Extremely common, harmless, and not a sign of a dirty house. Treat everyone at once and follow the fortnight of hygiene.
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Threadworms are small white worms, about a centimetre long and roughly the thickness of a cotton thread, that live in the bowel. The female crawls out at night to lay eggs around the anus, which is what causes the itching.
They are extremely common in UK children — particularly between four and eleven — and they are harmless. They do not damage the bowel, they do not cause serious illness, and they do not mean anything is wrong.
The thing worth saying plainly is that threadworms have nothing to do with cleanliness. Eggs are microscopic, survive on surfaces for up to two weeks, and spread readily wherever children play together. Parents routinely feel embarrassed about this, and there is no reason to.
Treatment is cheap, available from any pharmacy without a prescription, and does not need a doctor. The part that determines whether it works is not the tablet — it is treating everyone at once and following the hygiene measures for a fortnight.
Threadworms can migrate forwards and cause vulval itching, soreness and discharge — or symptoms that look exactly like a urinary infection. This is a genuinely common and frequently missed cause of recurrent vulval irritation and bedwetting in girls, and it is worth considering before anything more elaborate.
Teeth grinding is often blamed on worms; the evidence does not support it. Nor do they cause significant weight loss or serious illness. If a child is genuinely unwell, look for another explanation.
Eggs survive on surfaces for up to two weeks, which is exactly why the hygiene measures run for that long.
The simplest method is to look. About one to two hours after the child has fallen asleep, part the buttocks and look with a torch — the worms are visible as small white threads that move.
They can also be seen in the stool, or on toilet paper.
First thing in the morning, before washing or opening the bowels, press clear sticky tape against the skin around the anus and lift it off. Eggs stick to the tape and can be examined under a microscope.
In practice this is rarely necessary. Treatment is usually started on the history alone, because the itch-at-night pattern is characteristic and treatment is safe and inexpensive.
If treatment for worms does not work, the diagnosis is probably one of these.
Honestly: most people do not need a consultation for threadworms. Treatment is available over the counter for a few pounds, a pharmacist can advise for free, and the great majority of families sort this out themselves.
We would rather say that than take a fee for something a pharmacy handles perfectly well.
Threadworms are not an emergency. There is no scenario in which they need urgent care.
Seek medical advice if:
First: treat everyone in the household on the same day, whether or not they have symptoms. Adults included. Untreated family members are the commonest reason threadworms come straight back.
Second: follow the hygiene measures for two weeks, because that is how long eggs survive on surfaces. The medication kills the worms but not the eggs, which is why the fortnight matters as much as the tablet.
Mebendazole is available from pharmacies, is given as a single dose, and is usually repeated after two weeks to catch anything that hatched from remaining eggs.
It is not routinely recommended under the age of two, or in pregnancy and breastfeeding — in those situations hygiene measures alone, kept up rigorously for six weeks, are the recommended approach.
Threadworm treatment is available over the counter from any pharmacy for a few pounds, and a pharmacist will advise you for nothing. That is the correct first stop for the great majority of families, and we would rather send you there than take a consultation fee.
The NHS also provides:
This page follows NICE Clinical Knowledge Summaries on threadworm.
Threadworms are a recognised cause of vulvovaginitis and of urinary symptoms in girls, and should be considered where these recur without another explanation.
Reviewed against NICE CKS current at the date shown above.
No, and it is worth saying clearly. Threadworms have nothing to do with hygiene standards or housekeeping.
They spread wherever children play together, and the eggs are microscopic.
Yes — on the same day, whether or not they have symptoms. Adults included.
Untreated household members are the commonest reason worms return within weeks.
No. Treatment is available over the counter from any pharmacy for a few pounds.
Paying for a consultation to get it makes no sense, unless there is a child under two or someone pregnant.
Because the medication kills worms but not eggs. A second dose two weeks later catches anything that has hatched since.
Skipping it is a common reason for recurrence.
Eggs are laid around the bottom overnight. Washing them off first thing removes them before they get onto hands, clothing and surfaces.
It is the single most effective hygiene measure, and it is more useful than an evening bath.
Yes. No exclusion is needed and there is no reason to keep a child home.
Do tell the school if there is a wider outbreak, so other families can check.
The usual treatment is not routinely recommended below two. Hygiene measures alone, kept up rigorously for about six weeks, are the recommended approach.
Get advice rather than buying something off the shelf.
Hygiene measures alone are generally advised in pregnancy and breastfeeding.
Do not treat yourself — ask a pharmacist or a clinician first.
Quite possibly, and it is a well-recognised cause that is frequently overlooked. Threadworms can migrate forwards and cause vulval itching, soreness, or symptoms resembling a urinary infection.
Worth considering before more elaborate investigation.
August 30, 2026
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