Trypanophobia: how to overcome a fear of needles

Many people don’t love going to the doctor, but if you find yourself breaking out into a sweat at the mere thought of having your blood drawn or getting the flu or COVID-19 shot, you may have trypanophobia.

Trypanophobia, also known as needle phobia, is an intense fear of medical procedures involving needles or injections. While it may seem like many people don’t like needles, fearing them so much that you avoid seeking medical treatment can be dangerous for your health. 

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Trypanophobia is an extreme fear of medical procedures involving needles.

Although needle phobia has likely existed since the advent of so-called hypodermic needles (thin, hollow tubes with a sharp tip), the American Psychiatric Association didn’t categorize it as a phobia until 1994 (Raghavendra, 2010). 

Trypanophobia is a type of anxiety disorder known as a specific phobia. There are five classifications of specific phobias: animal, natural environment, blood-injection-injury, situational, and other. Trypanophobia falls under the blood-injection-injury type. 

Phobias cause unwarranted or excessive reactions to specific triggers. In the case of trypanophobia, being near hypodermic needles, anticipating getting vaccinated, or having your blood drawn causes an extreme fear response (American Psychiatric Association, 2013). 

To be classified as a phobia, the fear of needles has to be so excessive that it interferes with your quality of life. This could mean avoiding doctor’s appointments, missing vaccinations, skipping blood tests, enduring medical with symptoms of stress or panic, or being unable to receive care because you faint. One study found that 16% of adults avoid annual flu vaccinations because of a fear of needles, and 20% avoided tetanus shots (McLenon, 2019).

Many of those with fear of needles have close family members with the condition and have inherited a so-called vasovagal reflex––a drop in heart rate and blood pressure that causes fainting, triggered by the use of needles.

If you have this uncomfortable reflex, fainting caused by needles teaches your brain to fear needle punctures in the future. In that case, being worried that you will faint again during a doctor's visit tends to explain the fear of needles rather than a fear of the actual needles (Ritz, 2010; Hamilton, 1995). Approximately 50% of people with needle phobia have vasovagal trypanophobia (Raghavendra, 2010).

Others develop needle phobia following painful medical events or witnessing loved ones experience medical trauma. This is known as associative trypanophobia and affects 30% of people with needle phobia.

Other types of needle phobia include restrictive trypanophobia, a fear of being restrained while needles are used, and hyperalgesic trypanophobia, increased sensitivity to pain that leads to a fear of injections. (Raghavendra, 2010). 

Mental health professionals diagnose trypanophobia using the American Psychiatric Association’s diagnostic criteria for specific phobia.

Your fear of needles must be severe enough to cause anxiety symptoms such as panic attacks, increased heart rate, increased blood pressure, sweating, shaking, throat tightness, and shortness of breath.

People with vasovagal trypanophobia experience low blood pressure, low heart rate, dizziness, nausea, and fainting. While symptoms of vasovagal syncope typically resolve within two hours, the stress it puts on the body can be life-threatening for those with pre-existing heart conditions (Sokolowski, 2010). 

Specific phobias often exist alongside other anxiety disorders such as agoraphobia, social phobia, generalized anxiety disorder, as well as major depressive disorder, bipolar disorder, and alcohol dependence.

Having one phobia also makes you more likely to have other phobias (Kessler, 2005). Those with needle phobia also tend to develop iatrophobia, an irrational fear of doctors (Raghavendra, 2010).

One of the most effective phobia treatments is cognitive behavioral therapy (CBT) with exposure (Wolitzky-Taylor, 2008; Thng, 2020). CBT with exposure teaches you techniques designed to help improve coping skills while slowly reintroducing you to your triggers. 

Your therapist may ask you to imagine or visualize needles before utilizing them in a medical setting.

Treatment generally includes five to eight 90-minute sessions or one 2-3 hout session. The benefits of exposure therapy tend to last for at least one year, and you can maintain them through self-exposure (Koch, 2004). 

Medications such as benzodiazepines are another option for treating trypanophobia and other phobias, especially when talk therapy doesn’t work for you. Benzodiazepines are prescription drugs that make you feel calm. Those drugs kick in quickly, so your healthcare provider may prescribe them before medical appointments involving needles. 

Benzodiazepines are typically only used short-term due to their sedative nature and risk of addiction, dependence, and withdrawal after long-term treatment. Other medications, including topical anesthetics such as lidocaine, can also be used to numb the skin so that the needle isn’t felt as much (Sokolowski, 2010).

It’s essential to seek out treatment for trypanophobia for both your mental and physical health. Skipping a doctor’s appointment here and there to avoid needles might not seem like a big deal, but it could have negative effects in the long run.

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Current version

August 03, 2021

Written by

Jordan Davidson

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.