Fortunately, the most common type of worm infesting children, the pinworm, is essentially harmless. The pinworm is unpleasant to look at and may cause itching and, in girls, vaginal discharge, but it is not responsible for more serious health concerns. Pinworms cause more social concern than medical problems.
Pinworms are spread easily from one child to another by the transfer of eggs. Often an infected child scratches himself, picking up an egg, and then transfers it to the sandbox or a toilet seat where another child unknowingly picks up the egg and later transfers it to his mouth. The eggs are swallowed, later hatch, and the pinworm makes its way to the anus to again deposit its eggs. Pinworms usually present with itching around your child’s behind at night. Girls may also have vaginal itching. If you take a look at the skin around the anus you may see the adult worms which are whitish gray and threadlike, measuring about 1⁄4 to 1⁄2 inch (0.63–1.27 cm) long. Your pediatrician might collect some of the worms and eggs by applying the sticky side of a strip of clear cellophane tape to the skin around the anus. The tape can be examined under a microscope to confirm the presence of the parasite.
Pinworms can be treated easily with an oral over the counter drug (generic name is Pyrantal
, but can be found under the name of Pin-X
- a chewable, or Reese’s Pinworm Medicine
, a liquid), taken in a single dose and then repeated in one to two weeks. This medication causes the mature pinworms to be expelled through bowel movements. Some pediatricians may advise treating the other family members, as well, since one of them may be a carrier without having any symptoms. This medication is not recommended for use in children under two years of age. Also, when the infection is resolved, the child’s underclothes, bedclothes, and sheets should be washed carefully to reduce the risk of reinfection.
It is very difficult to prevent pinworms, but here are some hints that might be helpful.
- Encourage your child to wash her hands after using the bathroom.
- Encourage her sitter or child care provider to wash the toys frequently, particularly if pinworms have been detected in one or more of the children.
- Encourage your child to wash her hands after playing with a house cat or dog, since these pets can carry the eggs in their fur.
Steven P. Shelov, M.D., M.S., FAAP
Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)