Treatment of Threadworms

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If re-infestation is avoided, the problem will disappear spontaneously within six weeks, providing that strict hygiene measures are taken for this period. These include:

Daily vacuuming of carpets and damp-dusting surfaces;
Daily disinfecting of bathroom surfaces;
Wearing fitted underwear at night;
Changing and washing all nightwear every day - change bed linen at the same time, if possible;
Washing around the anal area first thing every morning;
Keeping fingernails short;
Discouraging children from sucking their thumbs;
Washing hands frequently, including scrubbing under nails;
Rinsing toothbrushes before use;
Making sure everyone has their own face flannel and towel;
Not eating food in the bedroom (eggs can be shaken off bedclothes and survive in dust).

To be effective, all family members need to follow these measures.

Children should be discouraged from scratching around their anus and should also wash their hands before eating and after visiting the toilet.

Drug treatments can also be used to remove threadworms. The most commonly used aremebendazole and piperazine. Mebendazole kills the worms, usually with only one dose, and is the preferred treatment for anyone over 2 years old. Piperazine only paralyses the worms until they are pushed naturally out of the bowel. Piperazine can be used in children from 3 months but needs to be taken in 2 doses, 2 weeks apart. Drug treatments are not usually suitable during pregnancy and breastfeeding, or in infants under 3 months, so hygiene measures alone are usually advised.

All members of the family or household need to be treated at the same time, to avoid re-infestation, even if they do not show symptoms. When using drug treatments, strict hygiene measures should still be followed for 2 weeks after treatment, because eggs can survive for this period outside the body.