Pinworm Infection Guide: Symptoms, Testing, Causes, and Treatments

Pinworm is a common parasitic infection in North America that affects millions of people (especially children) and can cause discomfort and potential complications if left untreated.

This guide covers the symptoms, causes, and treatments for pinworm infection.

We also explain the pinworm tape test and the upgraded adhesive paddle pinworm test, which doesn’t require you to own a microscope!

Key Takeaways

  • The classic pinworm symptom is nighttime anal and/or vaginal itching.
  • Diagnosis is made by observing pinworm eggs under a microscope (Tape Test), which involves placing adhesive on the anal area and inspecting it under a microscope for pinworms or eggs.
  • Treatment may be as simple as 2 rounds of over-the-counter medication, with simultaneous cleaning of places likely to harbor pinworm eggs.

Pinworm Infection: An Overview

A woman scratching their anal area due to pinworm infection

Pinworm infection is a widespread intestinal worm infection caused by tiny, white, threadlike worms called pinworms — also known as intestinal nematodes.

The infection is most common among school-age children, followed by preschoolers, and is often observed in settings like schools and daycare centers.

My battle with pinworms

When I was 23 years old and living in Taiwan, I had a parasite infection. I’m 90% sure that it was a pinworm infection, as it was a pretty small worm.

To treat it, I went to a local doctor and took the single pill they gave me, which fixed it!

And even though I wasn’t around young children at that time, I still caught it…just as I’ve seen other adults come back positive for pinworm on our testing.

Pinworm is contagious enough that almost anyone can catch it.

Pinworm infection occurs when someone accidentally ingests pinworm eggs, leading to potential complications if left untreated.

Although pinworm infection symptoms can be mild or even asymptomatic, it’s important to address the issue promptly, as pinworms are extremely contagious.

Pinworm infection diagnosis is made by identifying the female worm or eggs, which can be found in the anal or vaginal area. Variations of the “tape test” are the method for detecting pinworm infections and will be discussed further in this article.

Understanding the lifecycle and behavior of these pesky parasites is key to eliminating pinworm eggs and effectively treating the infection.

What are pinworms?

An image of Enterobius vermicularis, the human pinworm.

Pinworms are about half-inch long, white, parasitic adult worms that inhabit the large intestine of humans.

They lay their eggs around the outside of the anus (perianal area), which causes severe itching and discomfort.

And, although pinworm infection is most prevalent in children, it can affect individuals of all ages.

Why do pinworms itch?

At night, the female pinworm exits the intestinal tract and deposits her eggs on the skin surrounding the anus, causing itching due to the irritating adhesive material in which the eggs are deposited.

The wriggling of the female pinworm may also cause itchiness.

When the perianal area is itched, it causes pinworm eggs to spread onto:

  • fingers
  • bedding
  • toilet seats
  • places where you spend time naked
  • other objects and places that are touched first thing in the morning

The eggs (ova) laid by female pinworms can survive for two to three weeks on surfaces where the female adult worms deposit them. The long survival of these eggs means that cleaning protocols during treatment can help prevent reinfection.

Symptoms of pinworm infection

Symptoms of pinworm infection can include:

  • Asymptomatic (no symptoms)
  • Severe anal itching, particularly during the nighttime when the worms migrate to the host’s area around the anus to lay their eggs
  • Vaginal itching (in some cases)
  • Restlessness
  • Irritability
  • Difficulty sleeping due to the discomfort caused by the infection
  • Teeth grinding

A healthcare professional can help determine whether the symptoms are indicative of pinworm infection and prescribe the appropriate treatment.

Our at-home pinworm testing kit may also help, and can often cost less than a trip to the doctor.

Causes of Infection and Transmission

Pinworms are transmitted by ingestion or inhalation of eggs, which may occur after scratching the anal area or coming into contact with contaminated surfaces where pinworm eggs remain.

Pinworm eggs can be transferred to other surfaces via contamination of fingers, toys, bedding, toilet seats, food, liquids, clothes, or other individuals, as the eggs stick to fingers and various surfaces.

Also, note that you can re-infect yourself with pinworms. So, even if you live alone, it’s important to get treated and to follow hygiene protocols.

