To successfully treat threadworms, all household members must be treated, even if they have no symptoms.
The aim of treatment is to get rid of the threadworms and prevent re-infection. To do this, you can either:
- Follow strict hygiene measures (see below) for six weeks.
- Take medication and follow strict hygiene measures for two weeks.
Some treatments are available from your local pharmacy without prescription. Always follow the manufacturer’s instructions because they may not be suitable for everyone.
Visit your GP if you think that you have threadworms and you:
- are pregnant or breastfeeding
- your child has threadworms and they are under two years old
See below for treatment advice for pregnant and breastfeeding women and babies.
Strict hygiene measures can be used to clear up a threadworm infection and reduce the likelihood of re-infection.
The life span of threadworms is approximately six weeks, so it's important that the hygiene methods are followed for six weeks. Everyone in the household must follow the advice outlined below.
- Wash all night clothes, bed linen, towels and soft toys when you are first diagnosed. This can be done at normal temperatures but make sure that the washing is well rinsed.
- Thoroughly vacuum and dust the whole house, paying particular attention to the bedrooms. Continue to vacuum regularly and thoroughly.
- Carefully clean the bathroom and kitchen by damp-dusting surfaces and washing the cloth frequently in hot water. Continue to clean bathroom and kitchen surfaces regularly and thoroughly.
- Avoid shaking any material that may be contaminated with eggs, such as clothing or bed sheets. This will help prevent eggs being transferred to other surfaces.
- Don't eat food in the bedroom, because you may end up swallowing eggs that have been shaken off the bedclothes.
- Keep your fingernails short. Encourage other members of your household to do the same.
- Discourage nail-biting and sucking fingers. In particular, make sure that children don't suck their thumb.
- Wash your hands frequently and scrub under your fingernails, particularly before eating, after going to the toilet and before and after changing your baby's nappy.
- Wear close-fitting underwear at night and change your underwear every morning.
- Bath or shower regularly, particularly first thing in the morning. Make sure that you clean around your anus and vagina to remove any eggs.
- Ensure that everyone in your household has their own face flannel and towel. Don't share towels.
- Keep toothbrushes in a closed cupboard and rinse them thoroughly before use.
Children can easily pick up another threadworm infection from friends or at school, so maintaining good hygiene may help prevent another outbreak.
Medication can be used to treat threadworms. It should be taken by everyone in the household.
The risk of transmission between household members is high (around 75%), which means that everyone in the household is likely to be infected, even if they don't have any symptoms.
Mebendazole and piperazine are two medications that are commonly used to treat threadworm infections.
Mebendazole works by preventing the threadworms from being able to absorb glucose, which means that they will die within a few days.
Mebendazole is the preferred treatment for children over two years old. It can be bought over the counter from your local pharmacy or prescribed by your GP and is available as a chewable tablet or as a liquid.
As threadworm re-infections are very common, a second dose of mebendazole may be prescribed to be taken after two weeks. You should follow the dosage information on the label or in the patient information leaflet that comes with the medicine.
In rare cases, mebendazole can cause abdominal pain or diarrhoea, particularly if the threadworm infection is severe.
Piperazine paralyses the threadworms until they are passed naturally out of the bowel. It is combined with a medication called senna, which has a laxative effect to expel the worms more quickly.
Piperazine and senna usually come in a sachet of powder, which you mix with a small amount of milk or water before drinking.
Piperazine can be used to treat children who are between the ages of three months and two years old. As re-infection is very common, a second dose may be taken after two weeks.
Dosage information will be provided on the label or in the patient information leaflet that comes with piperazine.
Piperazine is not recommended if you have epilepsy (a condition that causes seizures) or problems with your liver or kidneys.
Mebendazole and piperazine are 90%-100% effective at killing the threadworms, but they don't kill the eggs. Therefore, the hygiene measures outlined above should be followed for two weeks after treatment.
Visit your GP if the infection continues after treatment. They may recommend that you begin a second course of medication.
Pregnancy and breastfeeding
If you are pregnant or breastfeeding, medication is usually not recommended. To treat threadworms, use the hygiene method.
See your GP if you are more than three months pregnant or if you are breastfeeding and you experience problems treating a threadworm infection using only the hygiene method. In certain circumstances, your GP may consider prescribing medication.
Babies under three months old
Medication is not recommended for babies under three months old who have a threadworm infection. Instead, follow the hygiene method.
Make sure that you wash your baby’s bottom gently but thoroughly every time you change their nappy. Also wash your hands thoroughly before and after changing their nappy.