How to Treat Pinworms: FAQs

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How to Treat Pinworms: Your Most Common Questions Answered

How to Treat Pinworms: Your Most Common Questions Answered | The Survival Doctor

by James Hubbard, MD, MPH

I wrote a post on how to treat pinworms a few months ago and have had so many comments and questions that I thought I’d answer some of the most common here. You’ll still need to read the older post. This just adds to it.

Here, I’ll address embarrassment, complications, vaginal pinworms, and why the pinworms can keep coming back.

Question #1: I’m so embarrassed. I don’t want anyone to know, even my family. How can I treat pinworms without telling anyone?

You must, at least, tell your family. There’s no way around it. As you can see from the answer to question 2, everyone in the family must be treated. Many are embarrassed because they think they’ve done something wrong or will be perceived as being dirty. But even the cleanest person can get pinworms.

Here are some facts to consider: In the United States, about ten percent of the population (all ages) has pinworms right now. This goes up to about twenty percent in young people and can hit fifty percent in groups (like schools) if pinworms are going around.

Question #2: Why can’t get I rid of these little critters? I treat them, and a few weeks or months later, they come back (or never go away).
Key Points to Emphasize
  • There is a lag of a month or two between the time you ingest the eggs and when you start having symptoms (and become contagious).
  • The worms lay their eggs at night.
  • The eggs are microscopic, light, and sticky, and can end up just about anywhere.
  • The eggs can last outside your body for up to three weeks.
  • One dose of the over-the-counter or prescription treatment (mentioned in my other post) kills the adults but not the eggs. You repeat the dose two weeks after the first to kill any worms that have hatched. Usually that and cleaning is enough.

To treat pinworms, ideally, you must have an understanding of their life cycle:

  1. You ingest the eggs that have come from another person.
  2. After a couple of weeks, the eggs hatch in your intestine.
  3. After another month or two they become adults and mate.
  4. In a few more weeks, the males die and the females crawl out your anus, usually at night, and lay thousands and thousands of microscopic eggs. Why do they crawl out? The eggs need more oxygen than is in your intestine. Why at night? I don’t know, but it becomes important in treatment.
  5. After the worms lay their eggs, most shrivel up and die. Some travel back into the intestine, but it’s unclear how many. And no matter what, they all die within about thirteen total weeks max.
  6. The wiggly worms itch; you inadvertently scratch in your sleep. Now they’re under your fingernails.
  7. The eggs are very, very tiny and almost as light as air. But they have a sticky quality to them also. So they get attached to your underwear, your sheets. Some even float in the air, and you can breathe them in. They don’t affect your lungs, but you can swallow some.
  8. They have to get into your intestine to hatch and grow into adults and start the cycle all over again.

Other things you can do (see my older post for details) include:

  • Apply a little petroleum jelly and maybe a little garlic around your rectum at night to kill the worms and eggs.
  • Wear fairly tight fitting underwear to bed so the worms won’t scatter as much.
  • First thing in the morning, take a bath. Wash your underwear in hot water.
  • Wash your bed sheets and vacuum every day, at least for a few days after taking the first and second dose of medicine.
  • Wear a dust mask or scarf around your face and nose while cleaning.
  • Open the curtains. The eggs don’t do as well in sunlight.
  • Wash hands with soap and water, and clean under the fingernails.
  • Clip fingernails short.
  • Keep your fingers out of your mouth as much as possible.
  • Treat everyone in the family at the same time, unless there’s a reason not to (such as pregnancy). Many people with pinworms have no symptoms but can still spread the eggs.
  • Wash all toys, change the sandbox, wash the toilet and the doorknobs. Wash the pets. (Humans can’t get the type of pinworms animals have, but some human pinworm eggs can get on animals’ fur.)
  • Consider that you or your family member may be getting them from other people. If pinworm infections are going around daycares, for example, they are very to eliminate for good.
  • As a last resort, talk to your doctor about everyone in the family taking a medicine daily for a month. Don’t do this without your doctor’s consent. Even then, you can get them back after you’re finished with the medicine, if you come in contact with someone who hasn’t been treated.

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Question #3: Can pinworms cause complications?

Other than rectal itching and the sleep disturbance caused by it, complications of pinworms are very rare. Some people can have abdominal pain, and it can cause an infection in the intestine, but that’s extremely rare.

Question #4: What about vaginal pinworms?

Pinworms only live in the intestine. However, when they come out the anus to lay eggs, some can crawl into the vagina. Rarely, they can even get into your uterus or fallopian tubes. Even occasionally they can get in your urethra (bladder opening).

But they cannot live long in any of those places. They don’t reproduce there and they die. So pinworms in those areas are short-lived at best. However, while they’re there, rarely, they can cause inflammation, even scarring. And you could get a bacterial infection (even rarer) since these aren’t exactly the cleanest critters around.

 


As long as you’re around others with pinworms (remember they may not even know it), the worms may be impossible to eliminate. Sooner or later, you’ll be away from those people, and the pinworms will live out their cycle and die. Meantime, fortunately, the complications (other than itching at night) are rare.

One more thing: There are many other causes of rectal itching. If itching persists despite treatment, check with your doctor to rule out the multiple other causes. It may even be you’re getting irritated from whatever topical medicine you’re using to treat them.

Hope this answers some of your questions about how to treat pinworms. Can anyone add any advice? If so, please comment.

