What Is Trypophobia?
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Medically reviewed by Elle Markman, PsyD
Trypophobia is an anxiety disorder characterized by an irrational and intense fear of or discomfort with clusters of holes, bumps, or repetitive patterns. As of 2023, this condition is not recognized as a distinct entity by the Diagnostic and Statistical Manual of Mental Health Disorders, 5th Ed. (DSM-5), which guides clinical practice in psychiatry and mental health. However, researchers estimate that up to 14% or more of the population experience some form of aversion to or fear of stimuli associated with trypophobia.
There’s still debate about whether trypophobia is a distinct mental health condition, but treatment used for anxiety and phobias can help reduce symptoms. Therapy is usually the primary form of treatment.
Symptoms
Trypophobia is a type of phobia: an extreme and irrational fear of a specific trigger or set of triggers. In this case, the triggers are objects and patterns dominated by clusters of holes, bumps, or nodules. People with trypophobia experience a combination of psychological and physical symptoms when exposed to patterns like these.
Psychological effects of trypophobia include:
Avoidance of patterns or stimuli that trigger attacks
Feelings of disgust or revulsion
A feeling of intense, irrational fear and discomfort
Anxiety
Panic attacks (brief episodes of sudden, intense, almost-paralyzing fear around a situation that doesn't actually present a high level of danger)
Trypophobia also triggers a response in the autonomic nervous system (ANS). The ANS regulates the body’s involuntary (automatic) processes, like heart rate, sweating, and breathing.
This can cause symptoms like:
Shivers or trembling
The sensation of skin-crawling
Rapid and/or shallow breathing
Panic attack symptoms, including disorientation, nausea, dry mouth, and dizziness
Trypophobia Causes
Your amygdala is the emotional and motivational center of your brain. When you experience fear, the activity in your amygdala changes in response to the perceived threat. Phobias occur when the fear response outweighs the potential threat of specific triggers. They're usually caused by a combination of genetics, previous traumas, learned responses, and underlying mental health conditions.
Researchers aren’t sure about the exact causes of trypophobia, though some believe they may be an overreaction to threatening patterns found in nature. This overreaction might be an evolutionary response to patterns that signified the presence of parasites or infectious diseases.
Clusters of round shapes or holes or repetitive patterns can trigger trypophobia responses.
Common triggers include:
Polka dot patterns
Lizard skin patterns
Animal prints
Sliced open pomegranates
Sliced bread
Stones set in concrete
Clusters of bumps or welts on skin
Scars or scaliness on skin
Risk Factors
Some populations have a higher risk of developing trypophobia. For example, this condition can be more common and chronic in people assigned female at birth. There also seems to be a genetic link: the condition is more common in people with a family history and learned responses of trypophobia.
Diagnosis
Diagnosing trypophobia involves a comprehensive evaluation by a mental health professional, like a psychiatrist or psychologist. The main difference between a psychiatrist and a psychologist is that a psychiatrist is more likely to prescribe medication, while psychologists are more likely to practice psychotherapy.
Trypophobia is not recognized by the DSM-5. As a result, there’s no established method of diagnosing the condition. Healthcare providers generally try to identify potential signs of the condition and rule out other potential causes of symptoms, such as:
Panic disorder: An anxiety disorder characterized by recurrent panic attacks
Obsessive-compulsive disorder (OCD): A mental health condition characterized by repetitive thoughts or behaviors to soothe anxiety
Central nervous system (CNS) tumors: Tumors in the brain or spinal cord
Schizophrenia: A chronic brain disorder that often causes delusions, hallucinations, and disorganized speech or behavior
Agoraphobia: A fear of being in public places, where it's hard to escape or where help might not be available
A healthcare provider will ask about your medical history, including any family history of trypophobia, medications you’re taking, and physical and mental health conditions. The psychiatric evaluation might include a rating scale like the Trypophobia Questionnaire. This questionnaire measures your responses to potentially triggering images.
Diagnostic criteria for a specific phobia can be helpful when diagnosing trypophobia.
