Pinworms

Main Symptoms

• The worm is usually seen in the anal and buttock area, especially at night or early morning
• A white, very thin, threadlike worm, about 1 inch long
• It moves (If it doesn't wiggle, it's probably lint or a thread)
• Itching and irritation of the anal area and buttocks (Caused by secretions from the migrating female pinworm)
• Rarely, the worm is seen on the surface of a bowel movement

Call Your Doctor during Weekday Office Hours If

• You think your child needs to be seen
• You have other questions or concerns
• Red and tender skin around the anus
• Pinworm is seen (Reason: probably needs a prescription medicine)

Parent Care at Home If

• Anal itching without pinworm being seen
• Pinworm exposure or contact

Anal Itching Without Pinworm Being Seen: Home Care Advice

1. Pinworm Checks: Check your child for pinworms.
   • Examine the area around the anus, using a flashlight.
   • Look for a 1-inch, white, threadlike worm that moves.
   • Do this a few hours after your child goes to bed and first thing in the morning for 2 consecutive nights.
2. Scotch Tape Test: If no adult pinworm is seen, call the office for instructions on doing a Scotch-tape test for pinworm eggs.
3. Steroid Cream: For the itching, wash the irritating secretions from the pinworm off the skin around the anus. For severe itch, apply 1% hydrocortisone 4 times per day.
4. Call Your Doctor If
   • Pinworm is seen
   • Skin around the anus becomes red or tender (strep bacteria have a special affinity for this site).
   • Anal itching persists > 1 week

Pinworm Exposure or Contact: Home Care Advice

1. Low Risk: If your child has had contact with a child with pinworms but has no symptoms, (and over a month has passed), your child probably won't get them. If contact is within the last 4 weeks, your child has a small chance of getting pinworms.
2. Scotch Tape Test: If you're still concerned, call the office for instructions on doing a Scotch tape test for pinworm eggs in about 1 month. (Reason: The swallowed egg will not mature into an adult pinworm for 3 or 4 weeks.)
3. Call Your Doctor If
   • Pinworm is seen
   • Anal itching persists > 1 week

Home Guidelines to Reduce Risk of Reinfection or Spread to Others

• Infection is caused by swallowing pinworm eggs. A child can get pinworms no matter how carefully you keep the kids and the house clean. The following hygiene measures, however, can help to reduce the chances of reinfection of the child and new infections in other people. Pets don't carry pinworms.
• Have the child scrub the hands and fingernails thoroughly before each meal and after each use of the toilet. Keep the fingernails cut short, because eggs can collect here. Thumb-sucking and nail-biting should be discouraged.
• Each morning give the child a shower, with rinsing of the anal area. Do this for 3 days after taking the pinworm medicine.
• Don't eat food that has fallen on the floor.
• Vacuum or wet-mop the child's bedroom once a week, because any eggs scattered on the floor are infectious for 1 or 2 weeks.
• Machine-washing at hot temperature will kill any eggs present in clothing or bedding.
• Contagiousness: Mildly contagious within the home. Children with pinworms do not need to miss any day care or school.