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Trypophobia – Understanding the Fear of Holes

Trypophobia – Understanding the Fear of Holes

Updated on May 27, 2022

Reviewed by Dr. Nereida Gonzalez-Berrios, MD , Certified Psychiatrist

Trypophobia - Symptoms, Causes, Treatment and How to Get Rid of It

Key Takeaways

  • Trypophobia is a fear of holes, patterns, or clusters of small open spaces. It causes aversion and disgust along with fright and terror.
  • The fear response can be elicited by seeing seedy fruits, sponges, honeycombs, patterns of small circles, bumps on the skin, and clusters of holes.
  • The exact cause of the illness is not known, yet scientists believe that the holes remind people of some dangerous things like snakes, honey bees, eyes of tarantulas; that can cause harm.
  • The symptoms show fear and avoidance response to a point of disgust and repellence.
  • Treatment options include exposure therapy and practicing relaxation exercises with positive visual imagery.

Do you feel yucky looking at a honeycomb, coral, strawberries, and clusters of pomegranate seeds? Does a closely packed pattern with small holes make you uncomfortable?

Is it the disgust or fear that causes the repulsion? If the sight of holes makes you fearful, uneasy, or terrified; you may be suffering from a lesser-known phobia called Trypophobia.

The condition causes extreme fear, nervousness, and tension in people who are not comfortable seeing irregular patterns of holes with less special frequency. 

The closely packed holes look bizarre and cause intense discomfort, if not fear. They react strongly to the visuals by avoiding them or showing a mixed feeling of dread and abhorrence.

In this article, we will discuss the symptoms, causal factors, and effective treatment plans of this uncommon phobia.

Continue reading for more…..

Trypophobia Infographic

Trypophobia - Definition, Signs & Treatment Plan
Trypophobia – Definition, Signs & Treatment Plan

What is Trypophobia?

Trypophobia refers to a type of specific phobia that causes an irrational and extreme fear for closely-packed holes, clusters, or patterns of small cavities, bumps, circles of small spaces, round dots, etc.

In DSM-5, (Diagnostic and Statistical Manual of Mental Disorders, edition-5), Trypophobia is not considered a distinct mental health problem until and unless the condition interferes with everyday life.

The term trypophobia became widely popular in 2015 when a web forum first started doing a lot of talk shows and research about this aversion response. 

It comes from a combination of two Greek words, ‘Trypa’ meaning punching and drilling holes, and ‘Phobos’ means fear. Thus, together trypophobia means “fear of holes”. 

Since then, many people started speaking about their discomfort about seeing clusters of holes. But, whether it is a typical phobia or a society-induced clinical condition needs to be understood with further research.

Trypophobia refers to a mental health condition where a person develops aversion and disgust for clusters of small holes, patterns, or shapes with small open spaces, irregular holes, closely-packed circles, bumps, etc. 

The disease is real and the sufferer feels an irrational fear for holes, though there is no immediate real threat.

Some people with trypophobia show hatred and disgust towards the small holes, but there are others who show fear response with several physical reactions and emotional problems.

If you are suffering from trypophobia, you might be extremely uncomfortable seeing and eating a custard apple, pomegranate, or strawberries. 

These seedy fruits have bumps, and holes in the outer covering or inner chambers that cause intense disgust and disrelish for them.

Trypophobia can cause many weird symptoms with varying degrees. The intensity of the fear response depends upon the severity of the illness. 

Some people get uncomfortable seeing the holes while others may have discomfort with thoughts of creeping-crawling insects coming out of those small holes. 

In some cases, the fear response causes alarm and a sense of terror; and the person can even experience a full-blown panic attack.

People with trypophobia can even feel fearful in seeing photos and images of holes. It is a weird kind of fear and aversion that is caused by natural shapes and holes existing in nature.

The fear feels queasy when the person sees a surface where many small holes are tightly-packed and patterned one after the other.

The typical example is the shape of a honeycomb (the hexagonal shape of the bee cells evokes disgust and aversion).

Trypophobia symptoms

People with trypophobia suffer from shaking and sickness when they see patterns of small clustered holes.

The fear is harmless but the suffering of the person is real and causes a lot of emotional discomforts.

The American Psychiatric Association does not recognize trypophobia as a typical specific phobia. It is more of disgust than the fear response that makes the person feel uncomfortable.

