Do you avoid medical or dental procedures that involve needles? This is a sign of trypanophobia.

Trypanophobia is an extreme fear of medical procedures involving injections or needles. This includes intravenous drips, injections, and vaccines.

Fear of needles is a type of specific phobia, which are fears that center on one particular object or situation. Other examples are fear of a specific animal (like snakes or spiders), fear of flying, and fear of heights.

Specific phobias are common, affecting approximately 8.7% of people in the United States.

Up to 4.5% of people have a blood-injection-injury phobia — a subset that includes trypanophobia — as outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).

Many people are uncomfortable with needles and experience some fear or anxiety associated with them. Needle phobia occurs less often than general anxiety related to needles.

The fear of needles exists on a continuum ranging from no fear to mild fear to phobia. People who have been diagnosed with blood-injection-injury phobia are at the most severe end of the spectrum.

People with needle phobia have a severe and persistent fear that can interfere with their daily life. It can have broader health effects, causing them to avoid beneficial medical check-ups or treatments where they might encounter their fear.

People with trypanophobia who are considering or receiving an injection may experience the following symptoms:

  • severe anxiety or fear
  • panic or panic attacks
  • nausea
  • sweating
  • trembling
  • heart palpitations
  • fainting
  • insomnia in the days or weeks leading up to medical appointments

Triggers for trypanophobia-related anxiety may include:

  • thinking about needles or injections
  • thinking about an upcoming medical or dental appointment
  • seeing a hypodermic needle
  • seeing someone else get an injection
  • thinking about fainting
  • sitting in a medical waiting room

Even in people whose symptoms aren’t severe enough to receive a diagnosis of trypanophobia, needle fear can have negative outcomes. The anxiety may still be high enough to make the person avoid important medical or dental procedures.

People with needle anxiety who also have a chronic health condition, such as diabetes, are a particularly vulnerable population.

The exact cause of specific phobias, including trypanophobia, is unknown. It may differ for each individual and stem from a variety of factors.

In some cases, people can trace their fear back to a difficult event in their past that involved needles, such as medical trauma or seeing someone else have a difficult experience that involved needles.

It’s not clear why some people develop specific phobias and others do not. Contributing factors may include:

  • genetics
  • brain chemistry
  • having an anxiety disorder or other phobias
  • family members with anxiety or phobias
  • extreme sensitivity, either physical or emotional
  • illness anxiety disorder, previously known as hypochondria
  • fainting easily

Trypanophobia is sometimes confused with belonephobia. In fact, the terms are so similar that they are often used interchangeably.

The difference is that trypanophobia is a fear of medical procedures involving needles, while belonephobia is an irrational fear of needles in general.

Belonephobia affects 3.5% to 10% of the population.

The most common treatment options for specific phobias, including trypanophobia, include the following:

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a staple therapy for specific phobias and anxiety disorders. In CBT, you learn how to confront and change any negative or distorted beliefs that lead to anxiety and fear.

Exposure therapy

Exposure therapy is a type of CBT and is typically included in treatments for phobias.

Research suggests that exposure-based therapies — in-person as well as imaginal or computer-based exposures — are effective for reducing phobias in children (age 7 and up) and adults.

Exposure therapy involves being exposed to your fear with the aim of gradually reducing your anxiety. Exposure therapy can be administered in several ways:

  • in a single session or over multiple sessions
  • in person or via imaginal exposure, such as imagining needle scenarios or watching them on a screen or through virtual reality

For trypanophobia, the therapist gently exposes you to your needle-related triggers, starting from the least difficult and gradually working toward the most difficult.

For instance, you might start exposure therapy by working through the following steps one at a time, from least difficult to most difficult:

  • sitting in a medical waiting room
  • seeing a syringe without a needle
  • seeing a syringe with a needle
  • holding a syringe with a needle
  • having the end of a needle held against your arm
  • receiving an injection

The exposure should last long enough for your fear to decrease and for you to realize that the “worst” didn’t happen.

For fainting: Applied muscle tension

Adding a specific behavioral technique, known as applied muscle tension (or simply “applied tension”), to exposure therapy can help reduce fainting.

Fainting during fearful medical procedures may occur due to what’s called a vasovagal response, which is a sudden drop in blood pressure. Applied tension is a behavioral technique that intentionally increases a person’s blood pressure immediately before and during the feared event.

During applied tension techniques, the client learns to tense up their various muscles. They can practice doing this several weeks before the feared event.

During applied tension, the person gets in a comfortable position (sitting or lying down). Next, they tense the muscles in their arms, legs, and torso for 10 to 15 seconds or until they can feel a warm sensation in their upper body and face. Then, they relax for 20 seconds and repeat this up to 4 times. They may do this several times a day for one or two weeks before the feared event.

If a person does this in the moments before a needle injection, it can help decrease their chances of fainting.

If you’re preparing for a medical appointment that involves a needle, there are some things you can do to prepare.

Firstly, let the healthcare professional know you have a fear of needles, especially if you’ve fainted before. They may have several tricks to help you through the procedure. You can also ask if it’s possible for them to use a topical numbing agent so that you won’t feel the needle.

There are several things you can do to prepare for a medical appointment that involves a needle:

  • If you’ve experienced dizziness or fainted around needles before, ask if you can lie down during the shot or at least have a chair with arms and a supportive back.
  • Bring a loved one to the procedure (if allowed) and hold their hand.
  • Practice relaxation techniques. You can practice various deep breathing exercises in advance, and use them when anxious feelings arise.
  • If you tend to faint, practice applied tension techniques in the weeks before a vaccine or other medical procedure. At the moment when the needle enters, you’ll want to relax the muscle receiving the shot.
  • Try to stay distracted during the procedure. Focus on anything other than the needle. This could be a picture on the wall, a spot on the floor, or just closing your eyes and thinking about a calming waterfall.

If you or someone you love has trypanophobia, it can help to reach out to a healthcare professional. There are many effective treatments for phobias. You don’t have to live in fear.

Mental health charity Mind offers several tips and online resources for people coping with anxiety and phobias. You can also find numerous online videos to help you learn breathing techniques and CBT for panic.