Pinworms: treatment by video in Puerto Rico

Pinworms (Enterobius vermicularis) are small worms that live in the intestine. Each is about the size of a staple. They are the most common worm infection in the United States, and they mostly affect preschool and school-age children, the people they live with and their caregivers.

At night, the female comes out and lays eggs around the anus. Scratching moves the eggs to the fingers, and from there to bedding, clothes, toys and food. Within 2 to 3 hours they can infect someone, and they are swallowed without anyone noticing. That is why the whole household often gets them. In adults, itching around the anus can also come from hemorrhoids.

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Pinworms are handled in a US$79 doctor visit, the same price for every age, with no membership. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. We do not bill insurance; the lab and the pharmacy charge separately. See all prices.

Many people have no symptoms. When they do, they include:

• Itching around the anus, worse at night
• Itching in the vaginal area in girls
• Poor sleep, or waking up from the itching
• Sometimes, belly pain
• Thin white worms around the anus at night or early in the morning

The tape test: as soon as your child wakes up, before bathing, using the toilet or getting dressed, press a piece of clear tape on the skin around the anus and peel it off. That picks up the eggs. Put it in the container or sealed bag the lab gives you, and repeat on 3 mornings in a row.

Treatment: two doses of an anti-worm medicine, the second 2 weeks after the first, because the medicine kills the worms but not the eggs. One is sold over the counter and others need a prescription. Usually everyone in the household is treated at the same time.

Special cases: treatment changes in pregnancy, so tell the doctor if you are or could be pregnant. For children under 2, the doctor weighs the risks and benefits with you. Pinworms do not usually cause weight loss or blood in the stool: if your child has either, they need an in-person evaluation and we refer you.

Washing hands with soap and warm water helps most.

• Wash hands after using the toilet, after changing diapers and before eating.
• Keep nails short, and discourage nail-biting and scratching.
• Bathe in the morning to remove eggs laid overnight.
• Change underwear every day, and wash pajamas and sheets often.

Pinworms are almost never an emergency. For your safety, go to the emergency room or call 911 if any of these signs appear. If your child has belly pain, read stomach pain. See when to go to the ER.

• Severe pain in the lower right belly
• A hard belly that is tender to the touch, especially with fever or vomiting
• A child who is very listless or hard to wake