Possible Causes
Pinworms
Pinworms are parasites that live in the intestines. The infection is spread by ingesting microscopic pinworm eggs. Young children often put their hands in their mouths and may not practice good hand hygiene before eating. An infected child may spread the infection if he gets eggs from the anal area on his hands and touches other children's hands or food. Eggs can get on objects such as shared toys, bedding, clothing, and toilet seats. Eggs can also get on surfaces when changing children's soiled underwear or bathing them.
Pinworms are common among preschool age children and adults who care for them. Pinworms are very contagious in a family or child care setting. Child care settings include family child care homes and center-based child care facilities.
Some children have pinworms without noticeable symptoms. The presence of pinworms can be diagnosed by a simple method. After the child has been asleep for 2 to 3 hours, apply transparent tape to the anus (rectum). Do not use translucent tape. The tape will collect any eggs and small, threadlike, white pinworms. Place the tape on a glass slide; seal another piece of tape over it; and take the specimen to a medical provider. The specimen can be examined under a microscope to identify eggs and pinworms.
Perianal Strep
Perianal strep may be suspected in infants and toddlers who have very red, itchy, or painful skin next to the rectum. Other family members may have recent strep throat infections.
Poor Toilet Hygiene
Toilet "accidents" and poor toilet hygiene are common among young children. When girls do not wipe after urinating, and boys or girls do not wipe well after a bowel movement, the skin in the area that is damp or soiled may become irritated, causing itching.
Small/Tight Clothing
If clothing worn over the anal area is too tight, it may irritate the child and cause the child to frequently clutch and pull at the clothing.
What Parents Should Do
- Consult the child's medical provider for testing and treatment.
- Follow caregiver recommendations.
- Trim the child's fingernails short.
- Be sure to wash the child's hands in the morning before breakfast and before any other meal or snack.
- If pinworms are the problem, wash the child's bed linen, clothing, and towels in hot water. Use the high heat setting when drying. Do not shake items—this will scatter the eggs.