Pinworms  

This Care Guide Covers:

  • A tiny, harmless worm that lives in the colon (large bowel)
  • It causes itching of the anus

View images
Pinworm Eggs Under a Microscope
Pinworm Eggs Under a Microscope

When to Call Your Doctor

Call Your Doctor During Weekday Office Hours If
  • You think your child needs to be seen
  • Pinworm is seen (Reason: needs a pinworm medicine)
  • Red and tender skin around the anus (Reason: could be Strep infection)
  • Anal itching lasts more than 1 week
  • You have other questions or concerns
Parent Care at Home If
  • Anal itching without a pinworm being seen
  • Pinworm exposure or contact, questions about
Causes & Health Information

Symptoms

  • Itching and irritation of the anus and buttocks is the main symptom
  • Sometimes, moves to the vagina and causes vaginal itching or discharge

Cause

  • A white, very thin, threadlike worm, about ¼ inch (6 mm) long.
  • It moves. (If it doesn't wiggle, it's probably lint or a thread.)
  • The worm may be seen around the anus or on the child's bottom. It is especially active at night or early morning.
  • Rarely, the pinworm is seen on the surface of a stool.

Return to School

  • Children with pinworms do not need to miss any child care or school.
CARE ADVICE FOR PINWORMS

Treatment for Pinworms
  1. What You Should Know:
    • Pinworms are the most common worm infection in the US.
    • Pinworms can cause anal itching.
    • Pinworms do not carry any diseases.
    • Treatment is very helpful.
    • Here is some care advice that should help.
  2. Pinworm Medicine:
    • If a pinworm was seen, your child's doctor will suggest a special pinworm medicine. Take as directed.
    • Give a repeat dose of the pinworm medicine in 2 weeks. Reason: To prevent the pinworms from coming back.
    • The repeat dose is needed because eggs can live for 1 to 2 weeks. Temperature and humidity levels also affect how long the eggs can stay alive.
  3. Treating Close Contacts:
    • There is a slight risk that Pinworms may spread to others.
    • Treat family members only if they have symptoms.
    • If another child sleeps with the infected child, they also should be treated.
    • If any of your child's friends have symptoms, be sure to tell their parents. These children should get tested or checked for pinworms.
  4. Return to School:
    • Children with pinworms do not need to miss any child care or school. 
  5. What to Expect:
    • After taking the pinworm medicine, itching should stop in 5 in 7 days.
  6. Prevention:
    • Wash hands and fingernails well before meals and after using the toilet. 
  7. Call Your Doctor If:
    • Anal symptoms last over 1 week after treatment
    • Your child becomes worse
Treatment for Anal Itching Without Pinworm Being Seen
  1. What You Should Know:
    • There are many causes of itching around the anus. Some are more common than pinworms.
    • The most common cause is stool that has been left on the skin. Stool contains chemicals and germs that can cause itchy skin rashes. Try to prevent this by washing the skin off. After wiping off stool with toilet tissue, cleanse the skin with warm water.
    • Bubble bath can also cause an itchy bottom. Children with dry skin are at special risk. Avoid bubble bath or any soapy bath water.
    • If these changes don't get rid of the anal itching, get a pinworm test.
  2. Pinworm Checks: Check your child for pinworms.
    • Examine the area around the anus, using a flashlight.
    • Look for a ¼-inch (6 mm), white, threadlike worm that moves.
    • Do this a few hours after your child goes to bed. Check him 2 nights in a row. Also, check him first thing in the morning for 2 days.
  3. Scotch Tape Test:
    • If no adult pinworm is seen, call your doctor's office. Ask for instructions on doing a Scotch-tape test for pinworm eggs. You can also use the technique below:
    • Take a piece of clear Scotch tape (with the sticky side down). Touch it to the skin on both sides of the anus. Do this in the morning soon after your child has awakened. Also, do this before any bath or shower.
    • Put the sticky tape side that touched the skin on a slide. If you don't have a slide, put it on a second piece of tape.
    • Do it 2 mornings in a row.
    • Bring the 2 samples in to be looked at under a microscope.
  4. Steroid Cream:
    • For the itching, wash the skin around the anus with warm water.
    • For severe itch, use 1% hydrocortisone cream 2 times per day. Use for 1 or 2 days. No prescription is needed.
  5. Call Your Doctor If:
    • Pinworm is seen
    • Skin around the anus gets red or tender
    • Anal itching lasts more than 1 week
    • Your child becomes worse
Treatment for Pinworm Exposure
  1. Low Risk:
    • Your child has had contact with a child with pinworms, but no symptoms now. Your child probably won't get them. This is especially likely if over a month has passed.
    • If contact is within the last month, your child may get pinworms. This risk is small.
    • Pinworms are harmless. They are never present very long without being seen or causing anal itching.
  2. Scotch Tape Test:
    • If you're still worried, call your doctor's office. Ask for instructions on doing a Scotch tape test. This can be done to look for pinworm eggs.
    • Do this about 1 month after contact.
    • Reason: The swallowed egg will not become an adult pinworm for 3 or 4 weeks.
  3. Call Your Doctor If:
    • Pinworm is seen (white, ¼ inch or 6 mm, and moves)
    • Anal itching lasts more than 1 week
Treatment for Reducing Reinfection or Spread to Others
  1. Preventing Infection:
    • Infection is caused by swallowing pinworm eggs.
    • A child can get pinworms no matter how carefully you clean.
    • The following hygiene measures, however, can help to reduce the chances of reinfection. It also can reduce the chance of new infections in other people.
    • Pets don't carry pinworms.
  2. Wash Hands:
    • Have your child scrub the hands and fingernails well before each meal. Also, wash the hands well after each use of the toilet.
    • Keep the fingernails cut short, because eggs can collect here.
    • Help your child give up thumb sucking and nail biting.
  3. Shower:
    • Each morning give your child a shower.
    • Always rinse the anal area.
    • Do this for 3 days after taking the pinworm medicine.
  4. Vacuum:
    • Vacuum or wet-mop your child's bedroom once a week.
    • Any eggs left on the floor can still infect others for 1 or 2 weeks.
  5. Wash Clothes:
    • Wash clothes and bedding at a hot temperature. This will kill any eggs left in them.
  6. Return to School:
    • Children with pinworms do not need to miss any child care or school.

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 9/1/2012

Last Revised: 1/13/2013

Content Set: Child Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.