Pinworms (enterobiasis) are tiny intestinal roundworms and the most common worm infection in the United States, especially among school-age children. The main symptom is intense itching around the anus, usually worse at night. Pinworm infections do not reliably clear on their own and are treated with a short course of anti-worm medicine; one over-the-counter option, pyrantel pamoate, exists in the US, while the other standard drugs require a prescription. Because the medicine kills the worms but not their eggs, a second dose two weeks later is standard, and the whole household is usually treated at the same time to prevent reinfection.
Available without a prescription — follow each label.
Pyrantel pamoate Reese's Pinworm Medicine Anthelmintic (anti-worm) | The only pinworm medicine sold without a prescription in the US (CDC). Per the FDA OTC anthelmintic monograph, it is labeled for the treatment of pinworms; CDC dosing is 11 mg/kg by mouth (maximum 1 gram), with a second dose repeated in 2 weeks because the drug kills worms but not eggs. Comes as an oral suspension, capsules, or chewable tablets. The label directs you not to use it in children under 2 years unless told to by a doctor; ask a doctor before use if you are pregnant or breastfeeding. Treat all household members at the same time. |
A doctor may prescribe these — not for self-treatment.
Emverm Anthelmintic (anti-worm) | A standard pinworm treatment a clinician may prescribe in the US, where mebendazole is prescription-only (it is sold over the counter in the UK, but not here). CDC dosing is 100 mg by mouth, repeated in 2 weeks. Do not self-start; it is generally avoided in pregnancy (especially the first trimester) and in very young children unless a doctor advises it. |
Albenza Anthelmintic (anti-worm) | A prescription anti-worm option a doctor may choose, often when other treatments are unsuitable. CDC dosing is 400 mg by mouth once, repeated in 2 weeks, taken on an empty stomach. Requires a clinician's diagnosis and prescription; it is generally deferred in pregnancy and used with caution in young children. |
For most uncomplicated pinworm cases in the US, the practical first step is the single over-the-counter option, pyrantel pamoate, which you can buy at a pharmacy without a prescription. Whatever medicine is used, two doses two weeks apart are recommended (the drug kills adult worms but not their eggs), and everyone in the household plus close caregivers should be treated at the same time, even those without symptoms, because reinfection is common. If you cannot or prefer not to take medicine, the NHS notes pinworms can sometimes be cleared with strict hygiene measures kept up for about 6 weeks. Self-care is just as important as the pill: wash hands well with soap and water before eating and after using the toilet, shower in the morning to wash away eggs laid overnight, keep fingernails short, avoid scratching and nail-biting, change underwear daily, and wash bedding, sleepwear, and towels in hot water and a hot dryer. Honest caveats: the standard anti-worm drugs are generally effective at clearing adult worms, but no medicine kills the eggs, so hygiene and the repeat dose are what prevent the cycle from restarting; choosing between prescription drugs is a clinical decision, and special groups (pregnancy, breastfeeding, children under 2) should check with a doctor or pharmacist first rather than self-treating.
See a pharmacist if you think you or your child have pinworms — they can confirm the over-the-counter option is appropriate. See a doctor (routine) if symptoms continue or come back after completing both doses and good hygiene, if you are pregnant or breastfeeding, if the person needing treatment is under 2 years old, or if you want a prescription option such as mebendazole or albendazole. Seek prompt medical care for red flags that suggest something more than ordinary pinworms: severe or persistent abdominal pain, marked weight loss or loss of appetite, significant vaginal irritation or discharge in girls, signs of skin infection from scratching (spreading redness, warmth, pus, or fever), or symptoms that do not improve with treatment — these warrant a clinician's assessment and a confirmed diagnosis rather than continued self-treatment.
General reference, not medical advice, and not a substitute for your doctor or pharmacist. The right choice depends on your symptoms, health conditions, age, and other medicines — always read each label and confirm before taking anything.