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Trypanophobia

What Is It, How It Is managed, and More

Author: Georgina Tiarks

Editors: Ahaana Singh, Lisa Miklush, PhD, RN, CNS

Illustrator: Jillian Dunbar


What is trypanophobia?

Trypanophobia refers to the fear of injections or hypodermic needles. Phobias are classified as an anxiety disorder in which one has an extreme fear of something. Trypanophobia, specifically, is a fear of needles used in medical procedures. This can be detrimental because it may prevent affected individuals from seeking necessary medical care that involves needles, such as blood tests, vaccinations,and intravenous fluids.  

While many individuals can manage their fear, others may avoid seeking some health care due to their fear of medical procedures involving injections. This can result in medication and vaccine noncompliance. A study showed that 16% of adults avoid the flu shot due to a fear of needles. Moreover, in anticipation of receiving medical attention, people with trypanophobia may experience severe anxiety that impacts their mental health

What does trypanophobia mean?

In Greek, “trypano” means a device used to drill a hole, and “phobia” refers to an extreme fear. Therefore, trypanophobia roughly translates to a fear of needles, or devices used to make a hole in the skin.  

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How common is trypanophobia?

Research shows that between 33% to 63% of children may have a specific phobia of needles. While individuals often become less afraid of needles by the time they are adults, some studies suggest that up to 10% of the total population experiences trypanophobia. 

What causes trypanophobia?

The exact cause of trypanophobia is unknown; however, various factors can lead to the development of trypanophobia. Predisposing factors may include temperament, genetics, environment, and negative past experiences.

The shock reflex upon needle puncture, which causes one to feel pain and negative emotions after an injection, is one mechanism suggested to be responsible for trypanophobia. After multiple negative experiences with needle injections, individuals may inherently associate needles with pain and, consequently, fear. This learned association occurs more commonly in children and may persist over several years.

In addition, there has been speculation that a fear of needles is genetic, potentially resulting from previous dangers associated with sharp objects. A genetic fear may be evolutionarily built into humans to keep individuals out of harm’s way. 

After a fear has been developed, an individual may also maintain that fear by ruminating about associated painful experiences. An individual may remember worse pain with previous needle exposures than they actually experienced at the time of the punctures. These memories may become increasingly distressing over time, which can further reinforce an individual’s fear response. 

Familial responses to needles may also play a role in the development of needle phobia, as coping and anxiety can be learned through observation. More specifically, a parent’s response to injections may alleviate or confirm a child’s fear. 

What are the signs and symptoms of trypanophobia?

Symptoms of trypanophobia vary depending on severity of the fear. These symptoms include but are not limited to panic attacks, increased heart rate, insomnia, dizziness, and elevated blood pressure. One may also feel the need to avoid or run from medical treatment. 

In more severe cases, an individual may experience a drop in blood pressure, which could result in fainting. 

How is trypanophobia diagnosed and treated?

To formally diagnose an individual with trypanophobia, their symptoms must align with the criteria set forth by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, which is currently in its 5th edition (DSM-5) . The diagnostic criteria include a persistent, severe anxiety about procedures involving the use of needles. A healthcare professional may ask questions about previous experiences with needles used in a medical setting as well as inquire about the individual’s medical, social, and family history. 

There are several treatment options for trypanophobia based on severity. For individuals with a milder fear, distraction and relaxation techniques to reduce blood pressure may provide immediate relief, but they are unlikely to eliminate the fear in the long term. Topical anesthetics may prevent physical pain during injections, which can reduce anxiety and the pain response. 

For those who need a more long-term solution, a newer intervention, known as computer-based exposure, can be used to familiarize an individual with the use of needles through repeated exposure on a computer. Additionally, cognitive behavioral therapy (CBT) can be a treatment option. CBT may allow an individual to work through their fear alongside a mental health professional.  

Treatment of trypanophobia in children may differ slightly in comparison with adult treatment methods. Some suggested approaches include reading the child a reassuring children’s book about needles or showing them how to inject a teddy bear.

In general, overcoming trypanophobia may require more than one treatment plan due to the complexity of the disorder, and treatment usually needs to be tailored based on an individual’s specific needs. Oftentimes, treating trypanophobia is dependent on the individual’s patience, willingness, and support to overcome their phobia.

What are the most important facts to know about trypanophobia?

Trypanophobia refers to the extreme fear of medical procedures involving needles. Some individuals with trypanophobia may avoid seeking medical care due to their fear. This fear is more common in children; however, some studies indicate that up to 10% of the population has a phobia of needles. While the exact cause is unknown, various factors can lead to the development of trypanophobia, including behavioral, environmental, genetic, and biological influences. Symptoms may vary based on severity but can include dizziness, panic attacks, increased heart rate, and, in severe cases, fainting. Trypanophobia can often be diagnosed by a healthcare professional asking the individual about the symptoms they experience regarding needle exposure. There are several treatment options for trypanophobia. For milder cases, distraction and relaxation techniques can work to divert one’s attention from the needle and the fear. In more severe cases, anesthetics, exposure-based therapies, and cognitive behavioral therapy may be beneficial. For children, one may consider showing them children’s books about medical procedures or demonstrating how to give an injection to a teddy bear. 

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Related links

Phobias
Anxiety disorders: Clinical practice
Panic disorder
Anxiety disorders, phobias and stress-related disorders: Pathology Review

Resources for research and reference

Hamilton, J. (1995). Needle phobia: A neglected diagnosis. The Journal of Family Practice, 41(2): 169–175.

McLenon, J., & Rogers, M. (2019). The fear of needles: A systematic review and meta-analysis. Journal of Advanced Nursing, 75(1): 30–42. DOI: 10.1111/jan.13818

McMurtry, C., Pillai Riddell, R., Taddio, A., Racine, N., Asmundson, G., Noel, M., Chambers, C., Shah, V., & HELPinKids&Adults Team. (2015). Far From “Just a Poke”: Common Painful Needle Procedures and the Development of Needle Fear. The Clinical Journal of Pain, 31(Suppl 10): S3-S11. DOI: 10.1097/AJP.0000000000000272

McMurtry, C., Taddio, A., Noel, M., Antony, M., Chambers, C., Asmundson, G., Riddell, R., Shah, V., MacDonald, N., Rogers, J., Bucci, L., Mousmanis, P., Lang, E., Halperin, S., Bowles, S., Halpert, C., Ipp, M., Rieder, M., Robson, K., Uleryk, E., Votta Bleeker, E., Dubey, V., Hanrahan, A., Lockett, D., & Scott, J. (2016). Exposure-based interventions for the management of individuals with high levels of needle fear across the lifespan: A clinical practice guideline and call for further research. Cognitive Behaviour Therapy, 45(3): 217–235. DOI: 10.1080/16506073.2016.1157204