Pulling Out The Big Guns For Needle Phobia In An Insane World Where Nobody Seems To Take It Seriously

a tutorial for anyone else who might need help

My needle phobia is genetic. I had no traumatic experiences, zero issue with shots as a kid, but one day randomly a vaccine at 16 laid me out unconscious on the ground as I tried to walk out of the clinic.

This phobia - probably blood, injury, injection phobia or BII, is genetic. It also seems to be one of the few phobias that can kill you from the fear response alone.

It was so bad for me I avoided medical care for a long time. People would say ‘oh don’t worry, don’t look’, which was absolutely infuriating. I would have panic attacks. Once I had to have an IV in for an hour and I sobbed the entire time. My body did not get accustomed to having something foreign in my skin, it did not get tired of panicking, it just managed to sustain a panic attack for the entire hour that it was inside my arm and all the nurses were very annoyed. Needle phobia is one of the few phobias where exposure therapy is ineffective and often actually makes the phobic response worse.

The title might be misleading - I didn’t fix the needle phobia - the terror is still there - but I’ve managed to get a handle on it well enough that I’m now in my second round of egg freezing - a process that requires injections every day and blood draws every few days for ~2 weeks. The first night of my first round I almost quit - I laid awake for many hours that night stress panicking, unable to sleep due to the fear of having to do it again the next day. But I’ve gone from that to being able to hold a semi-normal conversation during injections. That is insane.

This is a very detailed guide on all the insane shit I tried, all the stuff that failed, and finally the absurd, long elaborate process that succeeded. I hope it helps someone else.

I am going to say the word ‘needle’ a lot; if this is a problem for you, I recommend you get a friend to read it and do translation.

My own phobia comes from the painful sensation of something penetrating my skin. If it’s not painful or I can’t feel it, my brain doesn’t ‘believe’ it’s happening, and the phobia isn’t triggered. If your phobia is something more psychological like knowing about blood coming out of you, then this probably won’t help. All my strategies are about figuring out how to make me not feel a needle.

All The Other Stuff I Tried, Ranked From Worst To Best

8. Don’t look at it, think about something else, distract yourself

lol. this is like going ‘think about something else’ to handle getting in a freeway car wreck. not even gonna address this one, it’s laughable, if you say this to someone with a severe needle phobia you need to grow an empathy.

7. Vibrating the area

This operates on the idea that by vibrating the area next to a needle, it’ll confuse the nerve sensations. I tried Buzzy, and once in an attempt to be more local and have a stronger vibration I tried a vibrating toothbrush.

Pros: Cheap, easy to bring with you

Cons: Nurses don’t like it for blood draws cause it gets in the way, it’s hard to have it close to the penetration site. It also is simply not that effective! I can still pretty clearly feel the needle.

It’s possible this might be good for something like an IV (you could conceivably strap it on top of the entry point for the IV), or it might work if you had a full-on hitachi there, but I have personally given up on this method.

6. Shot Blocker

Similar to vibration, this is ‘hey, if we kinda stab a lot of sharp things at your skin everywhere, how will your brain know that one of them is going all the way in?’

Pros: Easy to carry in a bag. It also actually does kind of work for small injections.

Cons: Nurses still don’t like it for blood draws. They can sometimes be weird about the sterilization, especially cause it surrounds the needle site. You also have to *really* push down until the entire area kind of hurts, and this requires your hand to be positioned in a way that can get in the way of the practitioner.

I’d still use this as a backup method for smaller injections, but not larger ones, and I never bring this along for blood draws.

5. Anti-anxiety medication

Some sympathetic doctors would give me anti-anxiety meds. The recommended doses never worked for me, not even a little bit. The panic response completely cut through the medication at standard doses.

So I decided to try incrementally upping the medication until the panic response was under control. I tried this primarily with lorazepam. This did eventually work - I finally took a dose so high that I had around a 50% less intense panic response during a blood draw (though I still sobbed the entire time).

…Cons are that this dose was so high that I have memory loss from that day and as soon as I got home in the afternoon I slept for 14 hours. I don’t really like blasting out with benzos so hard and so regularly - I get STI tested a whole lot so I need something more sustainable.

