How To Navigate Injectables When You’re Scared Of Needles

If the thought of a needle piercing your skin elicits a visceral reaction, you’re not alone. In fact, an extreme fear of needles or needle phobia (formally known as trypanophobia) is fairly common. According to a study, it affects up to 30% of adults in varying degrees and for different personal and/or medical reasons, making many viable cosmetic treatments that require the use of needles simply out of the question.

While getting aesthetic procedures can be nerve-wracking for anyone, it’s especially anxiety-inducing for those with trypanophobia. “Needle phobia in the context of aesthetic medicine is a fear of needles, injections, and related treatments. This can cause significant discomfort around treatments like cosmetic injectables and procedures requiring blood draws, like PRP [platelet-rich plasma],” says Dr. Darren M. Smith, M.D., a board-certified plastic surgeon in New York City.

If your fear of needles is inhibiting your ability to sit for your pick of neuromodulator injections, filler, or the newest and buzziest radio frequency microneedling treatments, then this guide is for you. Ahead, learn more about dealing with needle phobia and how you can literally face your fears and book that dermatologist appointment for the bevy of aesthetic treatments you’ve always wanted to try.

What Does It Mean To Have Needle Phobia?

In the general sense, trypanophobia “is a specific phobia characterized by an intense fear of needles, injections, or medical procedures involving needles,” explains Dr. Evelyn Chan, M.D., a pediatrician and CEO of Smileyscope (which is virtual reality software used to help minimize the stress and anxiety associated with needle phobia). “Those who experience it often have severe anxiety, panic attacks, or even fainting at the mere sight or thought of needles.”

Dr. Chan explains that fear of needles can develop from a culmination of negative past experiences, witnessing someone else in any kind of distress or pain during a medical procedure, or it could just simply be feeling anxious about the idea of a needle puncturing the skin. “The fear might also be linked to a fear of pain, a fear of blood, or a fear of losing control,” she adds. Whatever the reason for being scared, it makes it extremely challenging for those that want to get aesthetic injectable treatments, where some patients simply avoid it altogether.

Though there are varying degrees of trypanophobia that manifest in different ways, there are techniques that can be used by medical professionals to reduce or mitigate this fear for patients that desire cosmetic injectables or microneedling. The general consensus is such: “In most cases, needle phobia is actually far less severe than the patient might initially believe, if it is addressed properly,” says Dr. Peter Lee, M.D., a board-certified plastic, reconstructive, and cosmetic surgeon and CEO of WAVE Plastic Surgery in Los Angeles. Dr. Lee instills hope for those who are scared of the needle: “We find that the vast majority of patients who initially present trypanophobia are willing to undergo treatments with injectables once their needle-phobia is addressed.”

Dr. Paul Jarrod Frank, M.D. a celebrity cosmetic dermatologist and owner of PFRANKMD in New York City, mirrors that sentiment, saying that by the time patients enter his office they have already taken a huge step in overcoming their phobia “...[I]t really just comes down to hand holding, alleviating their fears and making them feel comfortable not only about what they’re doing, but how they’re getting it. The needles that are often used are very small [and] the pain is relatively negligible.”

Aside from patients actually getting their foot in the door, the onus then falls on the provider administering the injectable treatment. “It’s important for us as healthcare providers to be aware of needle fear and take steps proactively to help our patients manage their apprehension and anxiety during medical procedures involving needles,” says Dr. Chan. “Often needle pain and anxiety is under-diagnosed and under-managed. This can lead to traumatic procedures and increased likelihood of developing long-term negative associations with needles.”

Techniques To Treat Needle Phobia

Though self-motivation plays a key role in actually scheduling your injectable appointment, there’s no doubt that choosing the right medical professional who knows how to make you feel comfortable, exhibits sensitivity, and has a general understanding of the extent of your needle phobia will help you pass this hurdle. “We can almost always make it work! It’s all about matching the fear with the appropriate response,” says Dr. Smith.

Below are some techniques used by medical professionals, as well as things to consider when choosing the right provider for you and your needs when seeking needle-based treatments.

1. Distraction Techniques

If you’re set on getting filler or Botox (or any other neuromodulator for that matter) it’s important to not actually see the needle itself. “The simplest thing that we [providers] can do for needle-phobic patients is we don’t let them see the needle,” says Dr. Frank. Dr. Chan utilizes distraction methods, such as engaging in conversation, storytelling, or even providing handheld gadgets to divert the patient's attention away from the needle. “Keeping [the patient’s] mind occupied can significantly reduce anxiety,” she adds.

