[1][6] Treatment is typically with two doses of the medications mebendazole, pyrantel pamoate, or albendazole two weeks apart.

[8][9][10] The itching occurs mainly during the night,[9][11] and is caused by the female pinworms migrating to lay eggs around the anus.

[20] They do not tolerate heat well, but can survive in low temperatures: at −8 degrees Celsius (18 °F), two-thirds of the eggs are still viable after 18 hours.

[21] Dust containing eggs can become airborne and widely dispersed when dislodged from surfaces, for instance when shaking out bed clothes and linen.

[11][18] According to Burkhart (2005), when this retroinfection occurs, it leads to a heavy parasitic load and ensures that the pinworm infestation continues.

[19] The emerging pinworm larvae grow rapidly to a size of 140 to 150 micrometres,[9] and migrate through the small intestine towards the colon.

[18] The egg-laying process begins approximately five weeks after initial ingestion of pinworm eggs by the human host.

[12] The gravid female pinworms migrate through the colon towards the rectum at a rate of 12 to 14 centimetres per hour.

[21] On the other hand, the light-yellowish thread-like adult pinworms are clearly visually detectable, usually during the night when they move near the anus, or on toilet paper.

[21] A third method of diagnosis is examining a sample from under their fingernails under a microscope as itching around the anal area is common and therefore they may have collected some eggs under their nails as a result.

[19] As such, routine examination of fecal material gives a positive diagnosis in only 5 to 15% of infected subjects,[14] and is therefore of little practical diagnostic use.

[14] On a microscopic level, pinworms have an identifying feature of alae (i.e., protruding ridges) running the length of the worm.

[25] This is due to the prevalence of the parasite and the ease of transmission through soiled night clothes, airborne eggs, contaminated furniture, toys and other objects.

[19] Infection may occur in the highest strata of society, where hygiene and nutritional status are typically high.

[21][26] The main measures are keeping fingernails short, and washing and scrubbing hands and fingers carefully, especially after defecation and before meals.

[26][27] Showering every morning is also highly recommended to wash off any eggs that may be still lying on the skin.

[8] Total elimination of the parasite in a household may require repeated doses of medication for up to a year or more.

[26] They work by inhibiting the microtubule function in the pinworm adults, causing glycogen depletion,[26] thereby effectively starving the parasite.

[27] A single 100 milligram dose of mebendazole with one repetition after two weeks, is considered the safest, and is usually effective with cure rate of 96%.

[26] Pyrantel pamoate (also called pyrantel embonate, brand names e.g., Reese's Pinworm Medicine, Pin-X, Combantrin, Anthel, Helmintox, and Helmex) kills adult pinworms through neuromuscular blockade,[27] and is considered as effective as the benzimidazole compounds and is used as a second-line medication.

Pinworms located in the genitourinary system (in this case, female genital area) may require other drug treatments.

[30][31] Pyrantel pamoate is the treatment of choice in pregnancy but should be used only after consultation with a health care practitioner rather than self-treatment.

[citation needed] Mebendazole has less than 10% of the oral dose absorbed into systemic circulation with a clinically insignificant amount of drug excreted in breastmilk, and therefore treatment should not be withheld during breastfeeding.

[18] In the United States, a study by the Center of Disease Control reported an overall incidence rate of 11.4% among people of all ages.

[34] The prevalence rates in children having been reported as high as 61% in India, 50% in England, 39% in Thailand, 37% in Sweden, and 29% in Denmark.

[18] Finger sucking has been shown to increase both incidence and relapse rates,[18] and nail biting has been similarly associated.