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Recurrent anal itching, taken Benadryl and Pin-X. Do I need to take another dose of albendazole early?

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General & Family Physician
Practicing since : 1978
Answered : 6714 Questions
3 weeks ago my college aged son said he had pinworms. I bought Pin-X. The entire family took it & I cleaned the entire house. For the first 2 weeks I was crazy with cleaning & laundry. Since then we have all practiced good hygeine, cut out finger nails, wash our hands like crazy, shower twice a day...

A week after I took Pin-X my symptoms started. The anal itching was insane & then I began w intense vaginal itching. I started probiotics, Microbex (with wormwood) & garlic supplements. A couple days later I used a medicated douche (which I never have before) & used an OTC yeast treatment just in case I had a yeast infection.

Fast forward a week of still no sleep & itching I called my doctor who said although he is sure it's not pinworm since I had taken Pin-X, started all those supplements, & took all those precautions,he would call in a prescription for albendazole. I took 400mg a week ago. My entire family took another dose of Pin-x & I cleaned the entire house again.

My question.........

I have been treated multiple times, yet I haven't slept for more than 3 hours a night. I have itching like crazy. And I swear I feel this tickle in & around my anus that feels like worms.

I have looked with a mirror. I have tried tape, but I'm pretty sure the only little, white looking string thing I found is toilet paper. I've seen nothing in my underwear or my feces. Yet this tickle/itch keeps me up! I've taken 2 Benadryl & have a witch XXXXXXX pad shoved in my anus & still can't sleep!

Do I take another dose of albendazole early? Help! Could I actually have made things worse with the treatment? I desperately need sleep.
Posted Sun, 26 Aug 2012 in Digestion and Bowels
Answered by Dr. Pavan Kumar Gupta 5 hours later
Thanks for the query.
Although there are various factors which put people most at risk for anal itching  and they are
Diabetes,long standing diarrhea,profuse sweating,recent anti biotic use and chronic skin conditions like psoriasis BUT since your history of anal itching is very short,I don't think these are the causes.
I feel your cause for anal itching is over enthusiastic cleaning of your anal area.
This itching is due to irritation of skin around your anus.

Some of the most common irritants include the following: 
Perfumes, chemicals, or XXXXXXX on toilet paper can cause an allergic reaction

Advise for you
Try not to irritate the skin even more by scrubbing the area with soap. This will only cause more irritation and itching. Gentle cleaning with water helps the area heal.

Change to a plain, soft, unscented toilet paper. 

If toilet paper feels too abrasive, try cleaning with unscented baby wipes or cotton moistened with mineral oil. Dry with cotton afterward to remove any moisture. 

Wear loose-fitting cotton underwear that allows sweat to evaporate.

Over-the-counter medicines such as creams containing hydrocortisone 1% to be used locally but don't use it for more than 2 weeks( to avoid skin damage )

Avoid food irritants and eat a high-fiber diet.
I hope you should be alright with these measures however if you don't become alright in next 2 weeks then get yourself checked by the doctor for hemorrhoids and other causes.

Do write to me if you have something more to ask.
Best of luck.
Above answer was peer-reviewed by
Follow-up: Recurrent anal itching, taken Benadryl and Pin-X. Do I need to take another dose of albendazole early? 47 minutes later
A couple more questions....

Why is the itching only bad at night & bad enough to keep me awake?

Why all the itching in the vsginal area?

I have had problems with hydrocortisone creams in the past. Could I try a diaper rash cream with zinc oxide? Would that do anything to help with the itch? your experience does treating the entire family with Pin-X multiple times take care of the infestation? Or do we need to continue every 2 weeks until all my symptoms are gone?

If I had them could I see them in my feces?

Answered by Dr. Pavan Kumar Gupta 8 hours later
Pinworms are white, parasitic worms that are about one-half inch long. While the infected person sleeps, female pinworms leave the intestinal tract and lay their eggs on the skin around the anus. The eggs are laid in a sticky, jelly-like substance that, along with the wriggling of the female pinworm, causes severe itching.

Pinworm is the most common infection in united states of XXXXXXX

Females may experience vaginal itching and irritation (vaginitis), if pinworms are near the vagina.

You can use diaper rash cream with zinc oxide and can take a antihistaminic tablet like cetrizine in night daily for 10 to 14 days.

Treatment and steps to prevent reinfection.....
1......The infected person should take the medicine orally. It is given in two doses. The second dose should be given two weeks after the first.
2......Bathe first thing in the morning to reduce egg contamination.
3......Wash hands and under the fingernails thoroughly, after using the bathroom, before eating and after changing diapers.
4.....Discourage nail biting and scratching bare anal areas to avoid re-infection.
5.....Keep fingernails trimmed very short.
6.....Infection often occurs in more than one family member. Treat all infected family members at the same time.
7......Change and wash underwear and pajamas in hot water daily.
8.....Machine-wash sheets, blankets, towels and clothing in hot water to destroy eggs. Machine-dry at high temperature.
9......Eggs are sensitive to sunlight, so open blinds in bedrooms in the daytime.
10.....     Since pinworm eggs are light and scatter easily, dust should be removed carefully from all surfaces in the home. Careful vacuuming or the use of an oiled cloth (which may be boiled or destroyed later) will help prevent the eggs from scattering.
11.....     Pinworm eggs continue to be present (excreted) in the feces of an infected person for up to a week after the treatment, so precautions should be taken to prevent reinfection by washing hands thoroughly, especially under the nails.

DIAGNOSIS is done by finding the female worm or eggs,To find it:

1....At night, the adult worms can sometimes be seen directly around the anal area or in pajamas. The worm (one-quarter to one-half inch long) is clearly visible to the naked eye. Finding a worm confirms the diagnosis.
2.....If adult worms are not visible, conduct a tape test in the morning. Apply a piece of transparent tape against the folds of skin around the anus to pick up any eggs or worms and then tested in a laboratory.

 Because bathing or a bowel movement can remove the eggs, the tape test should be done as soon as the person wakes up in the morning.

Above answer was peer-reviewed by
Follow-up: Recurrent anal itching, taken Benadryl and Pin-X. Do I need to take another dose of albendazole early? 3 hours later
You just responded with ALL the information I have read on the Internet.

That is why I have taken multiple doses of Pin X & albendazole. You didn't really answer my original question.

So, even after all my treatments AND doing everything I've read, I still itch. That is why I started this query.
I also didn't get answers to some of the questions in the second query. Like should we continue to treat the family.
Answered by Dr. Pavan Kumar Gupta 1 hour later
There is no need to take any more medications neither for you nor for your family.
You have already taken multiple doses of the medicines.
Continue the general measures outlined above.

Is your entire family having the similar problem and of same magnitude and intensity or is it only you who is having it now?
Apply local zinc oxide preparation and take Antihistaminic daily.
Above answer was peer-reviewed by
Follow-up: Recurrent anal itching, taken Benadryl and Pin-X. Do I need to take another dose of albendazole early? 1 hour later
No one in my family, other than me, is having symptoms.

My 19 year old who had them originally is the only one who had symptoms. He has been fine since the day after Pin-X.

Answered by Dr. Pavan Kumar Gupta 34 minutes later
It looks you have been over enthusiastic in adopting personal hygiene.
Be gentle with your anal skin.
Avoid soap and use unscented baby swipes.
Use zinc oxide cream and Antihistaminic tablets.
I know this all is going to take some time but you have to have some patience.
Above answer was peer-reviewed by
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