Trypophobia (fear of Holes): Causes, Symptoms and Treatment

Have you ever felt deeply uncomfortable or even repulsed when looking at images of clustered holes or repetitive patterns, like a lotus seed pod or honeycomb? If so, you may have experienced a reaction related to trypophobia, an often misunderstood condition that affects a surprising number of people. Though it’s not officially recognized as a distinct mental disorder in diagnostic manuals like the DSM-5, trypophobia has gained growing attention in psychology and neuroscience due to its intense and visceral effects.

The fear or aversion to holes may sound strange to some, but to those affected, it’s far from trivial. The emotional and physical reaction can range from mild discomfort to extreme anxiety, nausea, or even panic attacks. But what causes this unusual fear? Is it related to evolution, learned behavior, or something else entirely?

In this article, we explore the science and psychology behind trypophobia, including its possible causes, symptoms, and the most effective treatment strategies. Whether you suspect you may have this fear or are simply curious about how the brain reacts to patterns, this guide offers a comprehensive look into one of the most intriguing phobias of the modern age.

What is Trypophobia?

Trypophobia is the intense discomfort or fear triggered by viewing clusters of small holes or repetitive patterns, particularly when these are irregular, organic, or appear in natural formations. People with trypophobia may experience strong negative emotional responses to visuals such as:

• Honeycombs
• Lotus seed pods
• Coral
• Bubble clusters
• Pores or skin conditions
• Sponges
• Mold formations

Unlike typical fears that revolve around threats like animals or situations, trypophobia is often described more as revulsion than sheer terror. However, the physical symptoms can still mimic those of anxiety disorders.

Importantly, trypophobia is not yet formally classified as a phobia in the clinical sense. The term was coined in 2005 by internet users, and while growing research supports its validity, it remains an informal diagnosis. Despite this, the condition is very real for those who experience it.

The context: specific phobias

The DSM-5 manual includes several types of phobias within the category “Specific phobias”: panic of animals, the natural environment, such as phobia of storms, situational phobias (for example claustrophobia) and fear of blood, wounds and injections. Agoraphobia and social anxiety or phobia have their own sections in the DSM due to their frequency and severity.

Although specific phobias are the most common anxiety disorder, they are also the least disabling, since many times the person can easily avoid the phobic stimulus or rarely encounters it in its usual context. Extreme fear of snakes, for example, does not usually affect those who live in large cities.

Among the specific phobias we find some very peculiar ones, such as the fear of money or the fear of long words, called with some malice “hipopotomonstrosesquipedaliophobia” (we already mentioned these and other curious phobias in this article).

However, it must be taken into account that in the case of trypophobia what generates discomfort is not a specific living being or object, but a type of texture that can appear on practically all types of surfaces.

This texture is usually perceived through the visual system, and generates a response of strong aversion and anxiety that is irrational. However, the fact that the person is aware that the reaction is irrational does not make it dissipate.

Common Triggers of Trypophobia

People with trypophobia often report discomfort when looking at:

• Honeycombs
• Lotus seed pods
• Coral formations
• Sponges
• Bubble formations
• Insect eyes
• Skin diseases or rashes that create circular patterns
• Certain foods, like strawberries or aerated chocolate

The reaction varies among individuals. Some may feel mild discomfort, while others experience intense fear or even panic attacks.

Causes of Trypophobia

The exact cause of trypophobia is still debated, but researchers propose several theories:

1. Evolutionary Theory

Some scientists believe that trypophobia may have evolutionary roots. Clusters of holes resemble dangerous or poisonous organisms found in nature, such as:

• Venomous animals (e.g., snakes, frogs, or insects with specific skin patterns).
• Skin diseases (e.g., smallpox, measles, infections).
• Decaying matter, which could be associated with contamination or disease.

This suggests that the brain subconsciously associates these patterns with danger, triggering an instinctual aversion.

2. Psychological Conditioning

Another theory suggests that past negative experiences may create an aversion to hole-like patterns. If someone associates these images with something unpleasant, their brain learns to respond with fear or disgust.

