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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  • Alison

    I have out of town guests coming to stay with us and I just discovered that my daughter has pinworms. We are all going to the Dr tomorrow to get medicine. After I disinfect the house and we start the antibiotic, is our house considered safe for our guests? I was thinking about purchasing the OTC version for them to take preventively. Any help or advise is greatly appreciated!

    • James Hubbard, MD, MPH

      I would’t say they’re completely safe. Even if you’re all treated, your daughter could get them back from the same person why gave them to her. Your best bet is to wash and clean as alluded to in the post. And talk your doctor about more details. Here’s another post

  • Con m

    Hello I have had thread worms on and off for a few years I can’t seem to get rid of them I do everything it’s says keep clean n that but I keep getting them back I have been to the doctors but nothing. Ino I have and I have it around the penis area like little white dots on the scrotum and on my actual penis. It seems when I have an erection when I rub my bellend white stuff like worms come through I want to get rid it but I don’t no how please help ?

    • James Hubbard, MD, MPH

      The little white dots certainly don’t sound like pinworms. Perhaps you could see a urologist. I do have another post

      • Con m

        Do you have any idea what the white stuff on my bellend be. I mean it looks clear the I run my thumb along it and white bits come out :S. To embarrassed to tell anyone. Thanks for the other tips will try garlic if it comes back :)

        • James Hubbard, MD, MPH

          Other than semen, no. I have no idea.

  • Dj

    Is it alright to take anti parasitic medication when you are 22 weeks pregnant ?

    • James Hubbard, MD, MPH

      It would depend on the medicine. Even then, that’s definitely a question to ask your Obstetrician’s office

  • Jorge Sanchez

    I went through the hell of pinworms., at certain point I thought I will have to live with those little mother flowers for the rest of my life. Desperation made me go on line day after day for like a month! Until with a little from here and a little from there I found the cure. The battle is hard and I made the homework for you. Follow closely these steps and I GUARANTEE you will be free of pin(beep) in less than a month! Are you ready?
    1.- Buy two bundles of the herb EPAZOTE (pronounces apasotte) at a Mexican store, separate it in six sub-bundles, boil 2 litter of water, once the water reaches the boil point add one small bundle and get the water out of the stove. You are gonna drink one glass of that tea first thing in the morning on an empty stomach with a probiotic capsule and another glass of that tea before bed at night (don’t worry it tastes like nothing) and eat natural yogurt with as little sugar as possible.
    2.- buy an small bottle of garlic gel capsules (buy the low price ones) and a tube of Vaseline., every night you are gonna take a shower before bed and once you are out of the shower and dry out, make a mix in the palm of your hand (wear gloves) with a little Vaseline and the content of one garlic gel capsule and apply it to the anus, now cover your butt with a 7″ pice of plastic wrap x the long of the tube (tape it to your gluteus with six pieces of surgical tape), this is to avoid pinworm eggs to spread all over your bed and you end ingesting them again, also the garlic is going to kill the eggs. In the morning put gloves on and remove the plastic wrap and clean your butt very very good, here comes the hard part. You need to keep yourself baselined up…if you know what I mean, to avoid stain your underwear you probably want to wear feminine absorbing towels so get yourself a pack.
    3.- buy a bottle of disinfecting wet towels and disinfect every thing you touch in the morning, door knobs, toilet flush, kitchen utensils, etc. avoid swallowing the pinworm eggs again! and/or passing them out to the other members of the family.
    4.- isolate yourself, don’t let anybody to sleep on the same room with you and forget abut sex during the critical time!
    6.- VERY IMPORTANT!!! STOP FEEDING THOSE SUCKERS! Cut as much as possible your consumption of sugar, sweat food and starches (chocolates, sugar in coffee, cookies, bred, sweet rolls, beagles, subway bred etc., get ready to lose a lot of weight. Don’t worry, you’ll gain it back. In stead eat as much green stuff as you can.
    Do all that if you really want to get rid of pinworms in a month.
    And if you have an hiatal hernia say good bye to it as a bonus price for your “sugar sacrifice”

  • Overwhelmed

    Do disinfecting wipes kill pinworm eggs?

