How to Get Rid of Pinworms and Itchy Anus
What Are Pinworms (aka Butt Worms)?
If you've found thin, white worms in your stool or have extreme anal itching at night, you might have pinworms. Pinworms are human parasites that live in the intestine. They are small, white, and round, measuring between one-tenth of an inch to half an inch and live between two and eight weeks.
- Itching around the anus sometimes accompanied by a feeling of something wriggling on the skin. Itching occurs mostly at night
- Insomnia and restlessness due to itching
- Presence of pinworms on the anus or in the stool
- Vaginal discharge (rare)
- In children—loss of appetite, weight loss, irritability, inability to control urination
Pinworm infections are extremely common. In fact, according to HealthLine, they're one of the most common types of human intestinal worm infection.1 It occurs when tiny worms infest the intestines and lay eggs around your anus.1
For women, pinworms can occasionally (but rarely) migrate from the anus to the vagina. Pinworm infection is common, striking people across all economic levels. It is estimated that at any given time some 10% of the U.S. population is infected with pinworms, and an even higher percent in other countries.
The worms are extremely contagious and normally, the people most susceptible to getting pinworms are children between five and ten years old, people who live in institutions, or those who interact with these groups on a regular basis.1
Getting an infection does not necessarily you're bad or gross. You probably just got unlucky.
How Do You Get Pinworms?
A person becomes infected with pinworms by ingesting pinworm eggs.1 This can happen after contact with a contaminated person, food, or surface area. The pinworm egg is translucent and so small that it is invisible to the human eye except when many are clumped together.
Once swallowed or inhaled, pinworm eggs hatch in the small intestine and travel to the large intestine where they mate. The male dies after mating and is passed through the bowels. The female becomes filled with eggs (between 11,000 and 16,000) and makes her way to the opening of the anus in order to get the oxygen she needs to complete reproduction. Her presence at the anal opening causes a severe itching experience for the infected person. After depositing her eggs at the anal opening, the female dies.
Once on the infected person’s hands, the contamination can spread to toilet seats, bathroom fixtures, toys, clothing, and other people. Through contact with contaminated hands, surfaces, or food, the pinworm eggs enter a new human host and begins a new lifecycle. For this reason, thorough washing of hands, clothing, and surfaces are all important in treatment.
A pinworm infection can last indefinitely unless it is interrupted with drugs and strict hygiene. With proper treatment, however, some infections are cured in four weeks. Others may require up to a year to disappear.
According to HealthLine, the best way to check for pinworms is through something called the tape test,1 which is very simple. Simply take a piece of tape and stick it with the sticky side down on your anus or your child's anus first thing in the morning before bathing or using the restroom. If there are eggs present, some of them should stick to the tape, and you'll be able to take the tape in to the doctor for them to confirm a pinworm infection by looking at it through a microscope.
You can also check the toilet paper after wiping the anus to see if any adult pinworms are present, or examine your stool to check for the presence of pinworms.
How to Get Rid of Them
Getting rid of a pinworm infection, also called enterobiasis, can be daunting. There are many treatment approaches and this article summarizes the different options, which range from medication to strict personal and household hygiene practices.
Usually you can get rid of the infection using a combination of either over-the-counter or prescription medicine and rigorous personal hygiene. You don't necessarily need to see a doctor for this condition since it's possible to diagnose yourself and treat with over-the-counter medications.2
Since the worms are highly contagious, everyone in your household will need to be treated in order to prevent re-infections. If you have pets, there's no need to treat them since pinworms only seek human hosts.
Do You Need to See a Doctor?
Since pinworm medication can be purchased without a prescription, you do not technically need to see a doctor in order to treat an infection. However, it is possible that your anal itching is caused by something else besides pinworms.
If you find that the itch does not improve with treatment for a pinworm infection within a few weeks, you may want to see a doctor to determine what the problem could be.
Are There Natural Treatments?
Though not scientifically proven to treat pinworm infection, there are some natural treatments that are anecdotally said to help. Some of these are described below.
In general, practicing good hygiene can both help prevent a pinworm infection as well as keep the infection from recurring.
How to Get Rid of the Itch
Though pinworms are not a very dangerous infection, the itching that they cause can be extremely uncomfortable. You can soothe the itching by washing the area around the anus with warm water.3
If it's very severe, you can use a 1% hydrocortisone cream on the area twice a day for one or two days. Other antihistamines or analgesics (numbing creams) may also be effective and provide some relief.
Picture of Pinworm in Bowel Movement
Treating a Pinworm Infection Through Medication and Hygiene
The key to treating pinworms is to interrupt the worm's lifecycle. Pinworms are a hearty breed and difficult to kill. Over-the-counter and prescription drugs, combined with strict hygiene, are the most effective ways to get rid of this parasite.1
It’s important to treat the entire household at the same time, even those persons who aren’t infected. If you're pregnant or breast feeding, talk to your doctor before taking over-the-counter medication.
- Medication for the entire family. There are over-the-counter and prescription drugs available at the pharmacy: Pin-X and Reese's are just two examples of medicine with the active ingredient pyrantel pamoate. Pinworm drugs generally require a second dose two to three weeks after the first one.
