What Is Trypophobia? Symptoms, Causes, Diagnosis, Treatment, and Prevention

What Is Trypophobia? Symptoms, Causes, Diagnosis, Treatment, and Prevention
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Trypophobia is a fear of a repetitive pattern of closely packed holes or protrusions. Some people may refer to it as fear of holes or fear of circles. The name comes from the Greek word trypo, which means “hole.”

People with trypophobia may find themselves very anxious because of seemingly ordinary things like sponges, fruits with seeds, or a honeycomb.

This phobia doesn’t appear in the American Psychiatric Association’s current Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but some people with trypophobia may fit the DSM-5 criteria of having a “specific phobia,” which includes a “marked fear or anxiety about a specific object or situation.”

Signs and Symptoms of Trypophobia

Research into trypophobia is currently limited.

One early study of the condition, based on accounts by 200 members of a trypophobia Facebook support group, divided its symptoms into three categories.

Cognitive-Related Reactions

  • Feeling disgust, aversion, or repulsion
  • Feeling uncomfortable or uneasy
  • Feeling freaked out
  • Feeling anxious, full of dread, or fearful
  • Feeling like you are going crazy
  • Having an urge to destroy the holes

Skin-Related Reactions

  • Itchiness
  • Goosebumps
  • Skin crawling
  • Shivering

Physiological Reactions

  • Chills
  • Having trouble breathing
  • Feeling sick or nauseous
  • Feeling like panicking or screaming
  • Vomiting
  • Feeling like crying
  • Nervousness, such as heart pounding, sweating, or stomach ache

Causes and Risk Factors of Trypophobia

Initially, some psychologists theorized that trypophobia evolved through natural selection.

Their reasoning was that many deadly animals, including certain venomous snakes and insects, have repeating high-contrast bumps, circular markings, or pits on their skin. So our ancient ancestors who were disgusted or scared by those patterns would have had a greater chance of survival because they avoided or fled from them; these individuals survived to reproduce, then passed on those traits to their offspring, and the genetic variants that encode for this aversion remain in the gene pool to this day.
A study published in 2017 explored another angle. Since the danger of poisonous animals exists but is not generally a persistent threat, the authors propose that trypophobia is more likely an exaggerated response to a natural protective tendency to avoid infectious skin diseases such as smallpox and measles as well as parasites such as scabies and ticks.


However, these theories currently lack support from substantial evidence. Because trypophobia can produce a range of symptoms with varying degrees of intensity, it’s likely to be “a natural and widely shared phenomenon” that many people can experience to some degree, says Renzo Lanfranco, PhD, a research fellow in cognitive neuroscience at the Karolinska Institutet in Sweden who has researched trypophobia.

Trypophobia Triggers

Almost any repetitive pattern can trigger a trypophobia reaction, even if the image or item doesn’t strictly seem to fit the definition.

Some triggers are everyday items:

  • Sponges
  • Soap bubbles
  • Swiss cheese
  • Honeycombs
  • Hair follicles
  • Skin pores
  • Showerheads
  • Strawberries
  • Pomegranates
  • Poppy-seed bagels

Other people respond only to more exotic or unusual images:

  • Coral reefs
  • Lotus seed pods
  • Manipulated digital pictures, such as rows of holes or teeth embedded on an arm

Risk Factors

Not much is known about what may predispose someone to trypophobia.

The only reasonably strong link found so far is to social anxiety disorder, which is characterized by a strong, persistent fear of being judged by others. Avoidance of facial features, particularly the eyes, is an important marker of that condition. Clusters of circles or holes may make a person with social anxiety disorder feel as if all eyes are on them.

Some researchers have suggested that trypophobia may run in families in a similar manner to social anxiety disorder. This could be due to seeing a close relative react negatively to a trigger or to specific genetic links.

How Is Trypophobia Diagnosed?

There is no well-researched way to diagnose trypophobia. You can discover for yourself if you have it by looking at triggering images, however, which are easy to find on the internet.

If you’re merely bothered by these images, you likely have a mild aversion. If your reaction is stronger and includes a great deal of distress, or leads to avoidance or significant changes in behavior, it may be more on the level of a phobia.

How Long Does Trypophobia Last?

The duration of trypophobia depends on a person’s particular situation. Some people find the symptoms disruptive for their whole lives. Others effectively control and manage their condition.

Treatment and Medication Options for Trypophobia

Many people with a mild form of trypophobia control their fear and carry out daily activities simply by avoiding triggers and asking people to alert them to potential ones.

If your aversion is on the level of a diagnosable phobia, avoidance can make your situation worse. The following approaches treat problematic trypophobia.

Exposure Therapy

Exposure therapy is one of the most widely accepted techniques for taming phobias.

In progressive steps by yourself or with the help of a therapist, you look at mildly triggering images. As your distress decreases and it gets easier to tolerate the images, you slowly work up to staring at images that previously felt the most threatening.

Emotional Freedom Technique

Emotional freedom technique (EFT), also known as tapping, is a mind-body method for reducing stress and anxiety. It may help reduce or eliminate trypophobia, says Roberta Temes, PhD, a clinical psychologist in Scotch Plains, New Jersey.

EFT involves tapping specific acupuncture points on the body with your fingertips while focusing on the phobia and repeating positive affirmations.

