What do threadworms look like?

Threadworms, or pinworms, are pale and thread-like. They may be noticed in stool, on toilet paper, on underwear, or around the anus, often at night or in the morning. They can be difficult to distinguish from lint, mucus, food fibres or other harmless material. The more characteristic symptom is itching around the anus that becomes troublesome at night, when adult worms may move out to lay eggs. Scratching can irritate the skin and move eggs beneath the fingernails. Abdominal discomfort and disrupted sleep can occur, while bedwetting is not specific to threadworms and should not be used to identify them.

Do not handle suspected worms with bare hands. If safe, take a photograph and record when the material was seen and whether night-time itching is present. A clinician may recommend an adhesive tape test around the anus in the morning because stool testing may miss the eggs. Wash hands with soap, clean beneath short fingernails, change underwear and sleepwear, launder bedding and towels without shaking them, and clean frequently touched surfaces. Ask a pharmacist or GP about suitable treatment and household advice.

Seek a GP assessment when the appearance is unclear, itching does not settle, symptoms recur, or the affected person is pregnant, very young or immunocompromised. Prompt medical care is needed for severe abdominal pain, vomiting that continues, blood in stool, faintness or a swollen abdomen. These symptoms can point to another problem and should not be explained by a suspected threadworm sighting alone.

Could this be threadworms or a look-alike material? Is a tape test appropriate? What treatment and household cleaning plan should we follow, and when should we seek review?