What is Acarophobia? (An Overview)

In this blog we will discuss the symptoms, causes and treatment of Acarophobia.

A fear of very tiny insects that cause itching is known as Acarophobia.

People suffering from this type of specific phobia experience extreme anxiety when they see these tiny insects/bugs. If the anxiety worsens, one can also have full-blown panic attacks.

Acarophobia comes under anxiety disorders in the DSM-V.

Sufferers are unable to control their anxious feelings not only when they encounter a tiny insect in real life, but also when they think about them or the itching it causes.

Therefore, the mere thought of being exposed to an insect can instigate extreme levels of anxiety.

Phobias are irrational fears. However, the fear of tiny  insects is somewhat valid. This is because they can be harmful to humans as they carry a number of diseases.

If they come in contact with humans, it is very likely that they transmit these diseases to them.

Also, they can bite people which might lead to certain health issues. The itching they might cause can lead to other skin problems.

Fear of tiny insects, which one is very unlikely to see  is normal, as many people dislike them or are afraid of them.

However, in Acarophobia, one suffers from overwhelmingly high levels of anxiety when they see a tiny insect or even think about them.

For them, even the slightest site or presence of different insects can result in panic attacks. And sufferers are unable to rationalize their fear fully.

Additionally, people suffering from Acarophobia take all the possible measures to avoid tiny insects/bugs.

Avoidance produces pleasant feelings for them and they repeat their actions in order to maintain those feelings.

This repetitive action of avoiding tiny insects maintains their fear. It proves the sufferer that they are to be feared of and that only avoidance can make them feel good.

Though this can change their act of avoidance into compulsions. An individual might develop Obsessive-compulsive disorder in the long run. 

According to the DSM-V, someone suffering from Acarophobia must experience anxiety lasting for at least 6-months and this anxiety should affect one’s social and occupational functioning.

One might have to leave their house and move someplace else because of the fear of encountering tiny insects or bugs.

For example, someone living near a garden has a higher chance of getting exposed to them.

They may need to leave their family and live independently. Thus, their social relations are affected.

A child might even avoid attending school if they encountered a tiny insect in their classroom or school.

Likewise, one can leave his job if he’s afraid of encountering his fear stimuli in his office. This affects one’s career or academic life.

This occupational dysfunction can cause one to develop depression as a result of his inability to live a normal life or earn a good living for their family. 

Acarophobia is an irrational fear of very tiny insects. These insects can cause a feeling of itchiness and therefore, one experiences extreme anxiety.

Tiny insects which one fears in this type of phobia can be lice or small bugs. 

Symptoms of Acarophobia 

People with Acarophobia, like in all other specific phobias experience intense anxiety on having an encounter with tiny insects.

They’re unable to control this anxiety and thus end up feeling more anxious. This anxiety, in extreme cases, can give rise to full-blown panic attacks.

Sufferers go into flight or fight mode because of an adrenaline rush. In this state, the body’s physiological responses help one make decisions when in fear causing situations.

They either decide to escape the situation (flight) or stay and combat their fear (fight).

In the case of Acarophobia or any other type of specific phobia, the physiological symptoms that are produced when exposed to tiny insects (including extreme anxiety) cause the person to escape or avoid that situation.

Sufferers don’t have the courage to fight with their fear because of the unpleasant, terrifying experience the body goes through.  

In Acarophobia one experiences anxiety lasting for at least 6-months, according to the DSM-V. 

Apart from anxiety, Acarophobia has a number of other physiological symptoms which include:

  • Extreme anxiety when exposed to tiny insects
  • Extreme anxiety by just thinking about tiny insects/itching they cause
  • Avoiding tiny insects
  •  Full-blown panic attacks
  • Inability to handle anxiety
  • Muscle tension
  •  Increased heartbeat
  • Breathlessness
  • Feelings of dizziness 
  • Screaming or crying
  • Hot/cold flashes when in a flight or fight mode (A hot flash refers to the temporary heating up of the body when in a state of fear. And a cold flash means when the body suddenly starts to shiver or cool down, when encountered by a fear stimulus).
  • Migraine
  • Nausea
  • Upset stomach

Out of these, one should have at least 3-5 symptoms (including anxiety) to be diagnosed with Acarophobia. 

Causes of Acarophobia 

Like every other specific phobia, Acarophobia is a result of either genetics or a past traumatic experience.