Since pinworm eggs can survive on surfaces for two to three weeks, executing proper hygiene protocols can help prevent re-infection.

How To Test For Pinworms

An image showing the adhesive paddle for detecting pinworms.

The gold standard for pinworm diagnosis is the adhesive paddle test, aka the pinworm tape test.

How the tape test works

The tape test is a simple and effective method for detecting pinworm infection.

Here’s how it works:

  1. Placing a piece of clear tape (or adhesive paddle) on the anal area
  2. The adhesive side of the tape collects skin cells from the anal region
  3. Scrutinizing the tape under a microscope to search for pinworm eggs or worms.

We’ve created an upgraded version of the tape test, using an adhesive paddle where you can just mail your samples to our parasitologists, and they will analyze them. Learn more here

The tape test is a non-invasive and effective method to detect pinworm infection, with the only potential adverse effect being mild discomfort in the vicinity of the anus.

Identifying the presence of pinworms or their eggs allows individuals to take appropriate action to treat the infection and prevent its spread.

If your physician is trained on pinworm identification then they can perform this test. Otherwise, you can have our staff parasitologist send you the materials to take the test at home, and then you mail the adhesive sample back to us.

We’ll contact you with test results within 7-10 days.

Early detection of pinworm infection and taking appropriate action can help individuals avoid potential complications and discomfort associated with untreated pinworm infections.

Let’s delve deeper into how the tape test works, how to prepare for it, and how to interpret the results.

Preparing for the tape test

There is some debate on how to best prepare for the pinworm test. We believe that the test results will be more accurate when someone has been off antiparasitic medications or herbs for at least 2 weeks.

Tape Test Timing

To get the most accurate test results, we believe the most important thing is to do the tape test when the patient has nighttime itching around the anus or vagina. This timing will be most likely to get a positive because pinworms laying eggs will cause itchiness.

Interpreting the results

Abnormal results from the tape test, such as the presence of pinworm eggs or worms on the adhesive side of the tape, indicate a pinworm infection and likely require treatment for all household members. It is imperative to consult a healthcare professional for a definitive diagnosis and suitable treatment.

OTC Treatment Options for Pinworm Infection

A person taking medication to treat pinworm infection

Pyrantel pamoate is an over-the-counter anti-parasitic medication often used to treat pinworm infection. This medication works by killing the pinworms, allowing the infected person to recover from the infection. Albendazole and mebendazole may also be used to fight pinworms, but they require a prescription, and are typically more expensive than OTC medications, with stronger side effects.

Adverse effects of pyrantel pamoate may include gastrointestinal distress, but the medication is generally safe and effective when used as directed. Consulting a healthcare provider before using any medications is crucial to ensure proper treatment and dosage, especially for those who are pregnant, are nursing, or are young children.

While I am personally a big fan of using herbs to help cleanse parasites, I think the OTC pinworm medications are quite good, and have minimal side effects. I go over an example protocol below.

When to consult a healthcare provider

It’s advisable to consult a healthcare provider for severe anal itching or before using medications to treat pinworm infection, particularly for pregnant women, breastfeeding women or children under 2 years old. Seeking medical advice can help ensure an accurate diagnosis and appropriate treatment plan, minimizing the risk of complications and reinfection.

Treating family members

Treating all household members is recommended to prevent reinfection and further spread of pinworms. Family members and caregivers of an infected child should be treated with an oral anti-parasitic medication to minimize the chance of re-infection.

Treating everyone in the household significantly reduces the risk of pinworm infection recurrence. We have an example treatment protocol below.

Preventing Pinworm Infection and Reinfection

A person washing their hands to prevent pinworm infection and reinfection

Pinworm Prevention Hygiene Practices

Practicing proper handwashing is one of the most effective ways to prevent the spread of pinworm infection. It is recommended to wash your hands with soap and warm water for a minimum of 20 seconds, ensuring that all areas, including between the fingers and under the nails, are thoroughly scrubbed.

Along with handwashing, avoiding scratching the anal area and maintaining short fingernails can help reduce the risk of spreading pinworm eggs. By observing these hygiene practices, individuals can minimize the chance of pinworm infection and reinfection.