This criteria includes:
Immediate fear or anxiety when exposed to triggers
Avoidance of triggers for at least six months
Impaired daily functioning (for example, impaired social and occupational functioning)
Trypophobia Treatment
Trypophobia is consistent with the DSM-5’s definition of a specific phobia. Therefore, treatment will likely include approaches used to treat other phobias, including behavioral therapy and medications. The goal is to reduce symptom severity and frequency.
Behavioral Therapy
Cognitive behavioral therapy (CBT) with exposure therapy is the frontline treatment for specific phobias and is often indicated for trypophobia.
CBT focuses on changing your thinking and behaviors related to trypophobia. It includes strategies to reduce anxiety, such as mindfulness techniques and breathing exercises, as well as reinforcing the safety of triggers.
CBT is often paired with exposure therapy, which involves exposing you to triggers in controlled environments. Avoiding triggers can prevent symptoms, but it can increase fear and worsen symptoms over time. Exposure therapy helps break the fear-avoidance cycle.
Types of exposure therapy include:
Imaginal exposure: Imagining the trigger in vivid detail
Interoceptive exposure: Experiencing physical symptoms of anxiety—for example, running—so that you no longer associate those sensations with danger
In vivo exposure: In-person exposure to the trigger
Virtual reality exposure: Experiencing the trigger using virtual reality technology
Medications
Certain medications may also be prescribed for specific phobias like trypophobia. These medications can help reduce symptoms of anxiety related to the phobia.
Beta-blockers, including Lopressor (metoprolol) and Inderal (propranolol), are a class of medications used to reduce high blood pressure and control heart rhythm. They can help treat symptoms like sweating and shakiness caused by phobias, as well as panic attacks.
Benzodiazepines, including Xanax (alprazolam), Ativan (lorazepam), Klonopin (clonazepam), and Valium (diazepam), are a class of medications that slow your brain and nervous system. They're used to treat anxiety. Like beta-blockers, they can help reduce symptoms of panic attacks.
Prevention
Stress and anxiety increase your risk of developing trypophobia. Relaxation techniques and other stress-reduction strategies can lower that risk.
Stress-reduction strategies include:
Regular exercise: Regular exercise or physical activity improves sleep and can reduce anxiety and stress.
Prioritizing sleep: Sleep deprivation (not getting enough sleep) or lack of good quality sleep can affect mood and cognition.
Muscle relaxation: Stress tenses muscles and can contribute to chronic pain and fatigue. Things like massage, acupuncture, and hot baths can reduce tension.
Mindfulness: Mindfulness techniques like meditation can reduce anxiety and stress.
Pleasurable activities: Taking time for things you enjoy, whether it's walking in nature, reading a book, or watching a funny movie, can help you shift from stress to relaxation.
Social support: Connection with others can improve your resilience (your ability to recover from challenges).
Related Conditions
Like other anxiety disorders, having trypophobia increases your risk of developing other chronic (long-lasting) mental health conditions.
Conditions associated with trypophobia include:
Major depressive disorder (MDD): A condition that causes debilitating feelings of depression
Generalized anxiety disorder (GAD): A condition characterized by a continual state of anxiety or worry
Social anxiety disorder (SAD): Anxiety or fear surrounding social situations
Panic disorder: An anxiety disorder characterized by recurrent panic attacks
Bipolar disorder (BP): A mood disorder with symptoms that range from emotional highs (mania/hypomania) to extreme lows (depression)
Obsessive-compulsive disorder (OCD): A mental health condition characterized by repetitive thoughts or behaviors to soothe anxiety
Living With Trypophobia
Trypophobia can significantly affect your quality of life. This condition does not always resolve with treatment, so consistent support and monitoring is essential. Research suggests that 80% to 90% of people who have exposure therapy respond to treatment.
Other recommendations for managing trypophobia include:
Seeking social support from family and friends
Joining support groups for people living with phobias or chronic conditions, either in-person or virtually
Researching advocacy organizations, including the National Alliance on Mental Illness
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