- Bathe twice daily and change your underwear daily. Take a shower in the morning (showers are best because pinworms are immediately washed off the body and down the drain) and again in the evening before bed. Pay particular attention to the anal opening, using soap and allowing water to wash soap and pinworms away. Do not let children bathe together because of the risk of cross-contamination between them. Be sure to use fresh, clean bath cloths, towels, and underclothes. Wash used cloths and towels in very hot water with a good laundry soap.
- Clip fingernails short and practice strict hand washing. Keep yours and your children's nails short and wash hands using a nail brush every time you use the bathroom. Hand contamination is a key component of the pinworm lifecycle, so hand decontamination is a major part of treatment.
- Wash hands before every meal. You never know when you’ve contacted a contaminated surface. Do not break this rule. Always wash your hands before you eat and teach your children to do the same.
- Change and wash bedsheets every day for the first month. At night, the pinworm eggs that were deposited at the anus opening may spread to pajamas and bedsheets. Changing nightclothes every night and bedsheets every day is an important step in interrupting the pinworm lifecycle and preventing re-contamination. Use hot water. Pinworms are not easy to kill but hot water is the only confirmed way to get rid of them.
- Avoid shaking possibly contaminated bedsheets or clothing. This can cause pinworm eggs to fly into the air where they could be inhaled.
- Don’t scratch! Nighttime is the worst. If your children are infected, you may want to cover their hands at night to prevent scratching in their sleep. The incessant itching can be maddening, but resist the urge to scratch. When you scratch, you’re helping the pinworm complete its lifecycle. They get under the fingernails and spread to other surfaces from there. Also, scratching can cause a rupture in the pregnant female pinworm, causing her eggs to spill out and begin their lifecycle.
- Avoid nail-biting and thumb-sucking. This is difficult to do, especially if the infected person is a child, but try to encourage better hygiene habits.
These remedies have not been scientifically proven to treat pinworm infection; however, some people have found them to be effective. If you do opt to use a natural method, be sure you maintain excellent hygiene.
- Pumpkin seeds. Eat a handful of pumpkin seeds (shells and all) with each meal and in between meals. It will keep your bowel movements regular, flushing many pinworms out.4
- Diatomaceous earth (DE). This is another natural way to help regularize bowel movements. DE is said to be lethal to microscopic parasites but harmless to humans. Be sure to buy food grade diatomaceous earth.5 You can mix it into smoothies, applesauce, yogurt, etc. since it does not dissolve.
- Shredded raw carrots. According to HealthLine, it's thought that eating one cup of shredded raw carrots twice a day helps fight pinworms by promoting gut health and bowel movements.6
- Raw garlic. It is said that raw garlic kills the eggs of pinworms and prevents the females from laying more. You can either ingest the garlic by chopping it up and putting it on bread or in pasta, or you can eat the garlic clove whole. You can also make a salve by chopping up garlic, adding it to petroleum jelly or some other kind of oil and using a cotton swab to apply it to the anus at night.6
Cleaning Your Home
Even if the infection did not begin in your house, your home will be contaminated by the time you realize someone in the family is infected. You will need to clean all of the surfaces very thoroughly with good soap and hot water — paying special attention to any surfaces that a person might touch.
Peroxide and vinegar are a very effective method of sterilization.7 Spray undiluted peroxide on the surface, then spray undiluted white vinegar on it. Immediately wipe clean. This method has been proven to kill nearly all germs and bacteria. It's more effective than either peroxide or vinegar alone. And it's even safe for kitchen countertops.
In addition to washing surfaces with soap and hot water, use the peroxide and vinegar spray (before or after soap and water) to ensure a clean, sanitized surface. It doesn't matter whether peroxide or vinegar is sprayed first. Be sure to avoid mixing the two in the same container since that will create a different kind of acid that is stronger and potentially harmful.
When you first realize there’s a pinworm infection:
- Clean the entire home top to bottom including toilets, fixtures, counter tops, door knobs, light switches, and floors.
- Clean the kitchen, bedrooms, and all of your children’s toys with soap and hot water.
Daily for the first month of infection:
- Change bed sheets every day.
- Change into clean nightclothes every night.
- Clean the children’s toys every day.
- Vacuum carpets and sofas daily.
- It’s probably a good idea to clean sink fixtures and counter tops daily as well, especially if you have small children who have not yet learned to wash their hands frequently.
After the first month, relax and return to weekly cleaning of your home and bedsheets.
Good luck getting rid of these pests!
- Giorgi, Anna. Medically Reviewed by Steve Kim, MD. "Pinworm Infection." February 19, 2016. HealthLine. Accessed April 27, 2016.
- Berchelmann, Kathleen, MD. "That anal itch: how to diagnose and permanently get rid of pinworms." April 21, 2015. ChildrensMD. Accessed April 27, 2017.
- "Pinworms." (n.d.) Children's Hospital Colorado. Accessed April 27, 2017.
- Wickman, Gary. "Home Remedies for Pinworms." (n.d.) HealthGuidance. Accessed April 27, 2017.
- "How to Eliminate Pinworms Naturally." March 23, 2013. Earth Mama's World. Accessed April 27, 2017.
- Parker Gordon, Jerisha. Medically Reviewed by Judith Marcin, MD. "Home Remedies for Pinworms: Do They Work?" July 6, 2016. HealthLine. Accessed April 27, 2017.
- Oulton, Randal. "Peroxide and Vinegar Sterilization." February 14, 2006. Revised October 9, 2012. CooksInfo.com. Accessed 04/28/2017.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.