Someone who has a family history of anxiety disorders or specific phobias has a higher chance of developing Acarophobia than someone who doesn’t.

This is because they are genetically predisposed to develop it. 

This genetic tendency to develop a mental disorder/specific phobia can also be referred to as a Diathesis-stress relationship.

According to this, one with a genetic predisposition will not develop symptoms of Acarophobia until and unless there is some trigger event, instigating anxiety or fear of tiny insects.

This triggering event can be for example, coming in contact with a tiny insect in childhood.

The sufferer might have developed this fear since then because of the disgusting or unpleasant feelings it caused.

Also, he might be fearful of developing an allergy or other health problems because of the diseases those insects might transmit. 

Or, one might have been punished as children, locked in rooms where they were exposed to tiny insects. 

Another example of an environmental cause can be, learning to be afraid of tiny  insects by looking at parents.

It is possible that someone whose parents are afraid of tiny insects/bugs, or upon hearing an unpleasant experience of an individual’s encounter with them can induce fear in the person.

Also, watching documentaries on tiny bugs/insects can be the reason for one to develop Acarophobia.

One might be afraid of them because of the way they look, ‘ugly’. 

Therefore, it is evident that there is no one cause for specific phobias to develop. Genetics with environmental factors, together will cause one to have Acarophobia.

Treatment of Acarophobia 

Acarophobia, like all other specific phobias, has no exclusive type of treatment that is specifically designed to treat it.

Like all the other specific phobias, Acarophobia is treated by a number of different therapies including, Exposure Therapy, Cognitive-behavioral Therapy (CBT) and or medications that lower downs the anxiety or other physical symptoms.

• Cognitive-Behavioral Therapy (CBT)

It is one of the most frequently used treatments for patients with almost all kinds of mental disorders.

Acarophobia is defined as the irrational fear of tiny insects and/the itching they cause.

Thus, the therapist helps the patient in replacing these irrational thoughts with more rational ones.

The patients are helped out in analyzing and justifying the way they feel about being exposed to tiny insects.

Therapists assist them in uncovering the reasons behind their fear and later they provide them with alternate, pleasant thoughts.

The patient is told to maintain a thought diary (with ABCD column) which provides them a replacement for every irrational thought they have, when thinking about a particular situation.

The ABCD stands for:

i.      A (antecedents) a situation or triggering event.

ii.     B (belief) the thought that comes to one’s mind when in that triggering situation.

iii.    C (consequences) the symptoms/feelings caused by that event/thought

iv.    D (dispute) alternate, rational thoughts provided by the therapist in an attempt to    dispute/challenge those irrational beliefs.

This last section of the thought diary is what really plays a role in helping the person feel good/less anxious

• Exposure Therapy

It is one of the most frequently used ways of treating patients with Acarophobia (or any other kind of specific phobia).

In this therapy, the patient is exposed to the source of his fear over a certain span of time.

To begin with the therapy, the therapist exposes the patient to the least triggering stimuli, a picture of a tiny insect, lice for example.

As the therapy progresses and the patient is able to control his anxious feelings, imagery can be used to take the treatment a step further.

In this part of the treatment the patient is asked to visualize/imagine a situation in which he sees or encounters a tiny insect.

During this process of imagery, one actually feels being in that particular situation or place, experiencing various senses.

 Once the person successfully, without feeling anxious clears this step of the therapy, he is then exposed to real tiny insects.

While the patient is being exposed to different intensities of stimuli during the various stages of therapy, the therapist simultaneously teaches them coping exercises.

These include, breathing techniques or muscle relaxation methods to lower their anxiety, when in an actual fear/anxiety causing situation.

This teaches them how to remain calm when exposed to the fear stimuli.

Before actually starting the exposure therapy, the therapist needs to figure out the intensity of the patient’s fear, as to deduce whether they will be able to undergo this treatment, without any physical or psychological harm caused to them during the exposure processes.

However, these steps desensitize one to their fear of tiny insects, by exposing them to that stimuli repeatedly, until they learn to undergo the situation without anxiety/panic attacks.

• Dialectical Behavior Therapy (DBT)

This is another effective therapy used to treat Acarophobia.

It is more commonly used with people suffering from personality disorders, but is also useful with patients of this ‘animal’ specific phobia.

