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The holes in lotus seed heads elicit feelings of discomfort or repulsion in some people.[1][2]
SpecialtyPsychology, psychiatry
SymptomsDisgust, fear, anxiety, nausea[3][4][5]
TreatmentExposure therapy[1]
FrequencySome degree of symptoms relatively common[1][5]

Trypophobia is an aversion to the sight of clusters or patterns of small holes or bumps.[4] Symptoms may include disgust, fear, or anxiety.[3][4] There may also be associated nausea or itchiness.[5][1]

Example of triggers include honeycomb, lotus seed pods, and bubbles on top of a cup of coffee.[5][1][4] While not officially recognized as a separate mental disorder as if 2018, it may be diagnosed as a specific phobia if excessive fear and distress occur.[1][3] It is hypothesized that it is an evolutionary defense against external parasites or poisonous animals that has become excessive.[4][5] Exposure therapy is a possible treatment.[1]

Some degree of symptoms when viewing an object like a lotus seed pod occurs in about 16% of people, with women more commonly affected than men.[1][5] The term trypophobia was coined by a participant in an online forum in 2005, from the Greek "trypo" meaning "drilling holes" and "phobos" meaning "fear".[5] It become a popular topic on social media in the 2000s.[6] Formal study began around 2010 by psychologists Geoff Cole and Arnold Wilkins.[5]

Signs and symptoms

Shapes that elicit a reaction include clustered holes in innocuous contexts, such as fruit and bubbles, and in contexts associated with danger, such as holes made by insects and holes in wounds and diseased tissue such as those caused by mango flies in animals.

Upon seeing these shapes, some people shudder, fell their skin crawl, experienced panic attacks, sweated, palpitated, or felt nauseated or itchy.[1][7] Trypophobia may manifest as a reaction of fear, disgust, or both.[3] Disgust is usually the stronger emotion.[3] Other symptoms may include goose bumps, body shakes, feeling uncomfortable, and visual discomfort such as eyestrain, distortions, or illusions.[3][8] Trypophobia often presents with an autonomic nervous system response.[3]


Several possible causes have been proposed.[3] Geoff Cole and Arnold Wilkins believe the reaction is an "unconscious reflex reaction" based on a biological revulsion, rather than a learned cultural fear.[7] Imagery of various venomous animals (for example, certain types of snakes, insects, and spiders) have visual characteristics similar to trypophobic imagery. Because of this, it is hypothesized that trypophobia has an evolutionary basis meant to alert humans of dangerous organisms.[1][9][4] Can et al., however, believe the connection between trypophobia and evolution as a result of a threat from deadly creatures to be weak and that, if a connection does exist, it manifests later in life rather than in childhood.[3][10]

Martínez-Aguayo et al. described trypophobia as usually involving "an intense and disproportionate fear towards holes, repetitive patterns, protrusions, etc., and, in general, images that present high-contrast energy at low and midrange spatial frequencies."[3] Cole and Wilkins also stated the imagery has high spatial frequency with greater energy at midrange.[1][3] Whether together or separate, it appears that low and midrange spatial frequencies are necessary for inducing trypophobic reactions. Based on the imagery's visual cues, An Trong Dinh Le, Cole, and Wilkins developed a symptom questionnaire that they believe can be used to identify trypophobia.[3]

Researchers have also speculated that trypophobic reactions could be perceived as cues to infectious disease, which could be alerts that give one a survival advantage. In a study by Kupfer and Le, trypophobic and non-trypophobic participants showed significant aversion to disease-relevant cluster images, but only trypophobic participants displayed a significant aversion to disease-irrelevant cluster images. Martínez-Aguayo et al. stated that, because the reactions could not be attributed to different sensitivity levels or neuroticism differences, Kupfer and Le believe it supports their hypothesis that trypophobia is "an overgeneralized aversion towards cluster stimuli that indicates a parasitic and infectious disease threat".[3] Yamada and Sasaki also propose that trypophobic reactions are due to the imagery's visual similarities to skin diseases.[3]

