Treatment of pinworms is fairly simple, but relapses are common because the usual medications only kill the adult worms and have no effect on developing eggs or larvae. Retreatment in 1–2 weeks may decrease reinfection rates. Other preventative measures may also improve treatment success, including thorough handwashing and fingernail cleaning, discouraging thumbsucking, and wearing cotton underwear that has been washed in hot soapy water and is changed twice daily. Cleaning floors, bedlinens, and curtains frequently with hot soapy water and cleaning the toilet seat frequently may also decrease reinfection rates.
Medications used to treat pinworm infection include mebendazole (100 mg as a single dose), pyrantel pamoate (11 mg/kg [maximum, 1 g] as a single dose), pyrivinium pamoate (5 mg/kg [maximum, 350 mg] as a single dose), piperazine citrate (65 mg/kg for 7 days), and albendazole (400 mg as a single dose). Nausea, vomiting, and diarrhea are the most common side effects of these medications. Mebendazole has a 96% cure rate and has the fewest side effects; however, its safety during pregnancy has been questioned. Treatment is the same for adults and children, and the entire family should be treated at initial infection.
Pinworms in pregnancy
There are no reported cases in which infection with E. vermicularis caused fetal harm. One case was published that cited the presence of two adult pinworms within an embryo found on histologic examination of tissue after dilation and curettage for embryonic death. The authors believed that the cause of death was unrelated and that the pinworm infestation most likely occurred after the fetal demise.
Poor pregnancy outcome has also not been linked with pinworm infection. Because of this and the fact that the most commonly used drug, mebendazole, has been controversial for use during pregnancy, treatment of pregnant women infected with E. vermicularis is not completely straightforward. A recent study by de Silva et al. reviewed the effect of mebendazole therapy during pregnancy on pregnancy outcome. This investigation was performed in a country where treatment with antihelminthic medications in the second trimester is actually recommended because of the problems related to severe maternal anemia and fetal injury that may occur with certain helminths. They found no increase in major congenital defects when mebendazole was given to pregnant patients in the second trimester. Based on lack of large-scale studies and a limited number of isolated case reports of fetal malformations, as well as the knowledge that the drug is known to be teratogenic in rats and mice, there is an understandable reluctance to use this medication to treat pinworms in the first trimester. Some authors advocate no treatment until after delivery  unless the potential benefit greatly outweighs the risk to the fetus.
Pinworm infection is extremely common and likely will be encountered in any primary care practice. Its presentation may include a patient with severe symptoms or one that is completely asymptomatic. Therefore, accurate diagnosis requires a high index of suspicion. Diagnosis and treatment is easy, inexpensive, and effective, but relapses are common. Treatment of the pregnant patient requires understanding by the patient of the possible risk to the fetus and the fact that infection, although bothersome and embarrassing, has not been linked to poor pregnancy outcome.
If you have threadworms, it is important to shower in the morning in order to remove eggs and bacteria from the anal area.
Wash your hands thoroughly after each visit to the bathroom and before each meal.
Underwear should be changed daily.
Bedsheets should be changed frequently, especially 7 to 10 days after the treatment.
Infected children and adults should keep their nails short.
Infected children should ideally wear cotton gloves when sleeping.
Clean your home thoroughly, especially the bedrooms, and remove as much dust as possible.
Do not eat food in your bedroom.
If several family members are infected, you should all be treated on the same day.
Avoid food and drinks containing a lot of sugar, and eat high-fibre food to prevent constipation.
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