Hi Dr. Aviva, My 2 1/2 year-old daughter is being treated for pinworms. I would like to try everything I can to get rid of them…I have read they can be very hard to get rid of. She has been on Vermox for 1 week and I was researching natural remedies for treating pinworm infections online…I purchased papaya enzyme supplements and am wondering what dosage would be safe to give a 2-year-old. Any direction that you can give me in the dosage for my daughter would be great! Thank you for your time! ~ SH
Um, Excuse the Topic Butt…
Ok, I know this is a kinda’ gross sounding topic, so I hope you’re not reading it over your breakfast. But several different women have emailed in recently asking about pinworms in their kids and in pregnancy. So what are they and what can you do if you or your kiddos are dealing with them?
Pinworms: What are They and Who gets ‘Em?
Pinworms, tiny (about 1 cm) parasites with a threadlike appearance that live in the lower intestines, are such a nuisance! They are common in school-aged children, and are moderately contagious, particularly in households. They are common in all socioeconomic groups. There’s no blame, no thinking that you or your kids are dirty, and no blaming someone else.
The worms are spread by eggs that are picked up from hand contact, from kids who have been scratching their bottoms, contaminated food, soil or a sandbox. The eggs can remain dormant for months.
While pinworms are not dangerous, they can cause bothersome anal itching, vaginal itching or pain, night waking, irritability at bedtime or even during the day, constipation, chronic dry cough, nose picking, dark circles under the eyes, appetite for sweets, whininess, and bellyaches that may be mild or intense. These symptoms generally come and go in cycles of every 2 weeks, coincident with the life cycle of the worm. The female is especially active at the full moon and at night, when she lays her eggs around the anus (I know, this just keeps getting grosser!)
A diagnosis is made on the basis of a simple “scotch tape test,” by visibly seeing them at the child’s anus, or through a stool sample. The scotch tape test is simple and can be done at home. Touch a piece of clear Scotch tape, with the sticky side to the skin, to both sides of the buttocks near the anus. Do this in the morning before your child bathes or showers. Repeat two mornings in a row. Bring the 2 tape samples into the doctor’s office for microscopic examination.
What’s a Mom To Do?
While I am a huge proponent of herbs and natural medicines, take it from a mom-herbalist-MD, this is one of the few common health conditions that is more effectively treated with pharmaceuticals than with natural remedies. While we all prefer to avoid giving our kids pharmaceuticals, the natural alternatives are not that effective, take a long time to work if at all, and when it comes to herbs, the ones that are used for pinworm treatment are entirely 
unpalatable, and in the large doses needed, some can be toxic. Therefore, I tell my patients to treat their children and other symptomatic family members with an over-the-counter or prescribed anti-pinworm medication.
The one time I would make exception and try to treat with home remedies is during pregnancy. Most pinworm medications are category C, so can be used when necessary, but you can try an alternative first. However, most herbal medications traditionally used to kill intestinal worms, for example, wormwood, are unsafe in pregnancy.
A safe approach for pregnant women is to take 2-3 cloves of raw garlic daily for 6 weeks to eliminate pinworms, while treating the other members of the family conventionally. To eat the garlic use it raw on salads and vegetables. If your pregnant stomach can’t tolerate this, crush it with a garlic crusher, place it on a spoon with a small amount of honey and chase it with water.
Hysterical Hygiene: No Laughing Matter!
In addition to using the proper medication, what I laughingly (but seriously) call hysterical hygiene must be followed to completely eliminate the infection from the household. Aside from the anal itching, this is why I consider pinworms such a pain in the behind!
- Thoroughly wash hands before preparing food.
- Get children into the habit of washing hands with warm, soapy water upon awakening and before all meals.
- Keep fingernails short.
- Teach family members that if they do scratch, they should wash hands and under nails immediately, and remind them to stop scratching!
- Get kids (and adults) to wear underwear or close-fitting bottoms to bed to prevent eggs and critters from getting very far.