3. Neurological Processing and Visual Perception

Studies indicate that trypophobia may be linked to the way the brain processes visual stimuli. The human brain is wired to recognize high-contrast patterns, which can sometimes create a sense of discomfort or unease.

4. Cultural and Social Influence

Some people develop trypophobia after seeing disturbing images online or hearing others talk about it. This suggests that social conditioning and exposure may also contribute to the development of the fear.

Geoff Cole and Arnold Wilkins (2013), psychologists at the University of Essex, found in two studies that approximately 15% of participants appeared to be sensitive to trypophobic images, with this percentage being slightly higher in women than in men.

The authors attribute trypophobia to human evolution: the rejection of images similar to trypophobic ones would have been useful to us to reject poisonous animals like different types of snakes, scorpions and spiders that have repetitive patterns on their bodies.

Likewise, trypophobic reactions could have been useful for avoid contaminants such as those that could be found in mold, in open wounds or in corpses riddled with maggots.

Cole and Wilkins’ explanation is linked to Martin Seligman’s (1971) concept of biological preparation, best known for the theory of learned helplessness with which he explained depression.

According to Seligman, throughout evolution living beings have not only adapted physically but also we have inherited predispositions to associate certain events because they increased the chances of survival of our ancestors. For example, people would be especially prepared to associate danger with darkness or insects. The irrationality of phobias would be explained because they have a biological, not cognitive, origin.

Alternative explanations for this irrational anxiety

Other experts offer very different hypotheses about trypophobia. In an interview with NPR, anxiety psychiatrist Carol Matthews of the University of California said that, although any object is susceptible to causing pathological fear, possibly the case of trypophobia is due more to suggestion.

According to Matthews, people who read about trypophobia are influenced by others who say they have felt anxious reactions when seeing the same images and pay attention to bodily sensations that their minds would otherwise filter out or ignore.

If you ask us if an image makes us feel disgusted or itchy we are more likely to feel those sensations. What if they had not told us anything; This is known as the “priming effect.”

Even if we feel genuine disgust or anxiety when seeing trypophobic images, if they are not intense or frequent enough to interfere with our lives, we could not consider that we have a “phobia of holes.” It is important to keep this in mind, because for fear to be considered a phobia (pathological fear). It is necessary that it significantly harms the person who suffers from it.

Symptoms of Trypophobia

The intensity and nature of symptoms vary widely among individuals. For some, it may simply be an uncomfortable sensation or urge to look away, while others might experience full-blown physical and emotional reactions.

Common symptoms include:

• Intense discomfort or aversion when viewing hole clusters
• Goosebumps or shivers
• Itching or skin crawling sensations
• Nausea or vomiting
• Sweating or chills
• Panic attacks or rapid heartbeat
• Feelings of disgust, fear, or anxiety

Some individuals report intrusive thoughts or nightmares after seeing certain images. Others may actively avoid places, objects, or materials associated with triggering visuals, which can interfere with daily life or social functioning.

Some people with trypophobia describe extreme reactions similar to the physiological symptoms of panic attacks, such as tremors, tachycardia, nausea, or difficulty breathing. They may also experience a headache and dermatological symptoms, such as itching and goosebumps. Of course, these symptoms also make the person try to get away from the phobic stimulus, either by looking away, covering their eyes, or retreating to another place.

Unfortunately, the discomfort does not go away immediately, since the memory of the image continues to remain “marked” in consciousness, and this continues to fuel the appearance of the different symptoms (although as time passes they weaken until the anxiety crisis passes completely).

This change in the pattern of activity of the nervous system of people with trypophobia usually appears when viewing images with color patterns reminiscent of a surface full of holes very close to each other almost forming a mosaic of cracks. The contrast between the surface of these bodies and the darkness that indicates the degree of depth of the holes is usually the property of the image that has the most power to cause discomfort.

Let’s now see a classification of the symptoms of trypophobia, distinguishing between its different types. Of course, normally not all of them occur at the same time, but only some of them, and in different degrees of intensity. Cases in which they are very extreme are rare; It is normal to notice significant discomfort without falling into a panic attack.

