These common worms can seem scary and gross, but they are actually very harmless. So don’t freak out.

Symptoms include anal itching during the day that is usually much worse at night. Your child may wake during the night crying from itching and burning discomfort because the worms tend to crawl out onto the outer anus during the night to lay their eggs, then go back inside during the day. 

You can diagnosis these worms by using a flashlight to look at your child’s anus in the middle of the night (between 1 and 4 am). You will see the worms squirming around on the anus. They look like white threads about one inch long (maybe about the width of two threads woven together). You may also see these in your child’s stools. It’s useful to try to see these to confirm them before treating. If you don’t see them, but highly suspect them, the doctor can order a stool test to try to detect them. 

Here are your treatment options:

  • Natural treatments: there are some herbal and natural remedies you can investigate, but I am not well-versed in these. 
  • OTC medication called Pyrantel Pamoate (under various brand names) is the first line of medical treatment. Follow the single one-time dose on the bottle, and REPEAT this dose after two weeks. 
  • Repeating the dose is very important because the first dose only kills the adult worms. The second dose kills any new ones that hatched and grew up during the two weeks after the first dose. 
  • Consider treating the whole family, especially if sharing a bed with the child as these can be fairly contagious from the child spreading the eggs from his anus. 
  • Read online how to clean everything in your child’s room to eliminate all the eggs laid by the worms that your child may have transferred from his anus to his clothes, towels, bedding, etc. 
  • You should be able to manage all of this without needing an appointment with us. 
  • Prescription meds can be used if these recur. The main one is mebendazole, but it’s very expensive in some cases depending on your insurance. A slightly stronger version is called albendazole, which is much cheaper and can be used instead for cost reasons OR if the worms persist despite using mebendazole. Call or message us for an appointment if you need a prescription. 
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