- Give your kids a shower each morning for 3 days after the medication has been given, rinsing their bottom and anal area well.
- Change bath towels after each use, and launder hand towels every couple of days.
- Change all bedding every few days during treatment. Don’t shake out the sheets as you take them off the bed, as this will send the tiny eggs flying. Just fold up the sheets and wash on a hot cycle.
- Vacuum (don’t sweep) every couple of days, and damp-mop at least once a week.
- Clean around the toilet and wipe faucets and doorknobs in the bathroom every couple of days.
Medication without hygienic measures often fails to prevent re-infestation, so no matter what internal remedies you give, observe the hysterical hygiene rules!
Diet and Prevention
Even with a healthy diet, pinworms happen. However, de-emphasizing certain foods and emphasizing others can help eliminate them or prevent their recurrence. Decrease or eliminate refined foods such as white flour and other highly processed products, baked goods, sweets (including natural ones), juices, and even the amount of fruit in the diet.
Certain foods are considered irritating and discouraging to worms. These include pickles, apple cider vinegar, salty foods, onions, garlic, hot peppers, and Calimyrna figs. You may want to increase the spiciness of your diet for a while.
Raw pumpkin seeds are a traditional pinworm remedy. They are also super healthy. While they are not enough to treat pinworms alone, adding ¼ cup daily to the diet might be helpful in preventing recurrence.
Papaya enzymes are safe to take, but over the years, experience has shown me that they really aren’t that effective in treating pinworms. There is no standardized dosing for children; however, they really are quite safe. For children over 2 who can chew pills or tablets without risk of choking, give 1/3 of the adult dose.
Stomach hydrochloric acid (HCl) may help to destroy the eggs before they migrate to the intestines. Vegetarians sometimes have lower levels. Ditto for those taking PPIs- drugs like prilosec – which also inhibit stomach acid. If your family is strictly vegetarian and you are having chronic problems with pinworms, you may want to think about adding small amounts of meat to your diet and speak with a nutritionist or physician about ways you can raise the HCl levels. And talk with your doctor about getting off PPI’s if you’re on them, or your child is, and pinworms are a persistent problem.
What To Expect
Pinworms can be very challenging to eliminate with herbal remedies, but with persistence and scrupulous attention to hygiene and appropriate use of conventional medicines, it can be done. The worms have a life cycle of approximately 2 weeks, so the real trick to eliminating them is preventing re-infestation. If you are able to do this, you can clear up the problem in 3 to 6 weeks. Pregnant women should consult with their midwife or doctor before taking any pharmaceuticals. Garlic can be taken, 2-3 cloves daily, as a natural remedy during pregnancy, with follow-up using the medication if the garlic is not effective quickly enough.
Such a timely post – we have been struggling with this for a while. My question has to do with how to treat both a nursing mom and a baby too young to take the pharmaceuticals. My understanding is that it’s not safe for little ones til age three – is that correct? I have an 18-month-old who nurses quite a bit. I want to treat his two older brothers, but want to make sure we are all eliminating the pinworms simultaneously so as to prevent reinfection – don’t want to have to give the drugs again! Thanks in advance!
thank you for this post! we have been battling them for months, although I *think* they are gone now, we have been taking pinex most recently after natural remedies not working. I am pleased to hear your advice as natural remedies not the best for this one. That is what I have learned too. My biggest thing was one piece pjs so they can’t itch at night. My little boy sucks his thumb too, so it has really been challenging!
Hi after struggling with pinworms off and on for years i read somewhere that a topical application of vaseline was helpful. I didn’t have any Vaseline however so i used the closest thing i had which was some homemade plantain and yarrow salve. It instanly stopped the itching and the worms went away after around a week of thick nightly applications on the whole family. Thank you for the articles
The way I learned to effectively deal with pinworms is to liberally coat the anus with diaper rash cream every night. This breaks the life cycle of the pinworms by preventing them from effectively laying eggs. It takes about 6 weeks of faithfully doing this every night and following all of Aviva’s hygiene and cleanliness suggestions suggestions. It has always worked for me and my family. Anyone else have success with this?
