It’s estimated that anywhere from 20 to 42 million people in the United States, commonly children, have had a pinworm infection. While irritating, and perhaps embarrassing, a pinworm infection is generally considered harmless, according to the Merck Manual. (3)
Worms Present in Feces This is common, according to the National Organization for Rare Disorders. (4)Difficulty Sleeping Pinworms move to the area around the anus at night in order to lay eggs, which can induce itching that disturbs sleep.Vaginal ItchingVaginal Discharge (1)Nausea and Vomiting These are rarely reported.Bed Wetting This is a rare symptom.Stomach Pain This is also rare. (4)
School-age and preschool-age childrenInstitutionalized individualsThose who share a household with infected individualsIndividuals who are caregivers to the infected (5)
The eggs laid on the skin surrounding the anus can survive for up to three weeks, which allows plenty of time for the infected person to scratch the area, have the eggs become embedded under the fingernails, and inadvertently reinfect themselves, thus continuing the parasites’ lifecycle. (4) Examine the anus. Wake your child about one to two hours after you put him or her to bed, then check around his or her anus for wiggly, white, hair-thin worms that are about ¼ to ½ inch (0.63 to 1.27 centimeters) long. (3,6) Use transparent tape. First thing in the morning (before your child bathes or uses the bathroom), firmly place a 1-inch piece of transparent tape against the skin around the anus for a few seconds, allowing any pinworm eggs to stick to the tape. Next, transfer the tape to a glass slide, sticky side down, and place inside a sealed plastic bag. Repeat for three consecutive mornings and take the tape to the doctor for microscopic examination. If you see worms that have adhered to the tape, you can likely inform your doctor that you’ve found pinworms, according to UCSF Health. (7) Analyze under-the-fingernail samples. A physician may also opt to use a microscope to examine a specimen taken from under a child’s fingernails, notes the CDC. (Eggs may be found there due to scratching.) (8)
Medication Options for Pinworms
One of the following is usually the treatment of choice. No matter which is used, an initial dose is given, followed by a second dose two weeks later to prevent reinfection by worms hatched from eggs not killed the first go-round.
Prescription Emverm (mebendazole) and Albenza (albendazole) are oral meds that cause pinworms to be expelled through bowel movements. (3) They’re generally not recommended for use in children under 2 years old. (6)Over-the Counter (OTC) While Pin-Away (pyrantel) and Reese’s Pinworm Medicine (pyrantel pamoate) are available without prescription, they’re considered less effective than the other choices, according to the Centers for Disease Control and Prevention (CDC). (11)
Alternative and Complementary Therapies
Adhering to stringent hygiene measures for six weeks, which is the lifespan of a pinworm, can clear up an infection without medication. These practices also reduce the risk of reinfection. If any member of your household is a nail-biter or thumb-sucker, this method is likely not right for you, notes ChildrensMD. (12) These med-free measures include:
Keep fingernails short.Scrub fingernails with a nail brush daily.Wash hands thoroughly for at least 20 seconds after using the bathroom and before eating.Shower each morning to help remove eggs from the skin.Don’t share towels or washcloths.Wear snug underwear, avoiding boxer shorts.Change underwear every morning.Wash bed linens, pajamas, towels, and washcloths with each use; do not shake before laundering.Change hand towels daily.Vacuum carpets and clean floors at least once a week, paying special attention to the bedrooms and bathrooms.Clean kitchen and bathroom surfaces daily, especially faucets and the toilet flusher.Refrain from eating in the bedroom to avoid possibly swallowing eggs that have landed in bed linens.Keep toothbrushes in a closed cabinet. (Theoretically, airborne eggs can land on toothbrushes.) (12)
Always wash hands with soap and warm water for at least 20 seconds after using the bathroom or changing diapers, and prior to handling food.Frequently wash underwear, pajamas, bedding, and toys.Regularly vacuum.For adults, avoid of oral-anal contact during sexual relations. (3)Change underwear and bathing suits daily.Keep fingernails short and clean.Refrain from biting fingernails.Avoid scratching one’s rear end. (1)
Other complications are rare but can include: Vaginitis The vagina can become inflamed if a heavy infestation of worms travel from the anal area to the vagina and then into the uterus, fallopian tubes, and around the pelvic organs. Endometritis This occurs when pinworms move into the uterus, fallopian tubes, and around the pelvic organs, causing inflammation of the inner lining of the uterus. (2) Urinary Tract Infections (UTIs) UTIs may occur in some cases. Weight Loss Loss of weight is a rare but possible complication. (2) Peritonitis With this complication, inflammation occurs in the peritoneum, which is the tissue that lines the abdominal wall and covers most of the organs in the abdomen, according to research published in August 2015 in BMJ Case Reports. (14) Appendicitis Appendicitis is another potential secondary infection. (4) It’s estimated that anywhere from 20 to 42 million people in the United States have had a pinworm infection; about 50 percent of people under 18 years old, those who care for infected children, and individuals who are institutionalized have had a pinworm infection, according to the CDC. (5) Ascaris These parasitic worms are found in tropical areas and can cause either no symptoms, or symptoms such as fever, cough, wheezing, stomach cramps, vomiting, and restless sleep, according to the Cleveland Clinic. (16) Infection occurs when eggs are ingested after putting contaminated hands or fingers in one’s mouth — or by consuming produce that’s come in contact with contaminated soil and not properly cooked, washed, or peeled. (15) Hookworm Infections are most commonly found in temperate and warm, moist climates. The worms penetrate the skin when a person walks barefoot on contaminated soil and then travel to the small intestine, where they can cause abdominal pain and sometimes anemia. (4) People in good health may not exhibit any symptoms. (16) Whipworm Hot, humid climates are generally where whipworms are found. Like Ascaris, whipworm infections occur when eggs are ingested via hand-to-mouth action or after consuming contaminated fruits or vegetables. Usually, there are no symptoms, but a severe infection can bring about mucousy, watery, and bloody bowel movements and the frequent and painful passage of stool. Rectal prolapse (part of the large intestine slips outside of the anus) can also occur, per the CDC. (17) KidsHealth for the Nemours Foundation This nonprofit children’s health system provides readers with easy-to-understand info on a wide variety of health topics. The best part: You can find guidance on the very same topic written specifically for parents, for kids, and for teens. With pinworms, for instance, kids can learn about what’s making their rear end itchy in a friendly, kid-appropriate way. Meanwhile, parents can read more about the nitty-gritty. American Academy of Pediatrics The AAP is a professional organization that boasts roughly 67,000 pediatricians as members. The group is a leading national voice on children’s health, supporting research, science, and presenting the info in a user-friendly manner on its HealthyChildren.org website. Here, parents can find info on anal itching and pinworm infections. Plus, there’s an exceedingly helpful Symptom Checker, where parents can plug in various ills and injuries to get specific help.