The general symptoms of trypophobia look like an instant panic reaction causing aversion and avoidance of holes, or patterns with clusters of holes.

Some of the most common symptoms of trypophobia are –

  • Shaking and trembling
  • Nausea and vomiting
  • A fast beating heart
  • Skin itching
  • Goosebumps
  • Crawling sensation on skin
  • Shortness of breath
  • Yuck feeling
  • Excessive sweating
  • Feelings of aversion
  • Fear of encountering the small holes again
  • Chills or hot flushes
  • Choking sensation in the throat
  • Intense terror that can be seen from outside
  • Skin becoming pale or too red
  • A state of fright or flight response
  • Mental uneasiness
  • A helpless feeling while seeing the spores or holes

Common triggers of trypophobia symptoms

Trypophobia is a visual discomfort that causes immense disgust and aversion. People with this mental health condition feel sick and tired after getting exposed to such disturbing sights.

Some people with trypophobia may complain of mild discomfort whereas there are others who can feel some deep agony and fear after seeing several naturally occurring things around them with big or small holes.

Some of the common triggers that can kick off trypophobia symptoms are as follows:

  • Seedy fruits such as pomegranates or strawberries
  • Natural sponges
  • Honeycomb
  • Lotus pods
  • Hair follicles
  • Soap bubbles
  • Foam
  • Poppy seed bagels
  • Patterns of small clusters on the skin of animals such as snakes or poisoned dart frogs
  • Pores on skin
  • Sunflower 
  • Seed pods
  • Clusters of eyes as in spiders
  • Corals
  • Patterns of clustered holes in man-made objects
  • Spotted insects
  • Swiss cheese
  • Bumps and lesions on skin caused by some skin infection
  • Several graphic patterns with small pores, or big holes that are closely-knit

Most patients suffering from trypophobia experience negative emotions that accelerate the functioning of the autonomic nervous system that in turn can increase the fear response. It also brings a host of physical symptoms that can sometimes qualify for specific phobias.

Is trypophobia real – a fear or disgust or maybe both

A research study suggests that trypophobia is far more common than what has been expected. It showed that 16% of people suffer from trypophobia which is actually considered a strange and weird type of fear. 

The stimuli are small dark clusters of tiny holes or open spaces that are not threatening but cause a lot of fear in the person. 

If you are suffering from trypophobia, you must have noticed an immediate reaction to the sight of these irregular patterns of holes.

The sudden disgust causes nausea and you may feel like throwing up immediately.

Though the condition does not meet the clinical diagnosis for specific phobias, the fear is real and intense. It might take you longer than expected to come out of the situation.

You may not show a phobic reaction to all the triggers mentioned earlier in the article, but many of them do cause instant aversion in you.

This fear is lesser-known because many people may live with this disgust feeling for holes throughout their lives. You may feel haunted by the thoughts of meeting another hole next time. 

There is much debate in the clinical circle about whether the fear is real or just a disgusting feeling that you may have to see the compact circles or small clusters of infinite holes. 

The visual imagery is not at all soothing for you. Thus, it is real. And maybe trypophobia is a mixture of both fear and disgust.

Trypophobia prevalence rates (How common is the disorder?)

Here we have compiled some of the research findings in psychological science that suggest that trypophobia is real. The person can show instant physical symptoms, with bouts of panic attacks and fear.

  • A case study done on a 12-year-old girl showed that she had immense fear for some naturally occurring patterns of holes from early childhood. The fear caused anxiety, aversion, disgust, nausea, and general physical sickness whenever she comes across such clustered holes.
  • 40 million American adults manage trypophobia symptoms that accounts for 16% of the population.
  • One study’s findings have shown the reaction of trypophobia is a disgusting feeling that comes from seeing decomposing items, soars, scars, skin bumps, etc. This leads to avoidance response towards the stimuli that cause emotional discomfort.
  • A study done in 2013 examined the visual images of various types of clustered holes. The findings suggested that people who do not feel anything while seeing a honeycomb were totally different in their responses than those who suffer from trypophobia. The target group (sufferers) showed fear, avoidance response, and panic symptoms by seeing the honeycomb image. They subconsciously associated it with dangerous insects such as bees, or rattlesnakes whose skin patterns match that of a honeycomb.
  • A 2017 study showed that many patients with fear of holes also have symptoms of generalized anxiety disorder and depression. This means that co-morbid psychiatric conditions can give rise to various forms of weird phobias.
  • 25% of people with trypophobia also have one family member suffering from this disgust response.
  • Trypophobia is more common amongst women than men.
  • A research study done in 2016 suggested that people with social anxiety may have a higher risk of having discomfort with holes. They may associate the holes with the eyes of other people looking at them. Seeing closely-packed holes can cause fear of meeting and interacting with people.