The first step is identifying a feared object. “Let’s say it’s Swiss cheese,” says Dr. Temes. “This technique works best when you start in a state of terror, so you would visualize Swiss cheese until you became more and more upset. You then would tap different points on the face, upper body, or hands while saying something like, ‘Even though Swiss cheese disgusts me, I love and accept myself.’ ‘Even though Swiss cheese disgusts me, I am safe.’ Or ‘Even though Swiss cheese disgusts me, I’m okay. I can still go into the dairy aisle.’”

Temes explains that EFT “shifts the nervous system away from fight or flight and permits you to be brave in the face of your phobia because it permits you to accept yourself.”

Although science has not figured out how EFT works physiologically, research has found that it can reduce the intensity of phobias.

Community

It may help to know that you’re not alone. The public Facebook group Trypophobia: Fear of Clusters of Holes, which has more than 14,000 members, is a good place to find advice and support.

Medication

While exposure therapy is the preferred treatment method, doctors sometimes treat phobias with medications. Certain drugs can lessen anxiety and other symptoms that occur when someone  encounters a trigger.

Beta-blockers, which block the effects of adrenaline in the body, and sedatives, which help you relax, can be useful in managing the symptoms of some phobias, particularly in the short term.

Alternative and Complementary Therapies

Some common alternative treatments may help people with trypophobia relax and manage their anxiety:

Prevention of Trypophobia

If you’re experiencing acute symptoms of trypophobia, using relaxation techniques can shorten their duration and reduce their frequency and intensity in the future.

Deep breathing, for example, can calm your anxiety and fear by slowing down your heart rate and inducing a relaxation response in your body.

One simple, effective technique is called box breathing, because it has four parts of equal length. Here’s how to do it:

  • Inhale slowly through your nose for a count of four.
  • Pause for a count of four.
  • Exhale slowly through your nose for a count of four.
  • Pause for a count of four before starting the cycle again with an inhale.

Continue breathing this way for several rounds.

Complications of Trypophobia

If you have a severe phobia that’s disrupting your day-to-day life and don’t seek treatment for it, it could lead to complications:

  • Mood disorders
  • Social isolation
  • Strained social relationships
  • Substance abuse
  • Suicide (in severe cases)

Related Conditions of Trypophobia

Some conditions are related to trypophobia:

  • Social anxiety disorder involves a persistent fear of social situations.
  • Anxiety is a feeling of unease or worry in the absence of a specific threat.
  • Panic disorder is marked by unexpected panic attacks and fear of future attacks.
  • Obsessive-compulsive disorder, also known as OCD, is a condition that involves obsessive fears and corresponding compulsions that you’re unable to stop repeating.

Communities of Support for Trypophobia

Trypophobia Support Group on Facebook

Looking to connect with others? Individuals on Facebook have launched a closed group dedicated to providing support to those with trypophobia. The group currently has more than 5,500 members.

National Alliance on Mental Illness Support Groups

This organization offers free support groups for people who face mental health challenges. It also include groups for family members and friends of people who are having a tough time.

Resources We Trust

The Takeaway

Trypophobia is a fear of patterns of holes, circles, or bumps. If you have this fear, you may feel disgust or anxiety toward everyday objects like sponges or seeded fruits. While research into this condition is limited and it doesn’t appear in the DSM-5, forms of therapy that treat other phobias can help.

Common Questions & Answers

Is trypophobia real?
Trypophobia is not recognized as an official diagnosis, though many who experience it fit the criteria of having a specific phobia. Some experts consider it a kind of anxiety disorder.
Almost any repetitive pattern of holes, bumps, or circles can trigger a reaction, even if the image or item does not strictly seem to fit the definition.
No, but it could be an evolutionary response to skin diseases. Many serious skin diseases resemble a cluster of shapes. Some say trypophobia is an excessive reaction to things that resemble serious skin diseases. That response may have evolved as a way to keep people away from others’ skin diseases.
Exposure therapy — in which patients are gradually exposed to unpleasant images or situations — may be helpful. To the extent that trypophobia is a kind of anxiety, drugs used to treat anxiety may help.
There is little data, but some observers say it may be relatively common. It also appears to be more common in women than in men.
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Seth Gillihan, PhD

Medical Reviewer
Seth Gillihan, PhD, is a licensed psychologist in private practice in Ardmore, Pennsylvania, who helps people find personal growth by making important changes in their thoughts and habits. His work includes books, podcasts, and one-on-one sessions. He is the the host of the Think Act Be podcast and author of multiple books on mindfulness and CBT, including Retrain Your Brain, Cognitive Behavioral Therapy Made Simple, and Mindful Cognitive Behavioral Therapy.

He completed a doctorate in psychology at the University of Pennsylvania where he continued as a full-time faculty member from 2008 to 2012. He has been in private practice since 2012.

Nuna Alberts, LCSW

Author

Nuna Alberts, LCSW, has been in private practice for more than 20 years, treating hundreds of adolescents, adults, and couples for depression, anxiety, obsessive compulsive disorder, relationship problems and a range of other issues.

She earned a bachelor's in art history from Columbia University School of General Studies, with an emphasis on criticism, and received a master's in social work from New York University, where she focused on psychodynamic psychotherapy. For her master's in journalism thesis for Columbia University, she wrote about genetic testing and the ethical choices that can arise from it.

Her writing has been published in multiple magazines and national newspapers, and she was the editor and an author of the 2002 book Strengthen Your Immune System: Boosting the Body's Own Healing Powers in the Fight Against Disease. She is currently working on a book about psychotherapists' perspectives on their own psychotherapy.

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
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