Treating threadworms

Treatment for threadworms is aimed at getting rid of the parasites and preventing re-infestation. To successfully treat threadworms you can either follow strict hygiene methods (as outlined below), or see your GP who can prescribe medication for you. However, when taking medication, you should also ensure strict hygiene methods to prevent re-infestation.

Hygiene

Sensible hygiene measures can be used to clear up a threadworm infection, but also to reduce your chances of re-infestation. The life span of the threadworms is approximately six weeks so these hygiene methods should be followed for this period. These include:

•keeping finger nails short,
•discouraging nail biting or finger sucking - in particular, you should make sure that children do not suck their thumb,
•frequently washing hands, and scrubbing under finger nails, particularly before eating and after visiting the toilet,
•wearing close-fitting underwear at night, making sure to change them every morning,
•wearing cotton gloves at night as this may help prevent scratching during sleep,
•having a bath, or shower, and making sure that you clean around the anus and vagina each morning, to remove any eggs laid during the night,
•making sure everyone has their own face flannel and towel avoid using communal (shared) towels,
•not eating food in the bedroom, as eggs can be shaken off bedclothes and survive in dust, and
•vacuuming regularly and thoroughly.

Medication

Medicines can also be used to remove threadworms. The most common medications used are:

•Mebendazole - this kills the threadworms, usually with only one dose (100mg), and is the preferred treatment for anyone over two years of age. If re-infestation does occur, a repeated dose can be prescribed.
•Piperazine paralyses the worms until they are pushed naturally out of the bowel. Piperazine can be used in children aged from three months to two years of age, but needs to be taken in two doses (2.5ml each), two weeks apart.

Mebendazole and piperazine do not kill the eggs produced by threadworms, so strict hygiene measures should still be followed for two weeks after treatment. All members of your family, or household, need to be treated at the same time to avoid re-infestation, even if only one person displays symptoms. These medications should not be used in babies who are less than three months old.

If the infestation persists after using medication, see your GP who is likely to recommend that you begin a second course of medication. The whole family should be included in this treatment, and additional hygiene measures should be practised. These include:

•washing sleepwear, bed linen, towels, and cuddly toys - this can be done at normal temperatures but make sure that the washing is well rinsed,
•thoroughly vacuuming and dusting the whole house paying particular attention to the bedrooms,
•carefully clean the bathroom by 'damp-dusting' surfaces, and washing the cloth frequently in hot water, and
•keeping toothbrushes in a closed cupboard, rinsing them well before use.

During pregnancy

Medication for threadworm is not usually suitable during pregnancy and while breastfeeding. Only in the second or third trimester (weeks 14-26 and week 27 onwards) of pregnancy can medication be used. Mebendazole is often prescribed. Mebendazole or piperazine should never be taken during the first trimester of pregnancy. See your GP if you are unsure.