Pinworms

Is this your child's symptom?

• Tiny, harmless worms that can cause anal itching
• The pinworms live in the colon (large bowel)

Symptoms of Pinworms

• 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.
• The pinworm's secretions are a strong skin irritant and cause the itching.

When to Call for Pinworms

Contact Doctor During Office Hours

• 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 think your child needs to be seen
• You have other questions or concerns

Self Care at Home

• Anal itching without a pinworm being seen
• Questions about pinworm exposure or contact

Care Advice

Treatment for Pinworms

1. What You Should Know About Pinworm Treatment:
   • 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. Pinworm medicines are available without a prescription (such as Reese's Pinworm Medicine). There are also prescription medicines that treat pinworms. Your doctor will decide which one is best for your child. 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 Family Members and Close Contacts:
   • Pinworms can spread to others within the same home. How often others get pinworms varies.
   • Treat any child who sleeps with the infected child.
   • Treat family members only if they have symptoms.
   • Treat all family members if other family members develop symptoms.
   • 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 to 7 days.
6. Prevention of Pinworms:
   • 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
   • You think your child needs to be seen
   • Your child becomes worse

Treatment for Anal Itching Without Pinworm Being Seen

1. What You Should Know About Anal Itching:
   • 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 increased 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 Itching:
   • For the itching, wash the skin around the anus with warm water.
   • For severe itch, use 1% hydrocortisone cream (such as Cortaid) 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
   • You think your child needs to be seen
   • Your child becomes worse

Treatment for Pinworm Exposure

1. Low Risk for Getting Pinworms:
   • 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
   • You think your child needs to be seen

Treatment for Reducing Reinfection or Spread to Others

1. Preventing Pinworm Infections:
   • 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 during the 2 weeks of treatment.
   • Always rinse the anal area.
   • Continue for 3 days after taking the second dose of 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:
   • Have the infected child wear underwear at night during the 2 weeks of treatment. Caution: it may contain pinworm eggs. Remove it carefully just before showering. Wash the underwear each morning.
   • Bed sheets can also be washed on a more frequent basis.
   • 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.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 10/11/2023

Last Revised: 12/30/2022

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.