Trypophobia, the fear of clustered patterns of irregular holes, is a real condition — but not necessarily a phobia.

Do you feel uncomfortable, disgusted, or fearful when you look at lotus seed pods, a honeycomb, or the inside of a pomegranate?

Trypophobia is an aversion to clustered patterns of irregular holes, circles, or bumps. These images can trigger disgust or fear in people with this condition.

What could be causing this type of fear? Is trypophobia an evolutionary trait warning us of poisonous animals or skin diseases? Is it a learned fear?

There are very few studies on trypophobia, and it’s not recognized in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), but evidence can nonetheless shed a light on this condition.

Trypophobia is a strong feeling of disgust or fear toward clustered patterns of irregular holes, bumps, or circles. For instance, a person with trypophobia would have a strong negative reaction to items such as:

  • honeycombs
  • natural sponges
  • coral
  • wallpaper with an irregular pattern of circles and dots

Trypophobia is not recognized in the DSM-5, and the condition has prompted very few studies. But surveys and online anecdotes suggest that many people experience its symptoms.

Experts suggest that most people with trypophobia experience strong levels of disgust rather than the type of terror often seen in phobias. However, some people with trypophobia do exhibit significant levels of fear.

Either way, trypophobic images can trigger significant discomfort. Among 195 survey participants recruited from a trypophobia support group, 31% reported severe levels of anxiety and physical distress.

People with trypophobia feel disgust, fear, or both toward clustered patterns of holes or circles. These patterns are commonly seen in nature in plants and animals.

Here are a few things that may trigger a person with trypophobia:

  • lotus tree pods
  • coral
  • sponges
  • honeycomb
  • fruit with irregular seed patterns, such as raspberries, strawberries, or pomegranates
  • spots or bumps on frogs and toads
  • acne
  • mold
  • bread with lots of holes
  • Swiss cheese
  • insects with spotted patterns or false eyes
  • photos of skin diseases, such as mumps or measles

Although many people without trypophobia show an aversion toward disease-related photos, only those with trypophobia report disgust toward clusters of dots unrelated to disease that most other people would consider “harmless.“

Trypophobia symptoms are often chronic (long-term) and cause notable distress. They may include:

  • avoidance of irregular clusters or patterns of holes, dots, circles, or bumps
  • discomfort looking at these images
  • disgust
  • fear
  • shivers
  • skin-crawling sensation
  • sweating
  • fast breathing
  • rapid heart rate
  • panic attack

Research from 2018 suggests that the larger the cluster, the greater the trypophobic response.

Researchers say that most trypophobic reactions are based on disgust rather than fear, but these emotions are often mixed.

One 2018 study looked at whether the symptoms of trypophobia present more like a phobia or obsessive-compulsive disorder (OCD). Both of these disorders are characterized by significant levels of anxiety and fear.

For the study, the researchers looked at:

  • severity of psychological distress
  • socio-demographic factors, such as age, sex, education, etc.
  • whether the primary emotion of people with trypophobia resembled fear or disgust

Most of the participants with trypophobia met the DSM-5 criteria for having a specific phobia — but with disgust rather than fear. They did not meet the criteria for the high levels of distress or impairment required for a specific phobia diagnosis.

Only a small percentage of trypophobia participants met the criteria for OCD.

The findings show that:

  • 60.5% of participants reported mostly disgust (compared with fear).
  • 11.8% reported only disgust.
  • 5.1% reported mostly fear.
  • 1% reported only fear.
  • 21% experienced the same amount of fear and disgust.
  • Trypophobia was more common in women.
  • Symptoms tended to be chronic (long term).
  • The most common disorders people with trypophobia also had (comorbid disorders) were major depressive disorder (MDD) and generalized anxiety disorder (GAD).

The reasons for trypophobia are unclear. Some factors that may contribute include:

  • genetics
  • the presence of other mental disorders
  • an early learned response
  • trauma

There are a few theories regarding the origins of trypophobia. Some suggest it may be:

  • an evolutionary trait developed to alert us to the patterns of poisonous animals, such as snakes and frogs
  • a passed-down evolutionary aversion to health-threatening conditions, such as parasites or diseases
  • an extreme form of a natural human reaction to trypophobic images, rather than a true phobia

Overall, research on trypophobia is very limited.

Most studies that have investigated visual discomfort have involved people with migraine or epilepsy. This is because people with these conditions often have a hard time looking at specific patterns, such as striped pictures, cluster images, or text lines.

But in most of these studies, the researchers investigated causes from a visual perspective, rather than the underlying mechanisms of a phobia.

Of the few studies that have looked at the causes of trypophobia, here are some important findings:

  • Discomfort toward trypophobic images is higher in people with a history of skin problems.
  • The most common comorbid diagnoses among people with trypophobia are MDD and GAD.
  • Those who are prone to trypophobia are more likely to have greater sensitivity to disgust and visual discomfort and have more personal distress.
  • Social anxiety has an indirect but significant effect on the discomfort associated with looking at clusters of eyes or faces. These findings suggest that both trypophobia and social anxiety may contribute to the discomfort of being watched by many people.
  • Empathic traits, such as concern, perspective-taking, and personal distress, may contribute to being prone to trypophobia.
  • The general population tends to experience some discomfort while looking at trypophobic images.
  • In a study with children, the results suggest that discomfort toward irregular patterns is due to an instinctive response rather than a fear of venomous animals.

Trypophobia isn’t a clinically diagnosable mental disorder, but if the symptoms are severe enough, various types of treatments are available.

Treatments for other types of phobias may be used to address trypophobia, including:

  • Cognitive behavioral therapy (CBT). CBT helps you work through any negative or distorted belief patterns. This may be particularly helpful if previous trauma or a bad experience led to the fear.
  • Exposure therapy. You are gradually exposed to trypophobic images in a controlled environment so, over time, the images cause less distress.
  • Medication. Depending on the severity of your symptoms, a doctor may prescribe beta-blockers (propranolol) or benzodiazepines (lorazepam).
  • Visualization exercises at home. This may include imagining yourself calmly walking up to a wall with trypophobic patterns, breathing deeply, and imagining staying completely calm.

Long-term lifestyle changes to help reduce overall anxiety might be helpful as well, including:

Keep in mind that there is no one-size-fits-all solution. It may help to speak with a healthcare professional about your symptoms and work with them to find a treatment plan that suits your needs.

Feeling an aversion when it comes to clustered patterns of holes is not uncommon.

If your trypophobia symptoms are severe enough to interfere with your daily activities, it may be advisable to reach out for professional help. A psychiatrist or therapist trained to treat various phobias would be especially helpful.

If your symptoms don’t require professional care, you may consider joining a trypophobia support group. It may be very therapeutic to simply know that others have the same symptoms and to be able to share experiences with each other.