Whether trypophobia is associated with obsessive–compulsive disorder (OCD) has also been studied. A significant minority of those with trypophobia meet the DSM-5 criteria for an obsessive-compulsive disorder.[3] Martínez-Aguayo et al. stated that other findings refer to trypophobia having common comorbid psychiatric diagnosis, such as major depressive disorder or generalized anxiety disorder, although Le et al. felt that general anxiety does not cause trypophobia.[3]


Trypophobia is not recognized by name as a mental disorder, and so is not a specific diagnosis in the American Psychiatric Association's Diagnostic and Statistical Manual, Fifth Edition (DSM-5). However, it may fall under the broad category of specific phobia if it involves fear that is excessive, persistent, and associated with significant distress or impairment.[1]

Whether trypophobia can be accurately described as a specific phobia might depend on whether the person mainly responds with fear or with disgust. Because phobias involve fear, a response to trypophobic imagery that is based mostly or solely on disgust renders its status as a specific phobia questionable.[3] In one study, most of the participants with trypophobia met the DSM-5 criteria for a specific phobia, even though they experienced disgust instead of fear when shown imagery of clusters of holes; however, they did not meet the distress or impairment criterion.[3]


It is beleived that exposure therapy, which has been used to treat other phobias, is likely to be an effective treatment.[1]


The exact frequency of the condition is unknown,[1] though data suggests that having an aversion to trypophobic imagery is relatively common.[1][2][3] 16% of a sample of 286 participants reported discomfort or repulsion when presented with an image of a lotus seed pod and though non-trypophobic individuals also experienced more discomfort when viewing trypophobic imagery than when viewing neutral images.[1] Women appear to be more commonly affected than men.[3]

Society and culture

The term trypophobia is believed to have been coined by a participant in an online forum in 2005.[6] The word is from the Greek: τρῦπα, trŷpa, meaning "hole" and φόβος, phóbos, meaning "fear".[6] Groups on social media sites such as Facebook and Instagram exist for self-identified trypophobics to share and discuss images that they say induce the reaction.[6][11]

Because trypophobia is not well known to the general public, many people with the condition do not know the name for it and believe that they are alone in their trypophobic reactions and thoughts until they find an online community to share them with.[12] This has led to an increase in trypophobic images on social media; in some cases, people seek to intentionally induce trypophobia in those who have it by showing them trypophobic images, with the most trypophobic-inducing images being holes and clusters (especially the lotus seedhead) photoshopped onto human skin.[12] Cole and Wilkins also stated that the level of disgust with trypophobia increases if the holes are on human skin.[12] Writing in Popular Science, Jennifer Abbasi argues that emotional contagion within such social media groups may be responsible for some of the aversive reactions to such images.[6]

In 2017, trypophobia received media attention when American Horror Story featured a trypophobic character[13] and trypophobia-inducing advertisements promoting the storyline; some people were disturbed by the imagery,[12][14] and criticized the show for "insensitivity towards sufferers of trypophobia".[14] Although there was sentiment that the increased media attention could lead to people trying to induce trypophobia, there were also opinions that it might help people understand trypophobia and encourage more research on the matter.[12] Some users responded to the 2019 release of Apple's iPhone 11 Pro, which features three closely spaced camera lenses, with comments that it triggered their trypophobia.[15]

Writer and editor Kathleen McAuliffe suggested that trypophobia is yet to be extensively studied because researchers have not given as much attention to topics of disgust as they have to other areas of research, and because of the revulsion viewing the images could incite in researchers.[16]