What causes Trypophobia?

The exact cause of trypophobia is unknown. Some theories say that you can have an aversion towards clusters of small holes because you might associate with some danger.

In most cases, the danger is perceived rather than real. 

You may think insects coming out of the holes, or maybe the texture and shape of the hole appear disturbing. Sometimes, patients may associate the fear with snakes coming out of the holes.

The holes may remind you of skin bumps or rashes that were painful and thus you do not want to remember it at all.

Trypophobia may be caused by an unconscious reflex reaction that may occur as a survival mechanism to protect oneself from danger and threat.

For example, the pictures of patterned snakes, eyes of tarantulas, dotted insects can give rise to trypophobia.

You may associate the holes or patterns of small open spaces with the fear of being bitten or harmed by the reptile. 

Research findings have found that the fear or disgust that the person shows towards the holes is an adaptive response to alert them of some dangerous creatures or infections.

Scientific study 1

On the flip side, researchers have also claimed that trypophobia is a natural response to certain visual stimuli that looks odd and bizarre. Thus, it is not a phobia but an aversion to some specific objects that don’t look good.

One of the first and earliest scientific researches done on trypophobia was in the year 2015. It was conducted by Arnold Wilkins and Geoff Cole in England.

They found that certain poisonous animals such as snakes, spiders, toads, alligators have repetitive patterns or small clusters of holes on their bodies. 

People are generally scared of these animals because they pose a threat to life. In some cases, people with trypophobia showed an aversion to holes as an evolutionary response because the holes reminded them of some dangerous snake or wild creature coming out of the dugout space. 

Scientific study 2

In another study, scientists have found that trypophobia is caused by an exaggerated response to protect oneself from nasty skin diseases such as measles, chickenpox that cause rashes and bumps on the skin.

The findings were given by Tom Kupfer and An T.D. Le, in January 2017 who was studying trypophobia causes at the University of Kent. The article was later published in the Journal of ‘Cognition and Emotion’

How is trypophobia diagnosed?

Since APA (American Psychiatric Association) does not consider trypophobia as a specific phobia, there are no specific criteria for its diagnosis. 

Thus, in most cases, the doctor analyzes the patient’s condition by a detailed mental status examination.

If you are suffering from fear of holes, your doctor will ask you several questions to get an idea of your current mental health condition.

  • What are your symptoms? 
  • Describe the specific types and nature of holes that set you an alarm?
  • What are your physical reactions to sudden exposure to holes?
  • Do you avoid the situation or try to cope up with the disgust?
  • What is the specific thing that causes the fear?
  • Have you ever taken any treatment before?
  • From when are you suffering?
  • How does the condition affect your normal life?

After this initial assessment, your therapist might plan a treatment plan for you. Usually, the treatment plan is discussed in detail so that you know what to expect from your therapy sessions.

At times, therapists also use trypophobia tests with images of holes of various types. The pictures will be shown to you and they will record your time of exposure and associated feelings.

Your ability to go on seeing the disturbing visuals will determine the intensity of the illness. 

There are online self-administered tests found online that can be used with caution. One such test is Implicit Trypophobia Measure 0.5a. The images consist of pictures of holes of various shapes and sizes. Just remember, that it includes disturbing photos that may not be comfortable for you. Be cautious before using the test.

Complications of Trypophobia

If you live with trypophobia for a long time, you may suffer from a host of other illnesses that may worsen your quality of life in the long run.

  • Depression
  • Helplessness
  • Mood swings
  • Irritability
  • Avoidance response of places or things that you think might be having holes in them
  • Insomnia
  • Digestive issues
  • Feeling sick and tired
  • Constant negative thoughts about your next encounter with ‘holes’
  • Stress and conflicts at home due to this condition
  • Increased Blood pressure
  • Poor physical health due to loss of appetite
  • Frequent panic attacks that may leave you tired and exhausted

Trypophobia treatment

Like many other specific phobias such as acrophobia, claustrophobia, or arachnophobia; trypophobia can also be treated with psychotherapy and medication.

