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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  • Michael

    Hi Dr. I ask some questions about enterobiasis: 1 Why childrens are prone to have pinworms ( is age important )? 2 Is Pinworm’s Pathogenicity(number) important; I mean, does body(immunity, stomach acid, probiotics) prevent it by killing small number of them(eggs) 3 You have written ”inhaling eggs..” this must be rare, true? 2.question is very important please answer this detail.

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

      I think children are more prone because they tend to put fingers in mouths more, play with communal toys, not wash hands, etc. Inhaling eggs would be rare. To my knowledge, our immune system does not help prevent them.

  • Gwen

    I’m only 12 years old and I’ve had pinworms for a while my mom knows and I have taken medicne and she thinks that they have gone away but they haven’t i have constant itching down there and it is mostly around 8pm – till I am sleeping and during the night please help me give me suggestions.

  • Constantine

    I am 27 years old. 5 months ago I felt kind of wiggling moving sensation (not itching) in my rectum or anus. I thought it was pinworm and searched home remedies for this. When I saw its lifecycle morphology etc I got shocked! I was so scared because of its infectiousness. And I ate raw garlic every day, every damn day without any symptoms! Because I became paranoid! Although I didnt have pinworms I took mebendazole. I searched more in order to be relax. But no! every websites scared me. Finally I am suspicius for everyplace (kids, dust, food..). I am afraid to breathe for inhaling the eggs :(… Why did you do that? I cant live…. This knowledge ruined my life… Before that time I was so happy and I didnt have any ocd… I need positive information……. I dont want to be suspicius for my bed my clothes my home every morning… Every itching make me think it is pinworm.. Please help I am gonna mad!

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

      See a doctor, tell her/him your concerns and ask for a test. In fact, 1. you have no evidence you have them and 2. If you do, they are more of a nuisance than anything else. Sounds like you need some help with whatever is causing this exaggerated fear.

  • Constantine

    …And what about our immunity and stomach acid? Can they be obstacle for pinworm eggs? I had some episodes with this little monster when i was a child. I asked to my friends ” have you ever experienced pinworm?” and each said ”what is it? or no”… Why me? Is there any genetic factor? I mean, can some people tend to have them? OR… everybody can have them and just some feel the symtomes? what do you think? Sorry for bad English I am not from US. I see more information and stories about Enterobius Vermicularis in US. Thanks..

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

      As far as I know there is no genetic factor but some do feel the symptoms much more than others.

      • Constantine

        Thanks Dear Dr Hubbard.. I want to learn about gastric acid and immunity; can they prevent enterobiasis? For example ‘ I swallowed 2 eggs male-female, are they enough to infestation? or gastric acid can kill some of them?

  • Constantine

    Hi DR JAMES HUBBARD! Articles about Enterobius Vermicularis are contradictory: Some claims that retroinfection happens, some says that it is not true. (I saw these in parasitology books) what do you think about retroinfection(i mean not autoinfection). My question is about pinworm eggs and garlic? You said Garlic’s effectiveness is limited %7. However, Even Hippocrates and ancient China, also many countries and cultures believe that garlic is anthelmintic. Of course it cant compare with Mebendazole or Albendazole’s effectiveness But garlic is anthelmintic. Anyway, what kill pinworm eggs… I mean what temperature? I saw in a book ” pinworms are weak to 25 celcius and above” can it be true? Sunrise, alcohol, bleach,garlic directly, what kills pinworm eggs? Please inform me I will be paranoid. Because of all contradictories.

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

      Putting your washer on “hot” should kill the eggs, Or soaking and washing with hot water. I’m not sure the exact temperature but around 55 degrees celcius or above should do it. An estimate would be the water too hot to touch with your fingers.

      • Constantine

        When I was a child I experienced some pinworm infestations, but they are light (just 1 or max 2 worms). I didnt use any medicine but just handwashing etc. Pinworms were not important for me, It went away by itself without remedy.. I am 24 now and I learned many things about it. Thus, I am too afraid of it. Because internet showed it a very big problem and a monster to me…According to internet 7 billion people on earth must have pinworm in this situation. But MAXIMUM 1 billion, and most of them are children. What protect us? Please help Dear Dr Hubbard..

  • Digital_Dream

    I just saw a pinworm wriggling on my child’s finger yesterday after she scratched her itchy butt. She had told me late last year that she thought she had worms but I never saw any and she stopped complaining about the itching, so I figured her body got rid of them, which happens in many cases, but last night, I saw a critter with my own eyes and it was alive. I ran to the pharmacy this morning and bought the Reese’s Pinworm Medicine, which everyone says gives great results. The pharmacist said that if you can see the worms in poop, then this is a major infestation and that an OTC medication will not cure it but she said I have nothing to lose in trying. I don’t know how much truth there is to that, since many people who have seen the worms in poop or on their anus took the OTC meds and were cured…

    In the meantime, I don’t know what to do about the bed situation. I simply cannot go to the laundry every single day to wash sheets. I can easily go through $20 or more in one week if I do this, not to mention the time it takes to do all this, while caring for my child, cooking, doing homework, etc. is a freaking balancing act (I work full time and live alone with my child, so half my day is gone sitting at work and the rest of the time I am having to tend to her needs in between chores). The other issue is, my child sleeps in the same bed as me. We have a queen bed and we both wear clothing and underwear to bed, but I see the article mentions not to sleep in the same bed as someone who is infected. I don’t feel itching nor have I seen worms on myself or in my stools and plan to treat myself as a preventative, but I was wondering if I can get away with changing sheets maybe every 3 days and making sure we both wear pants or leggings to bed to prevent the eggs from spreading around.

    I have no issue changing towels and underwear daily and plan to do so (we already shower and change underwear daily anyway). I normally change sheets once a week but I guess this won’t be enough to prevent the eggs from spreading and/or hatching. I do have another bedroom with a bed in my condo, but my child refuses to sleep in bed alone and we have fights about it, and she will start crying and says she is afraid and cannot sleep in there, because every time she sleeps alone, she has awful nightmares. I plan to use the Vaseline on her bottom and thought that as long as she is wearing tight underwear and pants and I am too (and we change these daily), the eggs should not have contact with the linen and would get stuck on the Vaseline and underwear. I was hoping you or someone else reading my comment may have a suggestion as to how often I can get away with washing sheets without it being a constant cycle of re-infestation.

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

      The main thing to remember is your daughter got the pinworms from another person. If that person is not treated, and your daughter is still around her/him, she will get them back no matter how clean the bedding is. If she is in a group, it is possible all will need to be treated.

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  • Moochelly

    My daughter has pinworms so I started a paste combination of Vaseline and garlic, which has helped the itching tremendously. Unfortunately now, she either does not poop or if she does (every couple of days) she ends up pooping in her underwear. Do you have any idea why. I have yet to give her any other medication since my husband is worried it will mess up on her insides. Is there any truth to that? Thanks for all your help!

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

      Stress can be a cause, such as changes or, possibly, worry about the pin worms. Be sure she knows it is no big deal and be sure to act accordingly. Depending on her age, you could get her some OTC meds or talk to her doctor. She/he might call some meds in if she’s been seen lately or she might have to come in for a check up.