See also


  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 Milosevic, Irena; McCabe, Randi E. (2015). Phobias: The Psychology of Irrational Fear. ABC-CLIO. pp. 401–402. ISBN 978-1610695763. Archived from the original on June 29, 2020. Retrieved October 25, 2017.
  2. 2.0 2.1 Schacter, Daniel; Gilbert, Daniel; Wegner, Daniel; Hood, Bruce (2015). Psychology: Second European Edition. Palgrave Macmillan. p. 1391. ISBN 978-1137406750. Archived from the original on October 14, 2018. Retrieved October 25, 2017.
  3. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 Martínez-Aguayo, Juan Carlos; Lanfranco, Renzo C.; Arancibia, Marcelo; Sepúlveda, Elisa; Madrid, Eva (2018). "Trypophobia: What Do We Know So Far? A Case Report and Comprehensive Review of the Literature". Frontiers in Psychiatry. 9: 15. doi:10.3389/fpsyt.2018.00015. ISSN 1664-0640. PMC 5811467. PMID 29479321.
  4. 4.0 4.1 4.2 4.3 4.4 4.5 Kupfer, T. R.; Fessler, D. M. T. (19 July 2018). "Ectoparasite defence in humans: relationships to pathogen avoidance and clinical implications". Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences. 373 (1751): 20170207. doi:10.1098/rstb.2017.0207. PMC 6000138. PMID 29866920.
  5. 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 Skaggs, William (1 March 2014). "Are You Afraid of Holes?". Scientific American. Archived from the original on 11 November 2020. Retrieved 18 August 2022.
  6. 6.0 6.1 6.2 6.3 6.4 Abbasi, Jennifer (July 25, 2011). "Is Trypophobia a Real Phobia?". Popular Science. Archived from the original on April 7, 2016. Retrieved October 2, 2012.
  7. 7.0 7.1 Cole, Geoff G.; Wilkins, Arnold J. (October 2013). "Fear of Holes" (PDF). Psychological Science. 24 (10): 1980–1985. doi:10.1177/0956797613484937. PMID 23982244. S2CID 206586831. Archived from the original (PDF) on 2019-02-26.
  8. "Everything You Should Know About Trypophobia". Healthline. August 7, 2015. Archived from the original on October 26, 2017. Retrieved October 26, 2017.
  9. Hockenbury, Don; Hockenbury, Sandra E. (2016). Discovering Psychology. Macmillan Higher Education. p. xxxii (sidebar). ISBN 978-1464176968. Archived from the original on 2020-08-20. Retrieved 2022-09-30.
  10. Can, W.; Zhuoran, Z.; Zheng, J. (2017). "Is Trypophobia a Phobia?". Psychological Reports. 120 (2): 206–218. doi:10.1177/0033294116687298. PMID 28558623. S2CID 206427223. Archived from the original on 2022-08-22. Retrieved 2022-09-10.
  11. Doucleff, Michaeleen. "Fear Of Cantaloupes And Crumpets? A 'Phobia' Rises From The Web". NPR. Archived from the original on 19 July 2018. Retrieved 10 Apr 2016.
  12. 12.0 12.1 12.2 12.3 12.4 LaMottef, Sandee (September 14, 2017). "TV show triggers little-known phobia". CNN. Archived from the original on October 27, 2017. Retrieved October 26, 2017.
  13. King, Eric (September 6, 2017). "American Horror Story: Cult: Why is Ally afraid of small holes?". Entertainment Weekly. Archived from the original on November 8, 2017. Retrieved October 26, 2017.
  14. 14.0 14.1 Pavey, Harriet (September 5, 2017). "What is trypophobia? Bizarre fear of small holes featured in new American Horror Story series". London Evening Standard. Archived from the original on October 27, 2017. Retrieved October 26, 2017.
  15. "Apple's iPhone 11 Pro 'triggering' fear of holes". BBC News. 11 September 2019. Archived from the original on 11 September 2019. Retrieved 11 September 2019.
  16. McAuliffe, Kathleen (2016). This Is Your Brain on Parasites: How Tiny Creatures Manipulate Our Behavior. Houghton Mifflin Harcourt. p. 154. ISBN 978-0544193222. Archived from the original on October 14, 2018. Retrieved October 25, 2017.

External links

  • The dictionary definition of trypophobia at Wiktionary