THANK YOU!!! I can’t believe the range of symptoms on this one! It makes total sense, now. I have a feeling that dealing with pinworms is a fact of farm living and the topical application of the same yarrow/plantain salve (a la Susun Weed) has helped us a lot too. Nightly application and changing of pjs everynight and undies helps a lot. I might consider though the pharmaceuticals now that I see the range of symptoms. It may be more of a problem than I thought…Thanks for your sage advice. Your books have saved me many a trip to the doc or emergency and given me pause to calm myself and the empowerment to nourish and heal my family. I am so glad you’ve created this site. I’ve been waiting
Dr. Romm, Thank you for this post, however, our family has been struggling with this for more than 6-7 weeks. And unfortunately, we’ve done everything described above. We have a 4 year old and a newborn (wife still nursing) and we can’t seem to get rid of them. We’ve seen 3 separate doctors (including a GI specialist). We’ve taken dose after dose of both Vermox and Albenza. We wash our hands and clothes constantly, bath and shower with rubber gloves/masks. We’ve taken garlic, wormwood, ground clove, apple cider vinegar, pumpkin seeds, and any possible natural remedy we have read about. And yet, they still persist. What would you suggest we do? Help!!!
Hi Bryan
Sounds painful! Oy. I hope you’ve nipped it by now. If not, most likely there is some source of reinfection. I wouldn’t keep on with the herbs. Make sure you are doing the meds properly, with a repeat dose consistent with the rehatching cycle. If they are still occurring, have someone recheck the diagnosis! Best! Aviva
I have one kid out of 4 who seems to get everything. He had them a year ago and using Eucalyptus spray on his butt and garlic inside his body, I was blessed to get rid of them. They do not like eucalyptus, apparently they kill them or something. Who knows but it worked. Well he has them again this year. I notice when he showers and scrubs before bed and applies the eucalyptus he can sleep through the night. Then I garlic him during the day. I just started treating it so we will see how long it takes this time.
I think tonight, after more research, I will add the juice of the garlic to his anus. Garlic is a God-send for sure.
Claudia,
Does the garlic burn his bum? My 4 year old keeps getting the worms and taking the meds. She is super sensitive and knows when has them. Every time she says she has a worm in her bum we find it right away. So this time we are trying the natural route with crushed garlic mixed with diaper rash cream. She screams that the garlic burns — I don’t think she could tolerate a whole clove. I’m worried that the vermox is not safe in the multiple doses -like 8 over a years time. ??
Hi ive just found a pinworm on my daughters anus – i was completely unaware as to what it was until i goggled….. My daughter has been complaining of terrible tummy pains at night for the last few weeks and broken sleep which is not like her – and tonight was the first time she said her bum hurt too and when i looked there it was….. what is the first thing i need to do – Also please note my daughter is 7 and is a very nervous child so if i was to tell her there was a worm inside her she would probably have a panic attack – i kid you not!!!
One last question i read on a site that possible side effects are nervousness, anxiety & loss of appetite is it possible that my daughter has had these pinworms for a long time and this is what is adding to her anxiety as it seems to have become a lot worse especially at night – she always finds something to be worried about when she gets her tummy pains – (tonight she cried for over an hour about her school trip that is not for another few months!!!!!!)
Is it possible that the two are connected
Thank you so much in advance as i am now a very anxious mother
Hi!First, don’t worry. They are an unpleasant but overall not too harmful parasite. I’d probably not say anything and just give the medicine as a supplement since it might upset her so much and be traumatic. And yes, they can have been present for awhile and cause the symptoms you mention. The medication is the most certainly effective treatment. Best, Aviva
Hi,
like many of the folks above my family has struggled with pinworms. We have tried everything. I have heard that their may be a link to the mercury in fillings with the inability to get rid of the worms. Have you heard anything about this? Wondering if this makes sense.
