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Hair Transplant Trypophobia: Causes and Solutions

Knox Beasley, MD

Reviewed by Knox Beasley, MD

Written by Grace Gallagher

Published 09/10/2024

If the sight of lotus pods, honeycombs, or even sponges makes you feel uncomfortable or repulsed, you could be experiencing trypophobia — a fear of holes.

You may think this is completely unrelated to male pattern baldness, but the two worlds collide when it comes to hair transplants. This type of hair restoration surgery moves hair from a donor area to a recipient area and creates tiny holes on the scalp in the process. That’s where hair transplant trypophobia comes in.

Here, we’ll discuss all things hair transplant trypophobia, including the causes of trypophobia, how to deal with it, and what you can do about hair loss if you decide a hair transplant isn’t right for you.

Before we talk specifically about trypophobia after a hair transplant, it’s important to understand the condition. People with trypophobia are repulsed or scared of irregular patterns or clusters of small holes or bumps.

Some research suggests that certain graphic patterns with high-contrast colors can provoke feelings of anxiety, disgust, and other symptoms — visual signals that are also present in highly dangerous animals like the King Cobra. So, trypophobia may be born of an innate fear of these animals — or a survival instinct.

Common triggers include objects with holes in them (like sponges or coral), fruits with seeds, or digital images that have been manipulated (often, they intersperse lotus pod holes onto the skin).

Although not a recognized medical condition, trypophobia can cause significant discomfort or anxiety for those who experience it. Some research indicates that trypophobic images increase both heart rate and heart rate variability in those with the aversion, which are clear signs of anxiety.

So what does this have to do with hair transplants? Keep reading for details.

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All about hair, here

Hair transplant trypophobia is a strong aversion or fear some people experience when looking at closely clustered hair grafts or small holes left in the scalp after a hair transplant procedure.

It’s also possible to experience trypophobia during the healing phase of a hair transplant when the scalp has multiple tiny wounds or raised scabs.

Holes are only likely to be seen in a follicular unit extraction (FUE ) hair transplant, where a surgeon makes small “micro punches” with an instrument (also called a micro-punch tool).

Holes on the scalp aren’t a part of FUT (follicular unit transplantation) hair transplants. With this hair transplant technique, a full strip of skin is first removed from the back of the head, and then the hair is harvested from the strip, not directly from the scalp.

You can learn more about the differences between FUE and FUT hair transplants in our guide.

According to survey research done by the International Society of Hair Restoration Surgery (ISHRS), just over 50 percent of surveyed surgeons use punches between 0.81 and 0.9 millimeters in diameter. And 37 percent use a punch between 0.91 and 1 millimeter.

For context, 1 millimeter is about the thickness of a credit card or the size of a fishing line, so the holes are typically very small. These smaller holes heal quickly, looking like small grazes with slight red scabbing as they heal. The latest methods cause minimal pain and a faster recovery, which may ease concerns for those with trypophobia.

If you’re concerned about trypophobia after a hair transplant, you should absolutely talk to your surgeon about the size of the punch they plan to use.

Wondering how to deal with hair transplant trypophobia? If you experience trypophobia, it doesn’t necessarily mean that you can’t or shouldn’t get a hair transplant (though you may choose not to).

There are steps you can take to treat or minimize trypophobia and help you respond to triggers you’ll encounter in daily life, which can help you as you prepare for a hair transplant.

Cognitive Behavioral Therapy

Research shows that cognitive behavioral therapy (CBT) can be an effective way to treat phobias of all kinds, including trypophobia. CBT is a type of therapy based on the idea that thoughts, beliefs, and attitudes affect actions and can lead to negative thinking.

During CBT, a therapist works with the individual to identify and challenge distorted or unhelpful thoughts and develop healthier thinking patterns and coping strategies.

Exposure Therapy

Exposure therapy is often part of CBT for treating trypophobia. It’s typically done in increments, with a patient first exposed to mildly triggering images and working up to more difficult images.

It’s usually recommended that exposure therapy happens under the supervision of a professional who can teach you strategies to help you manage your fear and anxiety.

Research suggests that exposure therapy is the most effective psychological intervention for treating trypophobia.

Medication

Since trypophobia always includes an element of anxiety, anti-anxiety medications may help if a healthcare provider determines that course of action is right for you. You can learn all about anti-anxiety medications in our guide.

Relaxation Techniques

Relaxation techniques, such as deep breathing or meditation, can be an effective way to manage trypophobia, particularly after the condition is under control.

Research shows that breathing exercises can yield “significant improvements” in people with anxiety disorders, which phobias are categorized as.

One of the great things about breathwork and other relaxation techniques is that they’re usually free and accessible through apps or videos.

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For starters, if done correctly, holes from a hair transplant should be small and barely noticeable — unlike the big, deep-set holes you may see if you dare to Google “hair transplant trypophobia.”

Still, if you’re concerned about the appearance of holes, it makes sense you’d want a speedy, uneventful recovery from a hair transplant.

Here are some tips for the healing process:

  • Do your research before committing to a hair transplant surgeon. The easiest way to recover properly is to ensure a qualified, board-certified surgeon performs the procedure.

  • Plan to follow aftercare instructions closely.

