Pinworms: Night-Time Itching, the Tape Test, and Treating the Whole Household
Pinworms are common in kids and cause itching around the bottom, especially at night. Here's how to confirm them, treat everyone at home, and keep them from coming back.
Pinworms are tiny white worms, about a quarter to half an inch long, that live in the intestines and come out at night to lay eggs around the anus, causing itching. They're the most common worm infection in the U.S., especially in school-age children and their families, and they're not a sign of being unclean. They're easy to treat with an over-the-counter or prescription medicine, usually two doses two weeks apart, and everyone in the household is usually treated at the same time.
Signs of pinworms
- Itching around the anus, worse at night
- Restless sleep, waking up, or irritability from itching
- In girls, itching or irritation around the vagina
- Tiny white thread-like worms seen around the anus at night, on underwear, or in the toilet
- Many people have no symptoms
How they spread
Pinworm eggs get on fingers from scratching, then onto toys, bedding, towels, food and surfaces, and are swallowed. Eggs can survive for two to three weeks on surfaces. Pets don't spread pinworms.
The tape test
To confirm pinworms, press the sticky side of a piece of clear tape against the skin around the anus first thing in the morning, before bathing or using the toilet. Fold it sticky side together, put it in a sealed bag, and bring it to a visit, where it can be checked for eggs. Doing it three mornings in a row makes it more accurate. You can also look with a flashlight a couple of hours after your child falls asleep.
Treatment
- Over-the-counter pyrantel pamoate, following the label, or a prescription medicine
- A second dose two weeks later, because the medicine kills worms, not eggs
- Treat everyone in the household at the same time, even without symptoms
- Pregnant people and children under 2 should check with a clinician before taking medicine
Stopping them coming back
- Wash hands with soap and water often, especially after the toilet and before eating
- Keep fingernails short and discourage nail-biting and scratching
- Shower or bathe each morning to wash off eggs laid overnight
- Change underwear and pajamas every day
- Wash bedding, towels and pajamas in hot water after the first dose
- Vacuum and clean bathroom surfaces
When to get seen
Come in, or start with a telehealth visit, if you think your child or you have pinworms, if treatment didn't work, if itching has led to broken, sore skin, or for a child under 2 or anyone pregnant. At an AfterOurs clinic, a standard self-pay visit is $175, and a self-pay in-clinic visit never costs more than $330. Telehealth is $75. We contract with all major commercial and government plans, including Colorado Medicaid and Medicare. See the cost and insurance page. Our post on taking your child to urgent care has more for parents.
Get seen the same day if skin around the anus is red, swollen, hot or draining, which can mean an infection from scratching. Go to the ER if a child has severe belly pain, vomiting, a swollen belly or blood in the stool.
Where to find us
Four clinics across metro Denver, all ages welcome, se habla español:
- Hampden (Southeast Denver): 8 AM–11 PM daily
- Littleton: 8 AM–11 PM daily
- Thornton: 8 AM–11 PM daily
- Highlands: Mon–Fri 5–11 PM, Sat–Sun 8 AM–11 PM
Walk in, or book online.
Medically reviewed by Peter Martinuzzi, MD
This article is general health information, not medical advice for your situation. If you are worried, come in or book a telehealth visit — and if it is an emergency, call 911.