Thanks!
I have not heard this before. I can look into this. More likely, it is inadequate treatment…
Your comment about eggs not surviving stomach acid is incorrect. In fact, people get worms by ingesting eggs not worms. The cleanliness routine you suggest is to prevent ingestion of eggs and thus break the life cycle.
Hi there, Can you please send evidence about the eggs not surviving stomach acid being incorrect? For most parasites and bacteria this is absolutely the case. However, your comment has prompted my to do an extensive literature search and in fact, I cannot find evidence one way or the other. If you read the article correctly I believe I do state that infection is caused by the eggs and this is the reason for the hygiene. Please let me know how you read it otherwise. Always happy to correct. Also please include your credentials if you don’t mind. Thank you.
Dear Aviva,
Many sites recommend using diatomaceous earth for pinworms. I recently tried this for my daughter and I, in addition to squeaky clean living, garlic, pumpkin seeds, homeopath, etc. We are now ten days into treatment and I’ve just been warned about the de harming our digestive tract. Now I am confused and freaked out about the damage the de may have caused. Do you have any insights to offer? Since we are mid way through treatment, any recommendations on how to proceed? Do I keep the daily cleanings? It’s exhausting!
Yeah, I’m not comfortable with eating clay and soil. Too many potential contaminants, and really hard to move through the bowels. I’d do the meds. And yeah, unfortunately, the hysterical hygiene for about a month is necessary. I know it sucks! Sorry.
My 7 year old daughter has been struggling with these for 2 months. I have a 2 month old baby….is it possible for him to get it?
yes, it is…
This is new for me. My two year old has been complaining off and on for about 4 months that his tummy hurts, we always have him try and poop and it seems usually that was the problem. Now my 5 year old says the inside of his bum hurts. Now I’m off for some OTC meds and some hysterical cleaning. Hopefully this will do the trick.
Thanks for the post! We’ve been battling these off and on for years, and it’s a real trial. My daughter has severe anxiety; she has noticed the worms. It was interesting that someone pointed out a possible connection.
In any case, we’ve tried Vermox in the past and more recently a homeopathic tincture. My kids run around outside barefoot, which may be contributing to the problem. At first I really stepped up my clean routine, but tapered off, as I just plain ran out of steam. My biggest concern is possibly inadvertently passing them on to others. I am very paranoid about having anyone over. I had thought we were over it, but now it seems we’re not. Is it safe to donate articles that have been in our home (dishware in cabinets) and books, or do I need to scrupulously clean everything first? (What lengths do I need to go to to make sure our friends don’t get them?)
I know that they can be picked up almost anywhere, and are fairly common, but for my peace of mind, I hate to think of contributing to their spread. My daughter was upset about using a towel again and I said “look, you already have them!” If we wash our hands and clean our linens, and take the medicine, at what point can we expect to beat this? I’m concerned about eliminating them from our household, and minimizing the chance others will catch them. If someone is at our house, and doesn’t wash hands before eating, is that enough to catch them? Or does their immune system and other factors play more of a role? Germs are everywhere, but people don’t always get sick.
OH – sounds agonizing! Yes, in fact, that is enough to pass them on – sorry to say. I wouldn’t go toooooo crazy – or be paranoid. Put out fresh towels for guests, keep kids hands out of the communal food, etc. Common sense level of cleaning.
Carrot Juice and raw carrot helps get rid of pinworm, tried and tested. I also recommend vaseline smeared thickly around and in the anus at night as the worms can’t lay eggs or breathe! Its difficult to break the cycle so carrot juice twice a week should help. I have no credentials, this was tried and tested method that helped me.
Yes, the vaseline trick can work! Thank you for this helpful addition!
Aviva
Oh and do they look like thread really? Do they move? Some pictures on the web look thicker than thread?