Should I use this page, or skip it?
Use this page if a child has an itchy bottom at night or you have seen tiny white threads in poo. Skip it and call 999 only if they are otherwise severely unwell — threadworms themselves are not an emergency. See a GP rather than the pharmacy if the child is under 2 or you are pregnant or breastfeeding.
This page cannot see the worms for you. A pharmacist can still treat most households.
What are threadworms and what do they feel like?
Threadworms (pinworms) are tiny white worms in the gut. They look like short pieces of thread in poo or around the bottom, especially at night when they lay eggs. The classic symptom is an itchy bottom, often worse at night, with irritability or broken sleep. Girls may have itching around the vagina. Many infected people have no symptoms at all.
They are common in children and spread easily at home and school.
Can I see a pharmacist first?
Yes, for most people. NHS advice is to see a pharmacist if you think you or your child have threadworms. They can supply treatment for the household and tell you who should see a GP instead. Find a GPhC-registered pharmacy on Pick My Pharmacy.
Scotland has NHS Pharmacy First Scotland, Wales a Common Ailments Service, and Northern Ireland Pharmacy First NI — ask what they can supply locally.
How are threadworms treated?
Treatment has two parts. Medicine from a pharmacy kills the worms — follow the pack, and treat everyone over 2 in the household at the same time unless advised otherwise. Hygiene for two weeks stops eggs causing reinfection, because medicine does not kill eggs. If you cannot take medicine, NHS advice is six weeks of hygiene instead.
Wash hands, keep nails short, change underwear daily, wash bedding, and do not share towels. There is no need to stay off school.
When is it a GP, 111 or 999?
See a GP for children under 2, pregnancy, breastfeeding, or worms that have not cleared after proper treatment and hygiene. Use 111 if you cannot get pharmacy or GP advice and the skin around the bottom is badly broken. Call 999 only for unrelated emergencies — unresponsiveness, breathing difficulty, or a non-blanching rash with fever.
In England, Scotland and Wales call 111 (NHS 24 in Scotland). In Northern Ireland there is no general 111 — use GP out-of-hours on nidirect.
Do they need to stay off school with threadworms?
No. NHS advice is that there is no need to stay off nursery, school or work with threadworms. Treat and do the hygiene steps. Tell the school if you wish so other parents can check, but exclusion is not required. Keep nails short and remind them to wash hands.
Eggs can live for about two weeks outside the body, which is why hygiene continues after the tablet. If you cannot take medicine, NHS advice is six weeks of hygiene instead of two. This is unpleasant, not dangerous, for most otherwise well children.
What hygiene steps actually help?
Wash hands and scrub under nails, especially before eating and after the toilet. Shower in the morning. Change underwear daily. Wash sleepwear, sheets and towels. Do not share towels. Discourage nail-biting. Medicine kills worms but not eggs, which is why two weeks of hygiene matters.
Treat everyone over 2 in the household at the same time unless the pharmacist says someone should see a GP instead. Under-2s, pregnancy and breastfeeding need a GP or specific pharmacist advice first. Find a GPhC-registered pharmacy on Pick My Pharmacy.
This is a pharmacy problem for most households, not a reason to keep a well child off school.
Who should skip this page?
Skip this page if the child is already floppy, struggling to breathe, or has a non-blanching rash — that is 999, not worms. It is not a head lice combing guide, not a nappy rash cream page, and not a reason to keep a well child off school. Pregnancy and under-2s belong with a GP.
Common questions about threadworms
- How do I know if my child has threadworms?
- The main sign is an itchy bottom, particularly at night, sometimes with broken sleep. You may see tiny white thread-like worms in poo or around the bottom. Many people have no symptoms, which is why the whole household is often treated. Weight loss or very sore skin still needs a pharmacist or GP, not a wait.
- How do you catch threadworms?
- Eggs get under fingernails when a child scratches, then onto toys, bedding, food and other hands, and are swallowed. They survive for about two weeks outside the body. This is not a sign of a dirty house. Handwashing, short nails and treating everyone together breaks the cycle.
- How are threadworms treated?
- A pharmacist can supply a worming medicine for most people over 2. Treat everyone in the household at the same time, even without symptoms, unless the pharmacist says someone should see a GP instead. Follow the pack. Hygiene for two weeks is essential because the medicine does not kill eggs.
- Why does the whole family need treating?
- Eggs spread so easily that others are often infected without itching. Treating only the child who was spotted lets the worms bounce back. NHS advice is to treat everyone over 2 in the household. Under-2s, pregnancy and breastfeeding need a GP or specific pharmacist advice first.
- Should my child stay off school?
- No. NHS advice is that there is no need to stay off nursery, school or work with threadworms. Treat and do the hygiene steps. Tell the school if you wish so other parents can check, but exclusion is not required. Keep nails short and remind them to wash hands.
- What hygiene steps actually help?
- Wash hands and scrub under nails, especially before eating and after the toilet. Shower in the morning. Change underwear daily. Wash sleepwear, sheets and towels. Do not share towels. Discourage nail-biting. If you cannot take medicine, NHS advice is to use hygiene measures for six weeks instead of two.