Trypophobia is an aversion to clusters of roughly circular shapes, such as the holes in a sponge or the bubbles on a cup of coffee, and the evidence so far points more to disgust than to fear. [kupfer-le-2018] It is not an official diagnosis, none of the sources reviewed here reports a treatment trial, and the two leading explanations, a visual one and a disease-avoidance one, are both still theories. This guide covers what it is, whether it counts as a phobia, why clusters may bother some people, what is known about help and where the research stops. Our guide to phobias covers the wider category.
Content note: this page describes what sets trypophobia off in words and shows no images of clustered holes.
What is trypophobia?
Trypophobia is an aversion to clusters of small holes or bumps. People with it dislike roughly circular shapes grouped together, such as the holes of a sponge or the bubbles on a coffee. [kupfer-le-2018] A 2013 paper described it as a phobia not previously reported in the scientific literature, in which sufferers are averse to images of holes. [cole-wilkins-2013]
Other work describes the response as disgust or an unpleasant feeling, often with bodily reactions such as goosebumps, set off by a cluster of harmless objects such as lotus seed pods. [imaizumi-2016] A 2018 case report and review notes that the condition has not yet been recognised by diagnostic taxonomies such as the Diagnostic and Statistical Manual of Mental Disorders (DSM), the manual used to diagnose mental health conditions. [martinez-aguayo-2018]
Is trypophobia a real phobia?
It is a real reaction but not an official diagnosis, and whether it is a phobia at all is disputed. The 2018 review describes researchers who questioned whether it is really a phobia, because people commonly report disgust rather than fear, and if it does not involve fear in most cases it might not be a specific phobia. [martinez-aguayo-2018]
The same review summarises a survey of people with trypophobia, and most of them reported disgust more than fear: [martinez-aguayo-2018]
| What people reported when facing clusters of holes | Share |
|---|---|
| Mostly disgust | 60.5% |
| Only disgust | 11.8% |
| The same amount of fear and disgust | 21% |
| Mostly fear | 5.1% |
| Only fear | 1% |
The review also reports that trypophobia is more prevalent in women, chronic and persistent, and commonly found alongside depression and generalised anxiety disorder. It takes those findings from earlier studies, which we could not check at source. [martinez-aguayo-2018]
Why do clusters of holes bother some people?
Two explanations lead the research, one about how the images look and one about disease, and neither is proven. Cole and Wilkins ran a spectral analysis of images that induce trypophobia and found high-contrast energy at midrange spatial frequencies, a pattern typically associated with uncomfortable visual images. They also found that a range of potentially dangerous animals share it, and argued that the response arises in part because the images resemble dangerous organisms in basic visual features, though sufferers are not conscious of the link. [cole-wilkins-2013] The 2018 review adds that the hypothesised association between poisonous animals and trypophobia has not been established. [martinez-aguayo-2018]
The second explanation is disease avoidance. Kupfer and Le proposed that aversion to clusters is an evolutionarily prepared response to cues that resemble parasites and infectious disease, and that trypophobia is an exaggerated, overgeneralised version of it. In their study, people with trypophobia and comparison participants both reported aversion to disease-relevant clusters, but only the trypophobic group reported aversion to harmless clusters with no disease relevance. For both groups the level of aversion was predicted uniquely by disgust sensitivity, ratings showed the response was mainly disgust, and many open-ended answers described skin itching or crawling. [kupfer-le-2018]
Individual differences matter too. Among 126 Japanese adults, trypophobia proneness was predicted by core disgust sensitivity (the threat of disease), personal distress (an empathic trait of self-oriented emotional distress) and proneness to visual discomfort. [imaizumi-2016] The review notes that the models explained relatively little of the variation, which suggests other psychological factors are involved. [martinez-aguayo-2018] Both accounts could be partly right, and the studies reviewed here do not test one against the other.
What helps if clusters of holes bother you?
Nobody knows what works best, because none of the sources reviewed here reports a treatment trial. The one treatment report is a case of a 12-year-old girl who also had generalised anxiety disorder. She was treated with sertraline, a prescribed medicine used for anxiety and depression, along with cognitive behavioural therapy (CBT). At five weeks she rated her phobic symptoms about 20% better, and the report says she showed both fear and disgust towards the images at first and later only disgust. [martinez-aguayo-2018]
Its authors state that her response does not mean sertraline should be regarded as a standard treatment for trypophobic symptoms, and that proper clinical trials are desirable. [martinez-aguayo-2018] One child is not evidence about anyone else.
If the reaction costs you little, there may be nothing to treat. If it limits you, say by keeping you off social media or out of a kitchen, the usual approach to specific phobias is gradual exposure, and our guide to exposure therapy covers it. Nothing reviewed here shows that it works for trypophobia in particular, so ask a clinician who treats phobias and say that the evidence is thin.
Does this reaction cost you anything?
Tick anything that is true for you. This is a prompt for reflection, not a test, and it produces no diagnosis.
0 of 5 ticked
Several of these together suggest the reaction is costing you something. A doctor or a therapist who works with phobias can talk through what to try, and it helps to say that the research on trypophobia is limited.
One or two of these is common. Notice whether the list grows or whether the reaction starts to decide what you do.
A reaction that costs you nothing does not need treating, however strong it feels in the moment.
No screener on this site assesses trypophobia or other specific phobias. The hub above covers anxiety, depression, stress, sleep, burnout, self-esteem and loneliness.
What do the studies not show about trypophobia?
They do not show why it happens, whether it is a phobia, or how to treat it. Both explanations are theories: the visual one rests on a spectral analysis, and the disease one on ratings and open-ended answers. [cole-wilkins-2013] [kupfer-le-2018] The Japanese study had 126 adults and measured proneness to trypophobia, which is not the same as a diagnosis. [imaizumi-2016]
The survey percentages come to us through a review that does not name the survey in the passage we could read, and the treatment report is one child. [martinez-aguayo-2018] None of the studies shows that clusters of holes are dangerous or that the reaction signals a disease. They describe what people report feeling.
When to seek help
Speak to a doctor or therapist if the reaction limits what you do, if it comes with panic, or if it sits alongside low mood or constant worry, which the review reports as common companions. Our guides to anxiety and depression cover those patterns. Skin that crawls or itches without any trigger is a medical question and not a trypophobia one, so mention it as well.
If you feel unable to keep yourself safe, contact your local emergency services or a crisis helpline.
How MyFreud can help
If a trigger such as a screen or a kitchen is shaping your days, daily mood tracking in MyFreud shows the pattern, and the notepad is somewhere to note what set the reaction off, how strong it was and what you did next. It does not replace a clinician.
Download MyFreud and start today: App Store or Google Play.