably stop the deterioration of the symptoms but information of complete recovery is not yet known. The supportive treatment for nutrition improvement may play some role to diminish symptoms and may help to reverse some cases of the melanosis stage. The main challenge is how to provide the millions of people at risk with arsenic free, bacteriologically as well as chemically safe, and aesthetically acceptable alternative source of drinking water. It has been observed that tubewells, public and private, exist in several numbers in any cluster or community. It has also been found that generally not all tubewells in an area are affected by arsenic.