What are threadworms?
Threadworms, also known as pinworms, are tiny, white thread-like worms that live in the gut and lay eggs at night. It is the most common worm infection in the UK, and can affect anyone of any age.
Medically known as Enterobius vermicularis, a pinworm infection is called enterobiasis. Whilst it can look unsettling to see white threads in poo, thread worms are relatively harmless and do not cause serious medical harm. They are a common nuisance that can easily be resolved.
What are the symptoms of threadworms?
The most clear-cut symptom of threadworms is physically spotting the worms in poo. They are easy to spot and look like white threads.
Other common signs to look for include:
Intense itching around the bottom- particularly at night. Female worms crawl out to lay eggs, releasing a substance that causes itching.
Disturbed sleep - Due to the discomfort, many patients, particularly children often become restless, wake up frequently or experience bed wetting.
Irritability - a lack of sleep commonly leads to daytime tiredness and irritability.
How do you catch threadworms, and are they contagious?
Yes, threadworms are highly contagious, and are spread through accidentally ingesting microscopic eggs. It is not linked to poor hygiene or pets.
A person usually gets threadworms through a specific cycle of events:
Scratching - an infected person scratches their bottom at night, due to itching.
Transfer - the microscopic eggs stick to the fingers and under fingernails.
Contamination - if the infected person does not wash their hands, eggs are transferred to surfaces, toys, bedding or food.
Ingestion - a new host touches the contaminated objects, then their mouth, swallowing the eggs.
Each female worm can produce more than 10,000 eggs, which can survive on contaminated surfaces for up to 3 weeks.
How do you get rid of threadworms?
Getting rid of threadworms requires a two-fold approach:
Medication to kill the live worms in the body
Strict hygiene to get rid of any remaining eggs in the household.
The standard UK treatment is Ovex - containing the active ingredient mebendazole. This is a pharmacy-only (P) medicine which can be purchased over-the-counter once you have spoken to a pharmacist. Here at Quick Meds, simply fill out a short consultation asking about your symptoms to access treatment.
This treatment is taken as a single dose, repeated after 2 weeks alongside a strict hygiene routine.
As the eggs can spread easily through the home, the most important rule is to treat the entire household at the same time, even if they do not have symptoms.
Ovex tablet or liquid - which should I get?
Ovex works by starving the worms, killing them.
Available in both a tablet and a liquid form, both preparations are clinically identical. The choice between products depends on age of patients and preference:
Form | Best for | Considerations | |
|---|---|---|---|
Ovex Chewable Tablet | Adults and children over 2 years. | Orange-flavored - can be crushed if needed. | |
Ovex Suspension (Liquid) | Younger children (over 2 years) who struggle to swallow pills. | Banana-flavoured, easy to measure with a dosing spoon. |
The Hygiene Routine
Whilst the medication is effective at killing worms in the body, it does not destroy eggs that have been laid in the body or around the house. If these eggs are swallowed, a new cycle begins and the patient can get reinfected.
To break the cycle, a strict hygiene cycle must be started on the same day medication starts and continues for at least 2 weeks.
General Hygiene
Wash hands and scrub under nails, especially before eating, after using the toilet or changing nappies. Ensure children are encouraged to wash their hands regularly too.
Make sure everyone has a shower every morning and wears underwear at night, which is changed in the morning.
Wash Bedding And Clothing
All bedding and clothing, towels and soft toys must be washed immediately at a high temperature to kill any eggs. Do not shake the bedding when taking it off as this may spread the eggs into the air, contaminating other surfaces.
Disinfect The House
Vacuum carpets thoroughly and wipe down all surfaces, door handles, taps and toys to capture and remove loose eggs.
Keep Nails Short
Clip everyone's fingernail and scrub regularly with a nail brush. This stops eggs gathering under nails if someone scratches.
How long does treatment take to work?
Mebendazole gets to work straight away, killing adult worms within a few days. However, as it cannot kill the eggs, a second dose may be required after 2 weeks if re-infection is required.
The second dose catches any new worms that have hatched.
Threadworms In Pregnancy And In Children Under 2
Standard treatments available over-the-counter like Ovex are not licensed for all patients. The treatment is not licensed and should not be used by
Children under 2 years
Pregnant women
Breastfeeding mothers
For these groups, a GP should be consulted. A GP is optimally placed to either supply mebendazole under their supervision or offer an alternative, more suitable treatment.
For all groups, patients should rely on strict hygiene practice to naturally starve out the infection.
When should I see a pharmacist or GP?
For most cases, the infection can be treated safely with two doses of mebendazole and strict hygiene practice. A patient should consider seeing a GP if:
They are pregnant, breastfeeding or under 2 years old.
Symptoms do not improve, or worsen after completing the full treatment and hygiene routine.
There are signs of a secondary skin infection due to intense scratching.
The patient has recently travelled abroad.