2. Topical Anesthetics

The medical provider planning and caring about the patient’s comfort can go a long way in minimizing their anxiety during the appointment. “Some form of anesthetic should always be offered to the patient, whether it is the placement of topical anesthetic prior to the procedure, the injection of local anesthetic prior to the aesthetic procedure, or even something as simple as allowing the patient to apply an ice pack to the skin over the area to be treated prior to the procedure,” explains Dr. Lee. In addition, Dr. Smith says oral medication, such as Valium, can sometimes be used to relax a patient prior to injection. “For the most severe cases, IV sedation by a board-certified dermatologist can be an answer.”

3. Finding The Right Doctor & Office Environment

For some with needle phobia, going to a provider who is calm, understanding, confident, and above all else, patient, can make a huge difference for those seeking treatment. “The attitude of the injector will have a significant impact on the patient’s level of anxiety,” says Dr. Lee. “The injector should appear un-rushed in answering all of the patient’s questions and explaining the details of the procedure, as well as in the performing of it.” Additionally, finding a calming clinic, without harsh lighting and soothing colors can also help patients to feel more at ease when going for injectable treatments.

In a similar vein, the medical professional’s use of positive reinforcement can be beneficial. “Praising the patient for their bravery and acknowledging their efforts can boost their confidence and make the experience more positive,” says Dr. Chan.

4. Utilizing Your Own Relaxation Techniques

Relaxation techniques such as deep breathing, visualization (forming mental images to place yourself somewhere else), or mindfulness (calmly acknowledging present thoughts and circumstances) can help to manage anxiety before and during injectable treatments.

5. Therapeutic Interventions

Virtual reality (VR) therapy can help create an immersive and calming experience for patients. “VR [virtual reality] can transport [patients] to a different environment, effectively reducing anxiety and fear during the procedure,” says Dr. Chan. VR devices such as Smileyscope – which Dr. Chan created after working in hospitals with traumatized children – has proven to reduce patient pain (by 60%) and anxiety (by 40%). Dr. Chan has seen success with virtual reality devices during procedures such as vaccines, venipuncture, anesthetic, ER procedures, oncology/infusions, and women's health procedures.

Alternatively, cognitive behavioral therapy (CBT) or exposure therapy can be utilized. Dr. Chan says that these methods can help patients to understand and cope with their fear much more effectively.

6. Do Your Homework

Knowing what to expect going for a needle-based treatment can relieve anxiety and fear of the unknown. Educating yourself about the treatment you want, as well as having a practitioner that explains the step-by-step process can help to alleviate anxiety for some patients, says Dr. Chan.

7. Adopt A Gradual Approach To Procedures

Dr. Chan also recommends a gradual approach — starting with needle-free procedures and gradually building up to more invasive ones involving needles.

Alternatives To Needle-Free Treatments

If you’re still plagued by needle phobia, there’s still hope out there for achieving your aesthetic goals. “There are a few energy-based modalities that can offer similar benefits without needles,” says Dr. Smith. Dr. Frank recommends treatments such as Ultherapy, which utilizes ultrasound frequency, as well as EmFace and EXION, which both utilize targeted radio frequency to improve the appearance of the skin and help with laxity and collagen production.

Dr. Frank says he’s seen an increased demand for the aforementioned needle-less options, which he refers to as “injectable-sparing treatments.” The reason for this, he says, is that not only do “people [not] like needles or the trauma or fear associated with them, but because of the hyper commoditization and ‘overdone’ look that is associated with Botox and filler these days [so many turn to these treatments as alternatives].” He adds that, “People have fear of looking a certain way (an overdone way), so they tend to be looking more for injectable sparing [treatments] despite having a true phobia or not.”

What’s more, Dr. Frank says that there is something called “the law of diminishing returns” which is when patients need to start looking for these alternative “injectable-sparing treatments.” “The fact of the matter is, for many people, as they enter their mid to late 40s, there is a law of diminishing returns for the results of their injectables,” he says. “Whereas someone may do great with Botox and fillers in their 30s and 40s, they get to a certain age where they don't get the same effect — almost like the workouts that you did in your 20s don't seem to do it for you anymore; the diet in your 20s doesn’t do it for you anymore.”

This doesn’t make injectables bad, but for those that have needle phobia, this is the positive news that you want to hear.