Threadworms in children: causes, symptoms and treatment

While the thought of threadworms (also called pinworms) isn't pleasant, there's no need to panic! What's important is recognising the symptoms and starting treatment as soon as they affect your child. Here's everything you need to know...

Ugh, threadworms. Your stomach may turn at the thought of these tiny little white worms, which can appear in your child's poo or around their bottom¹.

But, given that up to 40% of kids catch them at some point², threadworms are just one of those common childhood ailments that's worth being clued up on ... especially if you don't want them reappearing anytime soon.

So, to find out everything about them – from key symptoms to knowing how to get rid of them (for good) – we dug into the research from the NHS and other experts, including Netmums’ official GP, Dr Kenny Livingstone.

Here's what expert advice says every parent should know about threadworms ...

What are the symptoms of threadworms in children?

An itchy bum is the most common symptom of threadworms (also called pinworms)¹, so if you notice your child scratching their bottom more than normal, it’s highly possible that threadworms are the cause.

Girls can get itchy around their vagina, too¹.

‘The itching tends to be more intense at night, as that’s when the worms come out of their bottom and lay their eggs around the anus. They also leave mucus behind, which contributes to the itching,’ explains Dr Kenny.

‘This itching can make it difficult for a child to get to sleep, be enough to disturb or even wake them in the night. So a tired, irritable child can also be a symptom.’

According to the NHS¹, severe cases of threadworms can include these other symptoms, too:

• weight loss
• skin irritation around the anus
• bedwetting (in kids who are normally dry at night)

Threadworms are unlikely to do your child any harm³, but they're contagious and can be very irritating, so it's always best to treat them¹.

How can I check if my child has threadworms?

If you think your child has threadworms, we’re sorry but the only way to tell for sure is to look for them³.

‘It’s not the most pleasant of tasks, but you may spot them if you look at your child’s poo. Otherwise, you’ll need to check their bottom – ideally late in the evening when the worms are most visible, or even once they're asleep,’ says Dr Kenny.

Threadworms look like tiny pieces of white thread, usually between 2mm and 13mm long². The eggs aren't visible to the naked eye².

Gross alert, here’s what you’re looking for:

What threadworms actually look like

If you're not sure whether your child has threadworms, your GP may ask you do to the 'tape test'². This involves pressing some clear sticky tape on the skin near your child's anus, first thing in the morning. The tape can then be sent to a lab to check for threadworm eggs².

What causes threadworms in children?

Threadworms spread when their eggs are swallowed².

‘An infected child will scratch their bottom and the tiny threadworm eggs stick to their fingers or under the nails. These are then passed on to anything they touch or swallowed if they put their fingers in their mouth,’ explains Dr Kenny.

‘That’s why teaching your child about good hand-washing is so important.’

Once your child has swallowed or even inhaled threadworm eggs, they pass into the intestine, where they hatch³.

After about a month or two, the threadworms will be fully grown and begin laying their own eggs around your child’s bottom². They can live for a further six weeks².

Why do threadworms keep coming back?

An infected child can transfer eggs onto anything they touch¹, including:

• bedding
• towels and flannels
• toys
• toothbrushes
• kitchen utensils
• pets
• furniture
• food
• kitchen and bathroom surfaces

‘Anyone who then touches something that has been contaminated with eggs and puts their hands in their mouth, can easily become infected, too,’ says Dr Kenny.

The eggs can survive outside the body for up to two weeks¹. If anyone gets the eggs in their mouths, the cycle starts again³.

How do I get rid of threadworms?

A bit like with nits and headlice, an outbreak of threadworms is something some families may find embarassing.

‘But there’s no need to feel embarrassed; threadworms are very common in young children,’ says Dr Kenny.

‘The important thing is to get treatment as soon as you spot the signs of threadworms in your child. This will stop them from suffering from any symptoms, and also prevent them from passing it on to others.’

The good news is that you don’t need to see your GP about threadworms unless someone in your home is:

• pregnant or breastfeeding¹
• under two years old¹

This is because you need to treat everyone in your home for threadworms at the same time, and standard threadworms medication may not be suitable for these groups¹.