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  • Sarah

    My daughter has pinworms in her vagina, and it hurts her at night. I removed one pinworm but I’m afraid there may be more. We took Mezendole? yesterday, I hope it will work soon. But I know the medicine won’t work in vagina, how can I help my daugther when it hurts?
    Also, we shower every morning, cleaned everything, change bedding everyday, wash hands before eating and after toilet, nails cut too.

    • ensampappa

      Its useless with mebendazole for vaginal pinworms, unless you use mebendazol straight into the affected area, however consult your doctor first. Albendazol has generall effect in the body, mebendazol has local effect (more or less). Mebendazol manytimes has zero effect, and so can also albendazol have. In most cases its transformed and broken down very fast in upper gastric tract.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      I cover pinworms in the vagina in question 4. If you can’t look and be sure there are no dying or dead worms in there, and get them out. Perhaps you could get a healthcare provider to look.

  • Frustrated and desperate

    I am having a REALLY hard time getting rid of pinworms. I am in the US and have taken several doses each of over the counter meds (pyrantel pamoate), and the prescrption meds albendazole and ivermectin. Each time, after about 4-5 days, the adults return.

    I saw a doctor who wanted to prescribe mebendazole, but apparently it has not
    been available in the US since 2011 :( :(

    I have been doing everything recommended and even had my apartment and carpets
    professionally cleaned. Can anyone out there tell me how they finally kicked pinworms???? The doctors seem clueless! Getting pretty desperate here…

  • curious

    Do pin worms lay eggs that look like brown seeds

    • ensampappa

      no.

  • curious

    Are pinworm eggs brown, they look like brown seeds???

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Pinworm eggs are too small to be seen by the naked eye.

  • J

    What type of doctor should you go see about being tested for Pinworm? I have had intense anal itching for the past week now, and through some online research feel that it is pinworm. I have taken the Reese’s OTC medicine, but not sure how long I should wait after taking it before trying to see a doctor, and if so can I got a doc in the box, or does it need to be a primary care doctor or even a GI doctor?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Definitely primary care. I’d suggest a family physician or if younger, either that or a pediatrician.

  • Scared To Tell

    Hi, I am really kinda freaked out right now. My rear is itching and I am really scared to tell mom and doctor. I have decided that I am not going to tell just treat it on my own. I need help for a cure. We don’t have any of that paste stuff, we only have cortisone….

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Well, if you read the post, you know I hear this all the time. Sooner or later you have to tell. One reason is that, if it’s pinworms, everybody in the family needs to be treated. And what do you think they’re going to be more mad about? You possibly having pinworms and it not being your fault in any way? Or you not telling and they get them.

      • Scared To Tell

        Dr.Hubbard… Thanks. I am really focusing on telling my mom to get me this medicine. And no, I am not working one bit about them getting mad at me( I don’t really have emotions as everyone says.) I just am kind of a secretive girl and kinda sneaky:-P would hydrocortisone work for itching at night??? Because we just bought some of that stuff. I haven’t tod yet but planning on doing it soon. Dr. Hubbard, you have really motivated me and I just wanted to thank you so much, it means a lot to me. And I am ten yes old and kinda the girl who stands off until someone else admits they have the same problem and then I admit it. Well, thanks again Dr. Hubbard. :-)

        • Scared To Tell

          Sorry, meant worried not worked. Going to bed now, goodnight!!!

          • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

            You’re welcome. And nothing much is going to help the itching until the pinworms have been treated.

  • concernedmomma

    My daughter has them.. I have been doing the laundering of sheets, her jammies, undies (daily basis), making her shower and wash that anal area in the morning, vacuuming, washing hands regularly. The Doc prescribed the albenza pill..( I may have spelt that wrong) and I am just wondering how long it take for the worms to die from the first treatment? We noticed a bunch of dead worms the last few days coming out in stools but tonight (4-days after first treatment) she was complaining about itching again. She said she found two worms still alive..and I checked her anal area… I noticed one coming in and out..wiggling.. I got it on the scotch tape and it seemed to die instantly. I have to say this whole experience is a bit eery for me.. and I have been really cleaning my house like a maniac..but I am wondering how long till they are dead? I mean I know there will have to be a second dose.. but I thought they would have all died from the first one by now.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      In general, the eggs can survive so it’s common to take a second dose a couple of weeks after the first. If I were you, I’d call your doctor and ask about that.

  • Luxury

    If you don’t treat pin worms will they eventually go away on its own ?

    • ensampappa

      Extremely rare cases.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Sometimes they will after a few months. I don’t know the percentage that go away. Of course you should be careful not to spread them during that time and people you’ve given them to could give them back to you in an endless cycle.

  • ppa1998

    How often can the PinX treatment be repeated? I have completed it every two weeks X 2 and got immediate relief for about 5 days…. Then ….. They’re back! Can I continue to repeat the Pin X cycle every two weeks until they are gone?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      You can repeat it but, If they’re coming back, you’ll have to find out how your getting them or, at least, cover all the bases. Otherwise, they’ll just keep coming back. All family members, whether they think they have them or not, should be treated at the same time. Be sure to read question #2. Also, read step 2 of this post http://www.thesurvivaldoctor.com/2012/04/17/getting-rid-of-pinworms/

  • lucy

    Help!!! I have pinworms in my nose and ears?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      I’ve never heard of pinworms in the ears. You should see a doctor.