    • James Hubbard, MD, MPH

      They should

      • Overwhelmed

        Thanks :-) And if laundered items can’t be done in hot water, is washing items still pretty effective?

        • James Hubbard, MD, MPH

          Add bleach if you can.

  • mack

    I live in ND, and it’s VERY cold outside. My dog seems to still be rubbing her butt on the carpet and I feel like I got them from her, but do pinworms die in extreme cold weather? It’s getting to be about -40 outside with wind too and I treated myself a month or so ago.. I can’t take a deep breath to save my life and I poop so much and it’s always the same type of stool with the noodle looking worms. I just cleaned my bathroom excessively and washed my sheets two days ago, taking Stromectol 4 pills at one time. Will they ever go away? What other actions do you suggest I take? I’m getting very anxious and I want these things to go away..

    • James Hubbard, MD, MPH

      Dogs have different pinworms than humans so you people don’t get pinworms from dogs. You should check with your vet about your dog and have your doctor check you over. And pinworms are the about the size of rice, not noodles. Again, you need to be checked by a doctor.

  • Meg

    Hello I’m 16, I’ve had pin worms on going for about 9 months, I’ve taken medication and my mum was a nurse and is now a cleaner so all my room and house is pretty much always clean, but I still manage to get pin worms again and again, I haven’t tried the garlic but tend to have a lot of garlic in my food anyway. I suffer with anxiety and I don’t sleep we’ll as it is but this is driving me insane. I can feel them wriggling and I can see them. My family haven’t got any symptoms but I was thinking that I might have caught them from my boy friend. But he always keeps his nails short, and he doesn’t get symptoms like me, and he sleeps like a rock. The only contact i had was his younger siblings 4, 6 & 7, but i haven’t seen them for ages and they keep coming back. and i get really low when i don’t have sugar in me. I’m gonna see if I can get some more tablets and take them every 3 days I take the ovlex ones. Any advise??

  • Gundegma

    hello, my daughter is 3 years old.Her vagina and anus area always red, lots of light green discharge. She took the pill 3 times, but still no change.I have tried all the steps to get rid of the pin worms. Now I am really worried if it is something else. Cant find any good doctor in my country. Please give me some advice, thank you.

    • mack

      She’s definitely got some sort of STD.. might want to check that out

      • James Hubbard, MD, MPH

        Mack, she does need to have it checked out definitely, and it could be an STD, but it’s certainly not definitely one.

  • Alexander

    I need a little help, I have the abdominal pain, and upset stomache+loss of appitite, the upset stomache; I took about 3 forkfulls of chicken noodle soup and now it feels like my stomache is filled i mean FILLED with gas, even I took a gasX pill and haven’t farted/burped even an hour after the pill was taken. my butthole KIND of itches and im constipated so I cant really poop and look for them in the poop :

    • James Hubbard, MD, MPH

      Alexander, I can’t diagnose individual cases. In general, nausea and bloating could be a stomach virus, food poisoning, an ulcer, appendicitis, and many more possibilities. It sounds like you need to see a doctor to check you out.

  • Shannon

    When I was a child I was a nail-biter and woke up a few times over my elementary school years with pinworms worms causing extreme vaginal itching at night. My mother was told to put a panty liner in my undies and to use a very liberal amount of Neosporin (or similar) on it so that when pressed against me it created a type of seal, thus cutting off oxygen to the worms. The insane itch was usually gone by morning which was both fast and effective. It did make me feel like I had to waddle to the bathroom in the morning (from the huge amount of Neosporin that I was “straddling”) and it was a bit messy to clean up but certainly worth the extra effort! It did, however, turn me off to ever using pads or panty liners ever again, unless absolutely necessary– a head start on information that most of my friends didn’t acquire until high school ;-)

    • James Hubbard, MD, MPH

      Thanks, Shannon.