Otherwise, if you need to treat threadworms, the best thing to do is ask your pharmacist for the recommended and age-appropriate treatment¹.

Strict hygiene is also a must, so all the family should be washing their hands frequently.¹

What's the best treatment for threadworms?

If someone has threadworms in your household, it's important to treat everyone, even if they're not showing any symptoms yet.⁴.

According to NICE, the most common medication used to treat threadworm infections is mebendazole² – usually sold under the brands Ovex or Vermox⁵.

‘Mebendazole is available as a single dose, without a prescription from your pharmacist if the patient is 2 years or over,’ says Dr Kenny. ‘A second dose after two weeks will prevent re-infection from adult worms that hatch from any eggs that remained after the first treatment.’

Mebendazole comes as a liquid or chewable tablet. For children under 2 years of age, they will need a prescription via their GP⁵.

Any threadworms in the intestine should die within a few days of treatment with mebendazole. However, it doesn’t kill the threadworm eggs⁵.

So, as well as taking medication, it’s really important to deworm your whole house to stop everyone from becoming infected again a few weeks later¹.

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Threadworms treatment: how do I deworm my house?

Patient UK recommends following this strict hygiene method³:

First, do a one-off deep clean of your home to remove any eggs:

1. Wash all sleepwear, bed linen, towels, and cuddly toys – this can be done at normal temperatures but make sure that the washing is well rinsed.
2. Thoroughly vacuum and damp-dust the whole house, paying particular attention to the bedrooms (vacuum mattresses) and areas where your kids play. Throw away any cloths or dusters you've used when you're done.
3. Thoroughly damp-dust the bathroom, washing the cloth frequently in hot water and throwing the cloth away when you're done.

Once the house is clean, everyone in the house should follow these steps for the next two weeks, to prevent eggs spreading again:

1. Wear close-fitting underwear at night and change underwear every morning.
2. Consider putting cotton gloves or socks on your child's hands at night, to stop them scratching in their sleep.
3. Bath or shower first thing every morning, and clean around anus and vagina to remove any eggs.
4. Change and wash night clothes every day.

Plus these general hygiene precautions, which are always a good idea:

• Wash hands frequently, and scrub under your fingernails, particularly before eating, after visiting the toilet, and before and after changing a nappy.
• Discourage nail biting and finger sucking – in particular, make sure that children do not suck their thumb.
• Ensure that everyone in your household has their own face flannel and towel. Avoid sharing towels.
• Keep toothbrushes in a closed cupboard and rinse them thoroughly before use.

The NHS adds that it's a good idea to keep everyone's fingernails trimmed short, so eggs don't get stuck under them¹.

And avoid shaking any material that may have eggs on it, such as clothing, or bed sheets, as this may transfer the eggs to other surfaces¹.

If you've followed all these steps and your child still keeps getting threadworms, it's possible that they're picking them up somewhere else, such as school or childcare³.

If you're worried, you could speak to the school about their hygiene policy, or ask your GP for further advice.

How can I get rid of threadworms naturally?

‘There’s no evidence to support that home remedies get rid of threadworms,’ says Dr Kenny.

‘The most effective way to treat them is with medication, alongside deworming your house and teaching children about good hand hygiene, so they don’t become infected at school or playgroup either.’

Can my child still go to school or childcare if they have threadworms?

Usually, yes. Although it will be easy for your child to pass them on, threadworms is such a common and harmless condition that it's usually recommended that kids who have it attend school or nursery as usual¹.

It's still a good idea to contact the school or childcare provider and let them know your child has threadworms, though. They can confirm that it's fine for your child to come in, and set up extra precautions - such as helping your child with hand-washing - to reduce the chance of passing the threadworms on.

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Sources

• ¹ NHS. 2021 Threadworms. [^]
• ² National Institute for Health and Care Excellence (NICE). 2018. Threadworm: Clinical Knowledge Summary. [^]
• ³ Patient. 2020. Threadworms. [^]
• ⁴ HSE (Ireland). 2020. Threadworms. [^]
• ⁵ NHS. 2019. Mebendazole. [^]