The choice of treatment is usually decided by the therapist by understanding the condition of the patient in detail. 

Cognitive behavior therapy

In CBT sessions, the patients are guided by the therapist to challenge their disturbing and irrational thoughts about holes and clustered patterns.

It is a talking therapy that helps to change your perceptions and immediate reactions to the feared stimuli.

CBT is an effective treatment for trypophobia because it helps you to share your deepest fears with the therapist and overcome them completely.

It is usually carried out in a residential treatment facility for phobias in the therapist’s clinic.

The aim of CBT is to alter mind states. It helps to recognize the causes behind your fears. When you know the exact reason for your irrational thoughts and fears, you’ll be able to cope with them in a better way.

Exposure therapy

Trypophobia can be treated with exposure therapy. In this method, your doctor or therapist will expose you to the visuals of various holes and clustered patterns with hollows.

Initially, a mild stimulus will be shown to you. Your responses will be recorded.

After you are used to a mild stimulus, you will be shown more complicated clusters of closely-packed holes and the process will continue till the time the intensity of symptoms decreases. 

Exposure therapy is done gradually and slowly so that you may get accustomed to the feared stimuli slowly and steadily.

Facing the triggers in such a way helps you to understand that your fear is irrational and there is no actual threat present in these holes.


If the anxiety symptoms are getting tough to manage, the therapist may use medications along with therapy. 

This is a short-term treatment that can help you lower your anxiety levels.

Several anti-anxiety drugs and beta-blockers are advised by doctors to help you cope with the aftermath of the panic attack that you may have suffered.

Relaxation techniques

There are various forms of relaxation exercises that you can use in your daily life to manage symptoms and cope up with your fear and disgust responses.

Some of the common techniques used are deep breathing exercises, progressive muscle relaxation, and visualization. 

In this method, you will be asked to think of soothing landscapes or picturesque scenarios such as flower gardens, sunset, walking along a sea beach, and seeing the sun rising from the horizon.

Whenever anxiety starts to set in, you will have to distract yourself by visualizing scenic beauties that can help in reducing the fear response. 

Moreover simple distraction techniques such as looking somewhere else, talking to someone, or finding something else to think and talk about can lower your chances of experiencing panic attacks.

How to get rid of Trypophobia? (Self-help tips)

Along with psychotherapy, you can use some self-help techniques to reduce your fear response and improve your quality of life. 

  • Make exercise and mediation a part of your daily life.
  • You can take a nature walk in soothing environments to foster positive thinking.
  • Practice mindfulness and be present in your moments. Stop thinking about your past experiences with clustered holes and repetitive patterns. It will trigger more disgust.
  • Seek support from people who love and care for you. Talk to them about your discomfort and get better insights about how to cope up with the disgust.
  • Take out some time for your hobbies and favorite pastimes.
  • Spend time with your family and friends.
  • Cuddle your pet. They are indeed good stress busters.
  • Eat balanced food and avoid caffeine, smoking, drug intake. It might make your condition worse.
  • Practice good sleeping habits and see that you wake up fresh every day. In case you are having sleep issues because of trypophobia, talk to your doctor for further advice. 
  • Join a support group of people suffering from trypophobia. Similar sufferers are a good support in times of distress.

Trypophobia Statistics

Trypophobia Statistics
Trypophobia Statistics (Sources – WebMD, The Atlantic, Bustle)

Summing Up from ‘ThePleasantMind’

Living with trypophobia is not easy because the suffering that the person goes through is real. It causes feelings of revulsion beyond doubt.

Any bizarre overreaction to stimulus or situations causes mental tension and nervousness. Neither can the symptoms be ignored nor can be minimized. 

Maybe seeking help from a mental health professional is the best way to help yourself in times of extreme stress. 

They will help you to manage symptoms, learn coping skills, and prevent the reoccurrence of disturbing visual scenes of compact holes when the real stimulus is not present.

Timely treatment may lead to complete recovery.

Article Sources


Are you interested to know more about ‘Germaphobia’ then click here?

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