Trypophobia: When Clustered Holes Trigger Fear and Disgust

Trypophobia: Understanding a Fear Amplified By Digital Media

A beehive, a lotus seed pod, and the pattern of bubbles in a coffee. What connects these seemingly unrelated objects?

Look closer and you’ll notice they all feature irregular patterns or clusters of holes. For many people, these images are harmless or even pleasant. But for those with trypophobia, these clustered patterns can trigger intense feelings of discomfort, disgust, or fear.

Trypophobia is a specific phobia, a type of anxiety disorder. People with this condition experience strong aversion to clusters of small holes. The term combines the Greek words “trypta” (hole) and “phobos” (fear), literally meaning “fear of holes.”

If you’re experiencing this condition, there are effective ways to manage and reduce symptoms over time. This article explores the scientific understanding of trypophobia, its symptoms and potential causes, and how therapy with a licensed clinical social worker can help in treatment.

What are the symptoms of trypophobia?

People with trypophobia typically avoid the visual triggers of their symptoms: images or objects featuring clustered holes found on certain foods, plants, and animals.

When a person with trypophobia encounters these triggers, they may experience:

• Strong feelings of fear or disgust
• Panic attacks
• Excessive sweating
• Rapid heartbeat
• Sensations of nausea or itchiness
• Goosebumps
• Body tremors
• Nausea and vomiting

Each person’s experience varies in intensity and manifestation. Some people may be unaware of their aversion until they encounter the source of their phobia. Because the trigger is usually identifiable, trypophobia is generally classified as a specific phobia.

If you’ve been diagnosed with a more complex phobic disorder, such as agoraphobia, panic disorder, or social phobia, daily life may feel more challenging as potential triggers can appear unexpectedly in various situations.

How does digital media intensify trypophobia symptoms?

While digital media has increased awareness about trypophobia, it can also worsen symptoms for those affected by this condition.

Across social media platforms and websites, images featuring clustered holes—particularly holes superimposed on human skin—can cause extreme distress for users with trypophobia.

Research indicates that the intensity of discomfort depends on the relationship between the holes and the background image. When human skin forms the background, it may evoke associations with skin diseases, potentially causing greater distress.

In 2017, trypophobic images gained mainstream attention when the TV show American Horror Story featured them in promotional materials. The show included a character with trypophobia and used triggering advertisements to promote the episode. Many viewers reported experiencing fear, disgust, and physical discomfort in response to these ads, criticizing the show for its insensitivity.

While unexpected encounters with triggering images online can be distressing, digital platforms also provide spaces where people with trypophobia can connect over their shared experiences. Online communities for people with trypophobia first emerged in 2005 and continue to provide valuable support today.

Causes of trypophobia

How does someone develop such a strong aversion to patterns with holes? While research continues, scientists have proposed several theories:

• Evolutionary origins: Trypophobia may represent an intensified reaction to dangerous animals and diseases. Some researchers suggest humans developed unconscious aversions to patterns associated with poisonous animals like snakes and certain insects. The feelings of disgust or fear may be an evolutionary, adaptive response.
• Natural human response: To some degree, many people naturally respond with discomfort to patterns associated with disease and decay. Some scientists argue that trypophobic reactions represent natural human responses rather than a distinct phobia.
• Co-occurring mental health conditions: People experiencing trypophobic reactions may have other diagnoses, such as generalized anxiety disorder or obsessive-compulsive disorder (OCD), which may intensify their fear, disgust, and vulnerability to panic attacks.

Studies suggest that individuals with certain psychological traits—such as visual discomfort, heightened disgust sensitivity, and strong empathic tendencies—are more likely to experience trypophobia. For many, a combination of evolutionary, environmental, and personality factors likely interact to produce trypophobic symptoms.

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 have substantial supporting evidence yet. However, researchers have identified multiple aspects of trypophobia, and a symptom scale has been developed and validated for studying this condition.

How do health professionals diagnose trypophobia?

While trypophobia isn’t formally recognized in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), some healthcare providers diagnose it as a specific phobia, depending on symptom severity. A specific phobia involves a marked and persistent fear of a specific object, activity, or situation—in this case, patterns with holes.

Some individuals with trypophobia may also exhibit symptoms of generalized anxiety disorder, major depressive disorder, or OCD. In certain cases, determining whether symptoms stem from one of these DSM-5 listed conditions or from a specific phobia can be challenging. A 2017 study found that participants with trypophobia experienced more disgust than fear when viewing clusters of holes; however, they more frequently met DSM-5 criteria for specific phobia than for OCD.

Researchers continue to investigate whether trypophobia should be classified as a phobia, anxiety disorder, or something distinct. Generally, healthcare providers work individually with clients to create treatment plans addressing their specific symptoms.

Validating trypophobia as a legitimate condition

Because trypophobia isn’t listed in the current DSM, some question whether it’s a “real” condition. You may have encountered discussions about trypophobia on social media or websites, contributing to both awareness and occasional controversy.

Research indicates that trypophobia is indeed a legitimate condition, though mental health professionals may need to refine diagnostic criteria to accurately reflect its symptoms. Most people with this condition experience intense disgust rather than fear as the primary symptom, making it difficult to categorize trypophobia as a typical specific phobia.

Studies suggest that trypophobia often runs in families and frequently occurs alongside other psychiatric conditions, particularly major depressive disorder and generalized anxiety disorder. Because this condition can cause significant distress, many researchers advocate for further study and diagnostic clarity to enable more accurate and compassionate treatment.

Treatments for trypophobia

Although trypophobia isn’t officially recognized as a diagnosable condition, several effective treatments can help people manage feelings of fear, disgust, and other symptoms triggered by hole patterns. Common treatment approaches include:

• Lifestyle modifications, including self-care practices, balanced nutrition, and regular physical activity to better manage emotional responses to everyday stressors.
• Exposure therapy, involving gradual, controlled exposure to distressing stimuli—in this case, images of holes or clusters—under the guidance of a trained mental health professional.
• Support groups, both online and in-person, where participants develop coping skills and connect with others sharing similar experiences.
• Talk therapy with a licensed clinical social worker or other qualified mental health professional.
• Cognitive behavioral therapy techniques to identify and challenge unhelpful thought patterns and behaviors, promoting positive change.

If you believe you have trypophobia or regularly experience intense aversion to hole patterns, therapy can be an excellent starting point. Many find it beneficial to discuss their experiences with a licensed mental health professional who can provide compassionate support and evidence-based coping strategies.

Telehealth therapy can help

While some prefer face-to-face counseling, telehealth therapy offers a convenient and equally effective option for many clients, including those with trypophobia and other specific phobias. Through ReachLink’s secure platform, you can connect with a licensed clinical social worker via video sessions from your home or any comfortable location. This flexibility can make therapy more accessible for people living with phobias and anxiety disorders. Many ReachLink therapists have extensive experience working with clients managing phobias, anxiety disorders, and related conditions.

While research specifically on telehealth treatments for trypophobia is limited, studies indicate that many people with this condition benefit from online support groups where they can connect with others experiencing similar symptoms. A 2019 study found that online exposure therapy effectively treated people with fear of air travel. Researchers concluded that internet-based exposure therapy may serve as a valuable alternative to in-person treatment, offering a less intimidating way for participants to confront their fears.

Takeaway

Living with trypophobia can make it feel impossible to avoid triggers that cause fear or disgust. However, with therapy, social support, and consistent self-care practices, people with trypophobia can develop effective coping strategies for navigating daily life, both offline and online. A licensed clinical social worker can be an essential part of your journey. With compassion, expertise, and professionalism, your therapist can provide the tools and support you need to face and overcome your fears.