Coping skills are taught in the DBT group which lasts for about 6 months and can have a number of people (depending on how many join the group).

        i. Half-smiling is the first module of DBT. It is a technique that is used with patients who are distressed because of their irrational thoughts.

The technique is known as ‘Half-smiling’ because the person is first advised to think about the stimuli that fears or upsets them, and while doing so they are told to lift the corners of their mouths by subtly smiling.

Smiling is not that will help one get rid of these unpleasant thoughts, it is the person’s ability to constrain itself from thinking about those thoughts while half smiling.

      ii. Mindfulness, the second module, is another technique used in DBT groups which helps the individual in getting rid of those negative thoughts.

Individuals are told to focus on the present and be attentive to what is going on around them at the moment. This helps in breaking the link between their mind and any negative thought that might come to them then. 

For example, a person is told to focus on his breath or on the sound of the blowing wind, making use of their auditory sense.

     iii. The third technique or module of the DBT is distress tolerance skills. This module teaches people to calm themselves down in healthy ways when they are distressed or emotionally overwhelmed.

Individuals are allowed to make wise, rational decisions and take immediate action, rather than being captured by emotionally destructive thoughts that might make the situation worse.

Reality acceptance skills are also learnt under this model so that people fully accept reality and later make plans on how to address the problem/fearful aspects to it.

• Mindfulness-Based Stress Reduction (MBSR)

MBSR is a meditation therapy, used to manage stress or anxiety. It is an 8-week program which includes group sessions.

Mindfulness meditation and Hatha yoga are practiced in these sessions. Lectures and group discussions are also done to talk about mental health and increase interactivity.

In mindfulness meditation the person is told to, for example, to focus on the sensations felt while breathing or the rhythm of the chest rising and falling during the process.

This distracts the person’s attention from something stressful to something which is neutral and soothing.

For quick and effective treatment, patients are also given a set of home works, for example 45 minutes of yoga and meditation sessions for 6 days a week and to record their results/feelings in a book or diary for 15 minutes a day.

• Drug Therapy

Drugs are used to reduce the physical symptoms caused by Acarophobia.

Drugs are very quick in effectiveness, as they start showing progress in the patients’ health at least 2 weeks after the medicine is taken.

This type of biological treatment is usually more effective if the cause of the phobia is only genetic.

However, these drugs/medicines are not to be taken without a doctor’s prescription or consultation.

Two types of drugs are used in the treatment of this phobia:

                    i. Anti-anxiety Drugs

Medicines like Valium are anti-anxiety drugs. They are most commonly used with patients who experience panic attacks and also lowers their anxiety by binding to receptor cells of the brain that cause these unpleasant symptoms.

                   ii.         Antidepressant Drugs

These drugs, as the name suggests don’t only treat depression but are also very effective in treating phobias.

Medicines like Lexapro reduce the anxious feelings of a person and makes him feel calm. They need to be taken on a daily basis but not without a doctor’s advice.

Whether the cause of Acarophobia, or any other type of specific phobia is genetics, environmental or both, the best and the most effective way of treating them is by using a combination of both biological treatments (drugs) with cognitive treatment (for example CBT/exposure therapy).

Titles to read 

by Leslie Sokol and Marci Fox

by Seth J Gillihan PhD

  • Phobias: The Psychology of Irrational Fear

by Irena Milosevic and Randi McCabe

by Michelle G. Craske, Martin M. Antony, et al.

Frequently Asked Questions

Q1) What causes Acarophobia?

Acarophobia is the irrational fear of tiny  insects.

It is caused either due to a genetic predisposition (family history) and or an environmental factor (a past traumatic event).

Q2) Do I have Acarophobia?

One can be diagnosed with Acarophobia if one shows symptoms of it.

These symptoms include extreme anxiety, panic attacks, inability to avoid anxiety, muscle tension etc.

Q3) What is the difference between Insectophobia and Acarophobia? 

Insectophobia is an irrational fear of insects. Whereas, Acarophobia is an irrational fear of specifically tiny insects.

Both are specific phobias. 

Q4) Is Acarophobia curable?

Yes. Like all other specific phobias, Acarophobia is also treated using psychotherapies.

These therapies include CBT, exposure therapy, MBSR and or medicinal drugs.

Examples of other interesting phobias



  • https://psychtimes.com/acarophobia-fear-of-tiny-insects-that-cause-itching/
  • www.apa.org
  • www.brain.org
  • www.psychologytoday.com