Understanding Pinworms and Treatments
Pinworms are very small parasitic worms that infect the intestines. They are found throughout the world. They are common in children and are easy to treat. Pinworms are the most common worm infection in the United States (approximately 1 out of 5), primarily affecting school-age children. Typically, children scratch their anal area and the eggs can get under the child’s fingernails and are transferred to other children, family members, and items in the house. By touching the eggs and then putting their fingers in their mouth, children swallow the eggs. The eggs eventually hatch in the small intestine and the worms mature in the colon. Female worms then move to the child’s anal area, especially at night, and deposit more eggs. This may cause intense itching and the area may even become infected. Pinworm eggs are spread directly from person to person or by touching bedding, food, or other items contaminated with the eggs.
Symptoms and Signs:
• Mild to intense itching around the anus
• Difficulty sleeping due to the itching that occurs during the night, when the adult worms migrate out through the anus to lay their eggs
• Irritability due to the itching and interrupted sleep at night
• Vaginal irritation or discomfort in young girls (if an adult worm enters the vagina rather than the anus)
• Irritated or infected skin around the anus from constant scratching
• Redness around the anal area
• Loss of appetite and weight (uncommon but can occur in severe infections)
• Pinworms can be spotted in the anal area, especially at night when the worms lay their eggs there
Treatment:
The main treatment is anti-parasitic medication, available over-the-counter and by prescription. More than one household member is likely to be infected, so the entire household is often treated. Treatment is often repeated after 10-14 days. To control egg infestation, make sure that everyone in the family washes their hands before meals and after using the toilet. Fingernails should be kept short and clean. All bed linens should be washed twice weekly, and toilet seats should be cleaned daily. Avoid scratching the infected area around the anus, because this contaminates the fingers and anything else that is subsequently touched. Keep hands and fingers away from the nose and mouth especially if there has been some time since they were washed. Carry out these measures
even while family members are treated with medication. If not treated, the infection can continue indefinitely. Sitting in a tub or cleaning the anal area with witch hazel or some other soothing solution several times a day can relieve severely rectal itching. Applying a light coating of hydrocortisone cream (0.5%) to the anal area can provide some comfort.
Expectations (prognosis): Pinworm infection is fully treatable. Do not blame yourself for this infection. As long as kids play with kids, this infection WILL occur. Many parents feel that only children who are “dirty” get pinworms, but this is clearly not the fact.
Prevention:
Wash hands after using the bathroom and before preparing food. Wash bedding and underclothing frequently, especially those of any affected family members.