Cleaning and disinfecting

Regular cleaning and disinfecting of surfaces, bedding, and clothing can help eliminate pinworm eggs and reduce the risk of infection. Washing sheets, bed linen, pajamas, and sleepwear in hot water can effectively kill pinworm eggs and help prevent reinfection.

Alongside cleaning personal items, sanitizing surfaces and objects potentially contaminated with pinworm eggs, such as:

  • doorknobs

  • toilet seats

  • furniture

  • countertops

  • cell phones

  • remote controls

is vital. Implementing a thorough cleaning and disinfecting routine can significantly reduce the risk of pinworm infection and reinfection.

Example Pinworm Treatment + Hygiene Protocol

Always check with your doctor before taking any medications or supplements. This is especially true for children under 2 years old, and for pregnant women.

  1. Get entire household on board about pinworm treatment. Explain the why, and explain the plan, and answer any questions. Agree on a day to start the protocol, explaining that you will repeat the treatment and cleaning again 2 weeks later.

  2. Purchase enough Reese’s Pinworm medication for the entire household.

  3. On the same day, the entire household:

    • Takes the correct amount of Reese’s Pinworm Medication (may not be safe for infants, pregnant or nursing women)

    • Washes all bedding with the hottest water possible, and detergent

    • Clean all areas where people spend time naked are cleaned (eg. sitting naked on a couch)

    • Bathrooms are cleaned

  4. Then 2 weeks later, the Reese’s medication is retaken, and the cleaning protocol is repeated.

    • This second treatment is necessary because any pinworm eggs that were swallowed, but not hatched, are not affected by Reese’s medication. This second round of treatment can decrease the chances of pinworms reoccurring.

On top of the medication and hygiene, some alternative healthcare practitioners may advise to minimize sugar, grains, alcohol and fruit while undergoing treatment. This is thought to “starve” the pinworms, making treatment more successful. I have not found research to prove this, but I think the logic is sound.

This is how I would eradicate pinworms in my household, but please check with doctor before taking any medication, even non-prescription medications and supplements.

Summary

In conclusion, pinworm infection is a common yet treatable condition that affects millions of people, particularly children. By understanding the symptoms, causes, and treatments for pinworm infection, individuals can take proactive steps to prevent and manage this uncomfortable condition.

The tape test provides a simple and effective method for detecting pinworm infection, allowing for timely treatment and prevention of complications. Through proper hygiene practices, regular cleaning and disinfecting routines, and education and awareness, individuals can significantly reduce the risk of pinworm infection and reinfection, ensuring the well-being of themselves and their families.

Frequently Asked Questions

How can I check myself for pinworms?

To check for pinworms, examine the area around the anus with a flashlight. If none are seen, check again for 2 or 3 additional nights…ideally after an itchy night. The most reliable way to diagnose this infection is to do press an adhesive against the patient’s anal opening and inspecting it under a microscope. We offer a more reliable version of that test, with an upgraded spatula, with adhesive on it. An experienced parasitologist will examine the sample. Click here to learn more about our upgraded pinworm tape test.

What are early signs of pinworm?

Pinworm infection can cause itching around the anus, difficulty sleeping, restlessness, loss of appetite, and vaginitis (girls). In severe cases, symptoms may include nervousness, irritability, and weight loss.

What kills pinworms naturally?

Consuming bitter melons, Palasha seeds, Kalmegh, garlic, cherry tomatoes, Parijat, Brahmi, turmeric, coconut oil, wormwood, carrots, pumpkin seeds and papaya seeds may help in eliminating pinworm infestations naturally. A supplement that contains many of those ingredients is the Freedom Cleanse Restore protocol. While using any natural methods, I would also consider engaging in pinworm hygiene practices. Always check with your doctor before starting a new supplement.

Will pinworms go away without medication?

Pinworm infection can be cleared up without medication by adhering to strict hygiene measures for a period of about six weeks. But because of how contagious pinworms are, I’m not sure if this is the best protocol.

How are pinworm infections transmitted?

Pinworm infections are mainly spread through ingestion or inhalation of eggs, which can come from contaminated surfaces or after scratching the anal area.

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