Trypophobia: A Fear Made Worse By The Internet

A beehive, a seed pod, and sprinkles on top of a cupcake. What do all three objects have in common?

At first glance, they might seem unrelated – but look again! All of these objects have irregular patterns, bumps, or clustered holes. For some people, looking at these images may be neutral experiences or even invoke comforting childhood memories of spending time outdoors. But for people with trypophobia, seeing any of these holey patterns could cause feelings of fear and disgust.

If you or someone you know are experiencing this condition, there are several ways to manage and reduce the symptoms over time. Read on to learn more about the scientific understanding of trypophobia, its symptoms and potential causes, and how therapy can play a role in the treatment.

What are the symptoms of trypophobia?

People with trypophobia often avoid the most obvious visual causes of their symptoms: any images or objects with clustered holes which appear on certain foods, plants, and animals.

If a person with trypophobia encounters one of these images or objects, they may experience any of the following symptoms: 

• Intense feelings of fear or disgust

• Panic attacks

• Sweating

• Heart palpitations

• Feelings of nausea or itchiness

• Goosebumps 

• Body shakes

• Nausea and vomiting

Every person’s experience of this condition differs slightly. In some cases, people may be unaware of their fear or disgust until they come in contact with the source of their phobia. Because the source is usually clearly identifiable, trypophobia is generally regarded as a specific phobia (formerly called a “simple phobia”). 

If you’ve been diagnosed with a more complex phobic disorder, such as agoraphobia (a phobia of open or unfamiliar places), panic disorder, and social phobia, it may feel more challenging to navigate everyday situations, where potentially upsetting stimuli can emerge unexpectedly.

How does the internet worsen the symptoms of trypophobia?

While the internet has increased public awareness of trypophobia, it can also worsen the symptoms of people experiencing this condition. 

In various online communities, the widespread circulation of images with holey patterns – in particular, holes in background images of human skin – can cause extreme discomfort among internet users with trypophobia. 

Some research suggests that the strength of discomfort depends on the relationship between the holes and the background image. When human skin forms the background, it may remind viewers of skin diseases and cause greater distress.

In 2017, trypophobic images made their film debut in an episode of the TV show American Horror Story. The episode featured a character with trypophobia, and the show creators used trypophobic advertisements to promote the episode. Some viewers reported feelings of fear, disgust, and nausea in response to the ads and criticized the show for its insensitivity toward audience viewers with trypophobia. 

While unexpected encounters with holey images online or on television can upset people with trypophobia, the Internet also offers a space for online users to bond over their common aversion to these images. The first online groups for people with trypophobia emerged in 2005, and they continue to thrive today.

Causes of trypophobia

How does someone develop such an intense aversion to patterns with holes? Research is still underway, but scientists have suggested the following theories to explain trypophobia:

• Evolutionary causes: Trypophobia may be an intensified reaction to dangerous animals and diseases. Some researchers theorize that humans developed unconscious reflex reactions to poisonous animals with patterned or clustered textures, such as snakes and insects. Feeling disgusted or fearful of these patterns may be an evolutionary, adaptive response.

• Human nature: To some extent, many people display a natural response of disgust or fear to holey patterns, which are easily associated with disease and decay. Some scientists argue that trypophobic reactions are simply natural human responses rather than symptoms of a phobia.

• Other mental health conditions: Some people with trypophobic reactions may have co-existing diagnoses, such as generalized anxiety disorder or obsessive-compulsive disorder (OCD), that intensify their fear, disgust, and susceptibility to panic attacks.

Another study notes that people with certain psychological traits, such as visual discomfort, disgust sensitivity, and empathic traits, are more likely to experience trypophobia. For many people, it’s likely that a combination of evolutionary, environmental, and personality factors interact and lead to the symptoms of trypophobia.

According to “Trypophobia: What Do We Know So Far? A Case Report and Comprehensive Review of the Literature,” none of the current theories about this phobia are supported by substantial evidence yet. However, researchers have partially determined multiple aspects of trypophobia and a symptom scale has been developed and validated for the study of trypophobia.

How do health professionals diagnose trypophobia?

While trypophobia is not formally recognized by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), some doctors diagnose it as a specific phobia, depending on the severity of a person’s symptoms. True to its name, a specific phobia is characterized by a marked and persistent fear of a specific object, activity, or situation: in this case, holey patterns.

Some people with trypophobia may also show symptoms of generalized anxiety disorder, major depressive disorder, and OCD. In some cases, it may be difficult to determine whether a person’s symptoms stem from one of these conditions, all of which are listed in the DSM-5, or a specific phobia. One 2017 study of people with trypophobia found that the participants experienced more disgust than fear when confronted with clusters of holes; however, they were more likely to meet DSM-5 criteria for a specific phobia than for OCD.

Researchers are still working to determine whether trypophobia should be diagnosed as a phobia, anxiety disorder, or something else entirely. In general, doctors work one-on-one with patients and craft a treatment plan in response to their unique symptoms. 

Defending trypophobia as a real condition

Because trypophobia is not listed by the current edition of the Diagnostic and Statistical Manual of Mental Disorders, some argue it’s not a “real” or valid condition. You may have seen discussions of trypophobia on the Internet or in your social media feed, which add to the complexity and occasional controversy of this condition.

Ultimately, research indicates that trypophobia is a real and valid condition, but psychologists may need to modify the current diagnostic criteria to accurately reflect the symptoms of trypophobia. Most people with this condition experience intense disgust instead of fear as the main symptom, making it difficult to classify trypophobia as a specific phobia.

Research has found that trypophobia often runs in families and occurs alongside other psychiatric conditions, especially major depressive disorder and generalized anxiety disorder. Because this condition can cause significant distress, many researchers argue that it deserves further attention and diagnostic clarity, enabling more accurate and compassionate treatment. 

Treatments for trypophobia

Although trypophobia is not a diagnosable condition, several treatments can help people overcome feelings of fear, disgust, and other symptoms in response to holey or clustered patterns. Common treatment options include:

• Lifestyle modifications, including a self-care plan, healthy diet, and regular exercise to manage the emotional impact of everyday stressors.

• Exposure therapy, which involves regular exposure to the distressing stimuli – in this case, holes or clusters – under the guidance of a trained professional. 

• Support groups, both online and in-person, to develop coping skills and relationships with people with similar experiences.

• Talk therapy with a board-certified therapist.

• Cognitive behavioral therapy methods to help identify and challenge thought patterns and behaviors to promote positive change. 

If you suspect that you have trypophobia or you regularly experience an intense fear of holes, talk therapy can be an excellent starting point. Many people find it helpful to discuss their feelings with a licensed mental health professional who can offer compassionate support as well as research-backed coping strategies. 

Online therapy can help

Although some people prefer face-to-face counseling, online therapy is a convenient and equally effective option for many patients, including those with trypophobia and other specific phobias. Using an online platform like BetterHelp, you can connect with a therapist from a smartphone, tablet, or computer; from there, you can communicate via live phone, video, chat sessions, and messaging. This flexibility may make it easier for people living with phobias to attend treatment. Many BetterHelp therapists have years of experience working with people with phobias, anxiety disorders, and related conditions.

While research on online treatments for trypophobia is limited, studies indicate that many people with this condition benefit from online support groups for people with common symptoms. Another 2019 study found that online exposure therapy was effective in treating people with a phobia of air travel. The researchers found that Internet-based exposure therapy may be a useful alternative to in-person exposure, as it offers a less frightening way for participants to confront their fears.