Private threadworms clinic in London, same-day paediatrics.

Recognising them

• Intense itching around the bottom, worse at night — this is the classic sign, because the female worm emerges to lay eggs in the evening.
• Disturbed sleep, irritability and tiredness.
• Fine white threads, about a centimetre long, visible in the stool or around the anus — look with a torch two or three hours after the child has fallen asleep.
• In girls, itching or irritation around the vulva.
• Some people have no symptoms at all, which is exactly why everyone in the house is treated.

Treatment

1. Treat every single person in the household on the same day, whether or not they have symptoms. This is the step people skip, and it is the reason threadworms recur.
2. Use mebendazole, available from a pharmacy without prescription for anyone over two years old. It is a single dose.
3. Start the hygiene routine the same day and continue it for two weeks — the medicine kills the worms but not the eggs already laid.
4. Take a second dose after two weeks if advised, or if symptoms return — ask your pharmacist.

The two-week routine

Pregnancy, breastfeeding and under-twos

Mebendazole is not usually recommended in pregnancy, while breastfeeding, or for children under two. In these situations the hygiene measures alone will normally clear the infection within about six weeks, because the adult worms have a short lifespan and reinfection is what sustains them. Speak to us before taking anything — there are circumstances where treatment is appropriate, and it should be a considered decision.

School, nursery and everyday life

• Children do not need to stay off school or nursery.
• Tell the school or nursery so other families can check, but there is no stigma here — threadworms are simply very common in groups of young children.
• Reinfection is common. If it happens, repeat the whole process rather than treating only the affected child again.
• Pets do not carry human threadworms and do not need treating.