Physiological symptoms

Among the psychological symptoms that trypophobia produces we find tremors, increased heart rate and muscle tension, as well as dizziness and the feeling that while exposed to the stimulus it is difficult to breathe.

Psychological symptoms

Among these psychological factors we find entering a state of alert and catastrophic thoughts, such as that we are going to have a heart attack if we continue looking at what causes trypophobia.

Behavioral symptoms

The behavioral symptoms are, as in all specific phobias, the tendency to avoid all those situations in which we suspect that the phobic stimulus it will make us feel bad and once we are exposed to it, the tendency to run away.

How to overcome this phobia?

As we have seen, a certain degree of trypophobia is normal in most people; We seem to be “designed” to feel at least a little anxiety and discomfort when looking at surfaces full of holes very close together.

However, in the same way that individual differences in personal traits such as height or strength occur to different degrees among members of our species, in certain cases trypophobia It can become so intense that it becomes an impediment to leading a normal life. As always happens with psychological phenomena, there are different degrees of intensity.

In these cases, it is advisable to go to psychological therapy, which will allow you to learn dynamics to better manage the symptoms and make their impact lessened.

There are several ways to resolve the anxiety caused by this type of phobia. Some patients may require only one of these treatments, or several of them. In any case, they should be placed in the hands of a mental health professional, preferably specialized in this type of disorder.

1. Psychological treatment

Specific phobias are mainly treated through exposure procedures which consist of facing what causes us fear, anxiety or disgust and prompts us to escape. For exposure treatment to be effective, the person must pay attention to the phobic stimulus while being exposed to it, which will progressively reduce the discomfort it causes.

It is a procedure in which the person gradually gains autonomy, although especially during the first phases of this the role of the therapist is of utmost importance so that adequate progress is made.

Furthermore, it is important that to go through this process, the commitment of patients is very important, since they must strive to progress and face uncomfortable situations. Fortunately, motivation is also part of the role of therapists, who will also work on the way in which patients perceive the trypophobia they experience.

2. Pharmacological treatment

Pharmacological treatment has been shown to be ineffective in overcoming specific phobias; Exposure and other variants of psychological intervention focused on the interaction with phobic stimuli are fundamentally recommended. On the other hand, medication can be useful for agoraphobia and social phobia, particularly anxiolytics and antidepressants. Since the latter is not the case with trypophobia, psychotherapy concentrates most of the efforts, and only if the discomfort is extreme.

However, this does not mean that in certain specific cases healthcare personnel will avoid the use of drugs in all cases. There are some circumstances in which they can be useful, especially if trypophobia overlaps with other psychological disorders; In any case, the indication or not of medications is subject to the criteria of the professionals who supervise each patient individually.

3. Exposure therapy

People with trypophobia, whether severe or irrelevant, can make the discomfort caused by this phenomenon is reduced by exposing yourself to images trypophobic. Exposure can be applied gradually, that is, starting with images that provoke moderate anxiety or disgust and progressively increasing the intensity of the phobic stimuli.

The well-known YouTuber Pewdiepie recently recorded himself “curing his trypophobia” through a type of computer-assisted self-exposure. Some of the images he uses are microbes, human skin with holes in it, and worms coming out of a dog’s back. It doesn’t seem like you need to have trypophobia to feel disgust when seeing images like these.

Trypophobia in Pop Culture and the Internet

Social media and the internet have played a massive role in raising awareness—and sometimes unintentionally triggering—trypophobia. Since the term emerged online, thousands of users have shared their experiences and reactions to trypophobic images.

Unfortunately, viral posts or prank videos often intentionally use these triggers for shock value, which can be distressing for affected individuals. While this has helped validate the condition for many sufferers, it also raises ethical concerns around exposure and consent.

Still, the increasing online discussion has prompted researchers to take the condition more seriously and study its psychological underpinnings more rigorously.

