Trypophobia: what triggers a fear of holes?

What if everyday things you came across––a honeycomb, a lotus flower, the pores of a sponge––filled you with an instant feeling of disgust?

This is the case for people with trypophobia or fear of holes. A fear of holes might seem like an odd thing, but it’s more common than you might think. Additionally, trypophobia support groups have raised awareness for the condition, making the medical world take notice. 

Let’s take a closer look at what trypophobia is, its triggers, and how to overcome it.

Ro

Improve and support your health from the comfort of home

Learn more

If we break down the word trypophobia, we get the words hole (trypo) and fear (phobia)––aka, fear of holes. But there's a little bit more to it than that. 

We’re not talking about black holes or big holes in the ground you could fall into. Trypophobia is triggered by geometric patterns and clusters of small holes. A common example is the alien-eyed look of a lotus flower seed head. 

Unlike other fear responses seen in those with specific phobias, such as coulrophobia (fear of clowns), most people with the condition report experiencing disgust when they see clusters of holes (Cole, 2013).  

Trypophobia triggers can include (Cole, 2013): 

• Cheese

• Bread

• Honeycomb

• Pomegranates

• Water condensation

• Soap bubbles

• Sponges

• Lesions seen with skin diseases

This is by no means an exhaustive list of all the things that can trigger trypophobia. While each is quite different, what they all have in common is repetitive patterns or clusters.

Clinicians don't know what the exact cause of trypophobia is, but here’s what the research says so far. 

One cause could be genetics. In one online survey, about a quarter of participants had an immediate family member who also reported experiencing trypophobia (Vlok-Barnard, 2017).

One interesting theory is that trypophobia is a product of human evolution. As we saw earlier, trypophobic triggers range from everyday household objects to exotic plants. When analyzed, the patterns and clusters in these objects possess similar spatial patterns and mathematical properties.

Similar features appear on poisonous animals like the blue-ringed octopus and poison dart frog. While it might be a stretch, in these cases, an aversion or disgust towards a dangerous animal could be life-saving (Cole, 2013). 

Symptoms of this phobia are unique in that they’re linked to feelings of disgust and uneasiness more often than panic. Here are some of the most commonly reported symptoms (Le, 2015):

• Feeling your skin crawl

• General uneasiness and discomfort

• Chills and shivering

• Feeling nervous

• Itchy skin

• Goosebumps

• Feeling anxious—fast heartbeat, sweaty palms, butterflies in your stomach

• Nausea or upset stomach

With trypophobia, repetitive patterns and clusters of holes induce feelings of disgust rather than fear. 

This presents a challenge for clinicians in terms of making a formal diagnosis. Those who react to clusters of holes with fear, anxiety, or panic attacks may be diagnosed with a specific phobia––the fear of a specific object (SAMHSA, 2016). 

One tool that may help is the trypophobia questionnaire (TQ), which measures the severity of symptoms. The TQ aims to identify trypophobia in people who don't meet the criteria for specific phobia. It's also a tool to measure an individual’s potential response to treatment options like therapy, which we’ll look at below (Le, 2015). 

When surveyed, the majority of people who identified as having the condition did not seek treatment (Vlok-Barnard, 2017). 

That said, if your aversion to holes is affecting day-to-day activities or your quality of life, there are treatment options out there. 

Cognitive behavioral therapy (CBT) is the treatment of choice for specific phobias. The goal of CBT therapy is to change the way you think about the thing that makes you uncomfortable.

In this case, it will likely involve looking at images that trigger your trypophobic response. Under the guidance of a therapist, exposure therapy may help diminish your body's response to these images over time (Thng, 2020). 

There are no medications that treat the underlying causes of trypophobia. However, some people may experience additional mental health conditions like depression, anxiety, and bipolar disorder where medication may be useful (Vlok-Barnard, 2017) 

There have also been case reports of people responding well to CBT combined with daily antidepressants. This isn't a standard treatment option, and medications are only sought out if another mental health issue is present (Martínez-Aguayo, 2018). 

Suppose you've tried to explain your phobia to a friend or someone trusted, only to be met with confusion. Others might feel too embarrassed to bring it up. 

Online support groups provide a safe place where you can discuss symptoms and triggers with people who have shared experiences. Here, people may also share independent coping mechanisms, like deep breathing and relaxation techniques, that have helped alleviate symptoms of trypophobia.

---

How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

September 10, 2021

Written by

Hope Chang, PharmD

Fact checked by

Yael Cooperman, MD

---

About the medical reviewer

Yael Cooperman, MD, Ro

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.