Pinworms

Symptoms

DEFINITION

• A tiny, harmless worm that lives in the colon and causes itching of the anus

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Symptoms

• Itching and irritation of the anal area and buttocks
• Occasionally, migrates 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 in the anal and buttock area, especially at night or early morning
• Rarely the pinworm is seen on the surface of a BM.

Return to School

• Children with pinworms do not need to miss any day care or school.

Should I Call?

WHEN TO CALL YOUR DOCTOR

Call Your Doctor During Weekday Office Hours If

• Pinworm is seen (Reason: probably needs a prescription medicine)
• Red and tender skin around the anus
• Anal itching persists over 1 week
• You have other questions or concerns

Parent Care at Home If

• Anal itching without pinworm being seen
• Pinworm exposure or contact

Care at Home

HOME CARE ADVICE FOR PINWORMS

Treatment for Pinworms

1. Pinworm Medicine:
   • If a pinworm was seen and your child's doctor concurs, she will call in a prescription. Take as directed.
   • Give a repeat dose of the pinworm medicine in 2 weeks (Reason: to prevent reinfection).
   • This interval is chosen because pinworm eggs can remain viable in the environment for 1 to 2 weeks, depending on room temperature and humidity.
2. Contagiousness:
   • Pinworms are mildly contagious.
   • Treat family members only if they have symptoms.
   • If another child sleeps with the infected child, they also should be treated.
   • If any of the child's friends have similar symptoms, be sure to tell their parents to get them tested.
3. Prevention: Wash hands and fingernails carefully before meals and after using toilet.
4. Call Your Doctor If:
   • Anal symptoms last over 1 week on treatment

Treatment for Anal Itching Without Pinworm Being Seen

1. Pinworm Checks: Check your child for pinworms.
   • Examine the area around the anus, using a flashlight.
   • Look for a ¼-inch, white, threadlike worm that moves.
   • Do this a few hours after your child goes to bed and first thing in the morning for 2 consecutive nights.
2. Scotch Tape Test: If no adult pinworm is seen, call your doctor's office for instructions on doing a Scotch-tape test for pinworm eggs or use the following technique:
   • Touch a piece of clear Scotch tape (with the sticky side down) to the skin on both sides of the anus. Do this in the morning soon after the child has awakened, and definitely before any bath or shower.
   • Do it 2 mornings in a row.
   • If no slide available, apply the piece of tape that has touched the skin to a second piece of tape.
   • Bring the 2 samples in for examination with a microscope.
3. Steroid Cream: For the itching, wash the skin around the anus. For severe itch, apply 1% hydrocortisone cream 4 times per day.
   
4. Call Your Doctor If:
   • Pinworm is seen
   • Skin around the anus becomes red or tender
   • Anal itching persists over 1 week
   • Your child becomes worse

Treatment for Pinworm Exposure or Contact

1. Low Risk:
   • If your child has had contact with a child with pinworms but has no symptoms, (and over a month has passed), your child probably won't get them.
   • If contact is within the last 4 weeks, your child has a small chance of getting pinworms.
   • Pinworms are harmless and are never present very long without causing anal itching.
2. Scotch Tape Test: If you're still concerned, call your doctor's office for instructions on doing a Scotch tape test for pinworm eggs in about 1 month. (Reason: The swallowed egg will not mature into 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 persists over 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 keep the kids and the house clean. The following hygiene measures, however, can help to reduce the chances of reinfection of your child and new infections in other people. Pets don't carry pinworms.
2. Hand-washing: Have your child child scrub the hands and fingernails thoroughly before each meal and after each use of the toilet. Keep the fingernails cut short, because eggs can collect here. Thumb-sucking and nail-biting should be discouraged.
   
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, because any eggs scattered on the floor are infectious for 1 or 2 weeks.
   
5. Wash Clothes: Machine-washing at hot temperature will kill any eggs present in clothing or bedding.
   
6. Contagiousness: Mildly contagious within the home. Children with pinworms do not need to miss any day care or school.
   

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Photo Example

Pinworm Eggs Under a Microscope

These are eggs of the human parasite Enterobius vermicularis, or "human pinworm". The eggs were captured on clear tape applied to the area around the anus.