  • Your surgeon will explain what’s expected, but generally, you should plan to stay clean and dry, avoid strenuous activity, and avoid touching your head for a set period.

  • If you’re worried trypophobia will make aftercare difficult, consider asking your doctor or a loved one if they’ll help you change your bandages and keep the area clean as you heal.

For a more in-depth look at the process, check out our post on hair transplant recovery.

You might decide a hair transplant isn’t the right choice for your mental health. In that case, there are plenty of other options for restoring your hair that won’t trigger trypophobia:

  • Finasteride. Finasteride is a prescription medication that blocks the effects of DHT (dihydrotestosterone), the hormone largely responsible for male pattern baldness. It’s one of two medications with approval from the FDA (U.S. Food and Drug Administration) specifically for treating male pattern hair loss.

  • Minoxidil. Minoxidil, commonly known as Rogaine®, is also FDA-approved for androgenetic alopecia in a topical solution or foam— it’s also sometimes available off-label in a pill or chewable. Minoxidil is a vasodilator, so it increases blood flow to the scalp and hair follicles. It also prolongs the anagen (growth) phase of the hair growth cycle.

  • Minoxidil and finasteride together. These two medications can be combined for even greater effects. We offer topical finasteride & minoxidil spray and serum as part of our line of hair hybrids.

  • Saw palmetto. Some research suggests that saw palmetto may inhibit the effects of DHT. Our thickening shampoo with saw palmetto is a good place to start if you’re not sure about medication.

  • Microneedling. Microneedling involves using a derma-roller to make tiny “micro-injuries” on the scalp. It shouldn’t actually hurt but is enough for blood and oxygen to rush to the scalp to heal the wounds, which may aid in hair growth or slow hair loss (though most of the research available is on microneedling paired with minoxidil — like this study showing that people who used both had thicker hair). The holes made from microneedling aren’t visible to the naked eye.

  • Low-level light therapy (LLLT). Low-level light therapy was FDA-approved in 2007 for treating androgenetic alopecia (pattern baldness) in men and women. There’s not a ton of research on its efficacy, but it’s thought that the light wavelengths aimed at the scalp (either done in-office or at home with a lighted cap) can encourage hair follicles to re-enter the anagen phase.

Hair loss treatments, delivered

The tiny incisions made during an FUE hair transplant can trigger symptoms of trypophobia (the fear of small holes), including panic attacks, intense repulsion, fear, and trouble breathing.

But modern techniques should only leave tiny incisions that heal quickly with proper aftercare.

Here’s what to remember about hair transplant trypophobia:

  • Hair transplant trypophobia is a real concern for some individuals, but understanding the condition and seeking proper treatment can help manage it effectively.

  • Consulting a qualified hair transplant surgeon at a reputable hair transplant clinic and following aftercare instructions closely are crucial steps in ensuring a smooth recovery and minimizing trypophobic triggers.

  • If you’re considering alternatives to hair transplant surgery because you’re worried about trypophobia, that’s totally valid. Options like finasteride, minoxidil, and low-level light therapy may be viable solutions for hair loss.

Curious to learn more about hair transplants? Check out our guides to Black hair transplant options and using minoxidil after a hair transplant.

If you’re not sure a hair transplant is right for you but are interested in exploring other hair loss treatments, start by taking our free online hair loss assessment, which will connect you with a healthcare professional who can help.

You can also explore our treatment options for anxiety and depression on our mental health platform.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

10 Sources

  1. Banushi B. (2023). Breathwork interventions for adults with clinically diagnosed anxiety disorders: a scoping review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9954474/
  2. Becker-Haimes EM. (2022). It’s all in the name: why exposure therapy could benefit from a new one. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9161762
  3. Cole G, et al. (2013). Fear of holes. https://www.researchgate.net/publication/256189089_Fear_of_Holes
  4. Cole GG. (2024). Is trypophobia real?. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10897704/
  5. Dhurat R, et al. (2013). A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: a pilot study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/
  6. ISHRS. (2022). International Society of Hair Restoration Surgery: 2022 Practice Census Results. https://ishrs.org/wp-content/uploads/2022/04/Report-2022-ISHRS-Practice-Census_04-19-22-FINAL.pdf
  7. Kaczkurkin AN. (2015). Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610618/
  8. Le A, et al. (2020). Trypophobia: heart rate, heart rate variability and cortical haemodynamic response. https://pubmed.ncbi.nlm.nih.gov/32663944/
  9. Pillai JK, et al. (2021). Role of low-level light therapy (LLLT) in androgenetic alopecia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8906269/
  10. Varadhila S, et al. (2022). Decreasing symptoms of specific phobias with cognitive behavior therapy. https://www.researchgate.net/publication/373411484_DECREASING_SYMPTOMS_OF_SPECIFIC_PHOBIAS_WITH_COGNITIVE_BEHAVIOR_THERAPY
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Knox Beasley, MD

Dr. Knox Beasley is a board certified dermatologist specializing in hair loss. He completed his undergraduate studies at the United States Military Academy at West Point, NY, and subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA. 

Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military, helping to diagnose dermatologic conditions in soldiers all over the world. 

Dr. Beasley is board certified by the American Board of Dermatology, and is a Fellow of the American Academy of Dermatology.

Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen of course) with his wife and two children in his spare time. 

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