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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  • wesley

    I found online that it is bad to put anything as suppository in the anal area especially at night when they are releasing their eggs in the anus. It is because when they are interrupted in releasing the eggs in the anal area they will be releasing the eggs inside the body is that true? this is very worrying.

    • James Hubbard, MD, MPH

      Wesley. No, I’ve never heard of that. I’m not sure why it would be worse even if it’s true.

  • Hi

    I got rid of them without telling anybody…without going to a doctor.

  • Hannah

    Do these worms burrow in the anal area in an attempt to lay their eggs when petroleum jelly is present? I have sensitive skin and it is causing massive discomfort in that area.

    • James Hubbard, MD, MPH

      They live in the intestine and travel to the anal area to lay eggs. They’re not known to burrow under the skin

  • Rema

    Hello, My 20 month old and my 5 yr old have pin worms. My son was treated with medicine. I saw pinworm on my daughters stool. But since she is a baby, the doctor suggested Stool test. But it came out negative for parasites ( Which is surprising since I saw wiggling worms on my daughters stool 3 times about 15 days before the test). Can the worms go away on its own (Since the test was done about 15 days after I saw the worms). Since the test is negative, doctor will not prescribe any medicine for her. Is there any home remedies I can do for my baby just to be sure?

    • James Hubbard, MD, MPH

      The usual test for pinworms is the tape test where some clear tape is applied next to the rectum and the tape is placed under the microscope to look for eggs. If you have a doctor you trust, he/she will usually know what’s best for your baby (individual treatment). Or you could get a second opinion. In general pinworms are more of a nuisance than a danger. Reasons to treat would to stop the itching (which could cause sleep problems) or because any contacts with the baby (including you and your son) will not be able to stay rid of them until everyone is treated. Here is a post on remedies. The comments are also very helpful.

  • 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.

    • 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


  • curious

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

    • 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?

    • 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….

    • 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!!!

          • James Hubbard, MD, MPH

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

          • Scared To Tell

            Dr. Hubbard, I still hqve pinworms but yesterday I got a pregnancy test and it came back positive. I am extremely worried because I am only 17. They discovered i am nine months pregnant and rushing to the delivering room because I’m about to give birth. Do you think pinworms would come out on the baby? I know it’s kind of a discusting question but I am about to be a mother so I need to know fast

          • James Hubbard, MD, MPH

            It’s possible but just tell the obstetrician and pediatrician and the risk of harm should be very very low.

          • Crystal (Scared To Tell)

            Hey Dr.Hubbard! They baby is doing great now! I named her Ella Claire. There were no pinworms on baby. The obstetrician and pedestrian said to tell you they said thank you! The birth was a bit of a struggle but we got through it! She was 7 pounds 11 ounces. One more thing…. During the birth the doctors thing she had a mini stroke, because she is paralyzed in the legs. But other than that she is doing fine! We go to the doctor tomorrow to get her first “big girl check up” :-P Its sad that she is paralyzed but I am so thankful for a healthy baby, right now she is brest feeding and doing very well. I was so conserend about her being paralyzed and all, so I put a baby breathing sock on to monatior her breathing and a baby monatior in her crib(which is right beside my bed) and on right next to my ear! Well, I’ll keep you updated on the baby! Thank you so much,
            Crystal Hills. A.k.a.-Scared To Tell

          • Crystal (Scared To Tell)

            OMG! Meant pediatrician not pedestrian! Dumb auto correct!

          • James Hubbard, MD, MPH

            Thank you for the update. I certainly wish you and Ella the best.

          • Scared To Tell

            Ok, thanks so much!!! Really appercitate it Dr. Hubbard! I will continue to follow your amazing advice! Thanks, Scared To Tell