Trypophobia is a condition in which a person experiences a fear of or aversion to clusters of small holes.

The term “trypophobia” is Greek for a fear of holes. It describes the aversion or unpleasant feeling a person may experience when they see a cluster of holes or similar repetitive patterns. Seeing these patterns may lead to symptoms such as fear, disgust, and anxiety.

At present, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) does not recognize trypophobia as a phobia. This is due to the ongoing debate as to whether it is a phobia or simply a feeling of disgust.

In this article, we discuss trypophobia, including the potential triggers, possible causes, and how to treat it.

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Trypophobia refers to the fear of or repulsion to patterns of holes. As such, people with trypophobia often find that specific images of clusters of small, irregular holes trigger their symptoms. Examples include the patterns present in objects such as:

  • sponges
  • soap bubbles
  • coral
  • sea sponges
  • honeycomb
  • water condensation
  • beehives
  • seed pods
  • strawberries
  • pomegranates
  • bubbles
  • clusters of eyes in insects

In addition to the debate regarding whether trypophobia is a fear or disgust, researchers continue to investigate what may cause this strong aversion.

Some people may make an unconscious association between hole patterns and some potentially dangerous animals that feature similar designs. A 2018 study investigating visual processing indicates that trypophobic images and dangerous animals trigger a similar response. This means that people may identify the pattern as a threat, with this identification initiating their survival instincts.

A 2017 study suggests that trypophobia is an evolutionary response to alert a person to the presence of parasites or other infectious diseases. The researchers suggest that those with trypophobia may perceive clusters of holes as either symptoms of parasites, such as fleas being present on the skin, or the spread of pathogens, such as droplets from a sneeze or cough.

However, another 2017 study notes that people experience discomfort following trypophobia stimuli due to the characteristics of the cluster pattern itself and not an association with dangerous animals. This may be due to the images possessing a particular spectral profile that results in a trypophobic sensation.

Some research suggests that trypophobia may be a type of specific phobia. This term refers to an intense reaction to something that poses little or no danger. Even though some people realize that their reaction is irrational, simply thinking about certain objects or situations can cause symptoms of anxiety. However, more research is necessary to support this idea.

People with trypophobia may experience various symptoms, including:

  • feelings of disgust, fear, or discomfort
  • goosebumps
  • skin itching
  • skin crawling
  • sweating
  • nausea
  • panic attacks

Older research on trypophobia suggests that it may occur as people subconsciously associate the pattern with a dangerous animal. Alternatively, it may also be a form of aposematism. This term refers to nature’s use of colors or patterns to warn predators that an animal is poisonous, venomous, or otherwise dangerous.

A 2017 study tried to identify clinical features of trypophobia. It found that the symptoms of trypophobia were typically long-term and persistent. Additionally, there was an association with depression and generalized anxiety disorder. Some experts may also relate it to obsessive-compulsive disorder (OCD), as this reaction is similar to the contamination fears that sometimes occur in people with OCD.

However, researchers note that people with trypophobia are more likely to experience feelings of disgust than fear and that strong feelings of disgust can be a symptom of a specific phobia.

Although more thorough research is still necessary, some people may believe that the data are sufficient to classify trypophobia as a specific phobia.

Although no treatment specific to trypophobia exists, some treatments are available for phobias in general. Treatments for phobias and other anxiety disorders may consist of self-help treatments, therapy, and medications.

These treatments have varied success rates.

Self-help treatments and therapies

People can use self-help techniques by themselves or with the help of a therapist or counselor.

These strategies may sometimes be effective in treating individual phobias, but they have varied rates of success.

Self-help strategies include:

  • Cognitive behavioral therapy (CBT): In this talking therapy, a therapist or counselor helps a person explore how certain thoughts cause their feelings and behaviors. They will work with the person to help them build the skills to challenge unhelpful thoughts and achieve their goals.
  • Exposure therapy (desensitization): This is a treatment method in which a therapist exposes a person to their phobia in small but increasing doses.
  • Relaxation techniques: Examples include breathing techniques and visualization methods.

Medications

At times, doctors will prescribe certain medications to treat phobias or the side effects of phobias, such as anxiety. These medications can include:

Currently, there is no proven way to prevent a person from experiencing symptoms of trypophobia. However, a person can try using certain relaxation techniques or other methods that a therapist suggests to help alleviate their reaction.

A person with trypophobia may experience symptoms such as fear, disgust, anxiety, goosebumps, and panic when seeing clusters of small holes. Some researchers suggest that this may occur due to recognizing the pattern as a danger, whereas others see it as simply experiencing disgust toward the pattern.

Currently, the DSM-5-TR does not recognize trypophobia as a condition. Some evidence suggests that people could classify it as a specific phobia, but more research is necessary to support this claim.