Diagnosing Trypophobia

Because trypophobia is not officially listed in diagnostic manuals, there are no standardized clinical criteria for diagnosis. However, psychologists and mental health professionals can evaluate the condition based on:

• Patient self-report of symptoms and triggers
• Duration and severity of emotional or physical responses
• Impact on daily functioning, avoidance behavior, or mental health
• Exclusion of other phobias or conditions like OCD or PTSD

Some online tools and questionnaires, such as the Trypophobia Questionnaire developed in research settings, can help assess the likelihood of the condition.

If the fear or aversion significantly disrupts one’s life, it is recommended to seek professional evaluation, even in the absence of a formal diagnosis.

Treatment Options for Trypophobia

There is no one-size-fits-all treatment, but several therapeutic strategies have proven effective in reducing the severity of trypophobic responses.

Cognitive Behavioral Therapy (CBT)

CBT is a well-established treatment for phobias and anxiety-related disorders. For trypophobia, CBT may involve:

• Identifying and challenging irrational thoughts associated with triggers
• Exposure therapy, which gradually desensitizes the individual to the feared images
• Coping techniques such as relaxation exercises, deep breathing, or grounding strategies

By slowly increasing exposure to less intense images, individuals can often reduce their emotional response and regain a sense of control.

Mindfulness and Acceptance-Based Techniques

Mindfulness practices can help reduce the automatic reactivity associated with trypophobia. Learning to observe uncomfortable sensations without judgment allows the brain to reframe the experience as non-threatening.

Acceptance and Commitment Therapy (ACT), for instance, focuses on psychological flexibility, helping individuals to live with distressing thoughts without avoidance or suppression.

Eye Movement Desensitization and Reprocessing (EMDR)

Though more commonly used for trauma, EMDR has been applied in some cases of intense phobia. It helps reprocess distressing associations in a controlled setting, which may reduce the emotional impact of trypophobic images over time.

Medication

In severe cases, medication such as anti-anxiety drugs or antidepressants may be used temporarily, especially if the phobia coexists with conditions like generalized anxiety or panic disorder. Medication should always be prescribed and monitored by a licensed healthcare provider.

Self-Help Strategies

In addition to professional treatment, self-help strategies may be useful:

• Limiting exposure to triggering content, especially on social media
• Using content warnings or browser filters to avoid surprise imagery
• Practicing grounding techniques during exposure
• Engaging in relaxation exercises such as yoga, breathing, or progressive muscle relaxation
• Seeking support from online or in-person communities

Consistency and patience are key. For many, managing trypophobia becomes easier over time as their brain adapts and anxiety diminishes.

FAQs About Trypophobia (Fear of Holes)

What causes trypophobia?

The exact cause is unknown, but evolutionary fear responses, visual processing issues, and psychological conditioning are possible explanations.

Is trypophobia a real disorder?

Trypophobia is not officially recognized as a mental disorder in the DSM-5, but many people experience significant discomfort and anxiety when exposed to certain images.

How common is trypophobia?

Research suggests that up to 16% of people experience some level of discomfort when looking at clusters of holes. However, severity varies.

Can trypophobia be cured?

There is no specific “cure”, but treatments like Cognitive-Behavioral Therapy (CBT), exposure therapy, and relaxation techniques can help manage symptoms effectively.

Are there any self-help techniques for trypophobia?

Yes, self-help strategies include:

• Practicing deep breathing to reduce anxiety.
• Gradually exposing yourself to less intense images.
• Using positive affirmations to counter fear responses.
• Seeking professional therapy if symptoms are severe.

Why do hole patterns make some people uncomfortable?

Some theories suggest that these patterns resemble dangerous animals, skin diseases, or decay, triggering a subconscious fear response. The brain’s pattern recognition system may also play a role.

Can children develop trypophobia?

Yes, children can develop trypophobia, especially if they are exposed to disturbing images or learn the fear from others.

What are the most common objects that trigger trypophobia?

Common trypophobia triggers include lotus seed pods, honeycombs, coral, sponges, strawberries, and bubble formations.