Around 20% of children develop pinworms before adulthood. Confirm diagnosis using the tape test, collecting eggs on adhesive tape and analyzing them under a microscope. Manage the infection with hygiene measures like frequent handwashing and washing bed linens in hot water. First-line treatment includes pyrantel pamoate (11 mg/kg as a single dose, repeat in 2 weeks). Treatment can extended to all household members to prevent reinfection.
January 10, 2025

Pinworm OTC Eradication

Evidence-Based Over-the-Counter Guide

William Shen

William Shen

Co-founder & CPO

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Pinworm infection, caused by Enterobius vermicularis, commonly affects children and is characterized by perianal itching, especially at night. Around 20% of children in the United States are estimated to develop a pinworm infection at some point. 

Diagnosis (tape test):

  • Shine a flashlight at the anal area. The worms are tiny, white, and threadlike. If none are seen, check for 2 or 3 additional nights.

  • Tape Test: In the morning before bathing, because pinworms lay their eggs at night, firmly press the sticky side of a 1-inch (2.5 centimeters) strip of cellophane tape over the anal area for a few seconds. The eggs stick to the tape.

  • Visualization: The tape is then transferred to a glass slide, sticky side down. Put the piece of tape in a plastic bag and seal the bag. Wash your hands well. Take the bag to your health care provider. The provider will check the tape to see if there are eggs.

Hygiene measures:

  • Wash hands frequently, especially before meals and after using the toilet.

  • Wash bed linens, underwear, and towels in hot water to eliminate eggs and prevent re-infection.

First-line recommendations:

  • Pyrantel pamoate: 11 mg/kg orally as a single dose (maximum dose: 1 g). Repeat in 2 weeks if reinfection occurs. Treat household members prophylactically to prevent reinfection. Pyrantel pamoate FDA-approved syrup (FDA M024).

Prescription medications:

  • Mebendazole: Orally administered, broad-spectrum antihelminthic drug, 100 mg as a single dose, repeated in 2 weeks.

  • Albendazole: Orally administered, broad-spectrum antihelminthic drug, 400 mg as a single dose, repeated in 2 weeks.

Citations:

Kimberlin DW. Red Book: 2024-2027 Report of the Committee on Infectious Diseases, 33rd Edition. American Academy of Pediatrics; 2024

Stermer, E., Sukhotnic, I., & Shaoul, R. (2009). Pruritus ani: an approach to an itching condition. Journal of pediatric gastroenterology and nutrition, 48(5), 513-516.

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