I did notice, though, that the next time I had to deal with a needle after that, I was a bit less panicked. I suspect going through one draw while not panicking sort of helped my body ‘learn’ that it didn’t have to panic in the future. This effect didn’t last though.

I’ve also tried valium, which was a little better than lorazepam, but I haven’t found a doctor willing to prescribe me a whole lot of it yet.

I’ve also tried propranolol, a beta-blocker medication that helps block adrenaline response. It’s hard to tell if it’s effective. The doses I’ve tried it (20mg I think?) didn’t have any noticeable impact on the fear intensity. It’s possible that it will help decrease terror over time, in the sense that if you can stop your body from physically panicking a little, it might train your brain that there’s not as much to worry about as you thought. But I’m not sure and this needs further experimentation.

4. Lidocaine Injection

I don’t know about this one on its own. It requires a needle to put the lidocaine in. Most doctors won’t do this, especially not for a blood draw. I got this once for an IV and it was the best experience I’ve had with an IV. But they told me they were going to ‘give me lidocaine’ and I thought it was topical; the actual injection part was a complete surprise to me, and I’m glad they didn’t tell me, cause it hurt real bad.

Now the surprise is ruined, and injecting lidocaine straight will cause the same panic.

4B. Topical lidocaine

You can get the highest strength lidocaine cream you can and leave it on in advance. This is…. fine. It penetrates only 1-2mm, and I find it reduces the pain by maybe ~15%. I’ve mostly stopped using it because I do better with other methods.

3. Butterfly needles

If you’re brave, you can ask for butterfly needles. I have trouble asking because if they say no, then I know they’re going to be putting in a much bigger needle and that makes my panic way worse.

If you’re coming with someone for moral support, you can ask that person to privately ask the practitioner to use a butterfly needle, and simply have nobody tell you.

They do hurt much less than most needles, but the tradeoff is that blood draws take much longer. But I have occasionally experienced no pain using butterfly needles alone, which is a huge accomplishment. Thus despite the inconvenience, an actual ‘no pain’ option ranks high on my list.

2. Ice

Shockingly good! Ice packs are like ‘don’t press directly against the skin’. Ignore this. Press it directly against the skin, for ~5-10 minutes. I push it in hard.

I discovered that for some reason, a bottle of alcohol left in the freezer will freeze you colder than just an ice pack. This can also give you frostbite.

My injection area ~1 week after I froze for too long

Turns out really cold skin goes leathery and hard to penetrate! If your skin is getting leathery, or holding wrinkles (like if you pinch it the pinch just stays there like a permanent ripple in your skin), then you have gone too far and you’ve probably burned yourself. Just check yourself occasionally to make sure your skin texture still feels human.

Ice is easy to transport, I have a little mobile case I use with a few ice packs in it for blood draws at the clinic.

1. Iontophoresis

All right guys here we go, the big guns

Turns out iontophoresis - driving an electrical current through the skin - is a thing people have studied for administering lidocaine decades ago. They used to have devices for this, but you can’t get them anymore, and doctors have no idea this exists.

It’s supposed to go something like this:

You get something (battery, electrical device) that will send a current through wires, between 2-5mA.

You attach the positive wire to a conductive pad or something, and then somehow put a bunch of lidocaine in that pad.

You put the negative pad a few inches away from the positive one, and then run the current. The lidocaine molecule is positively charged and small enough to be able to go between skin cells, so the current will pull it through your skin. The documentation usually says the numbing hits roughly 5 millimeters deep.

Cool. I wanted to try it. How?

The lidocaine

I needed to get my hands on some lidocaine. But it takes a while for this to administer - usually 15-25 minutes, and I wanted the most numbing possible, so I was aiming for the upper end. But lidocaine alone gets washed away by your body kinda fast. In the studies, people usually mix the lidocaine with a little epinephrine (pretty common in lidocaine injections) to help constrict the blood flow and keep the lidocaine in the area for longer.

I could not, for the life of me, find anybody who would prescribe this to me. There were sketchy indian websites that sold injectable lidocaine, but it was without the epinephrine.

I figured I could probably just mix my own. I got some vials of the 2% lidocaine-only (I actually ordered from a few pharmacies, and all of them did come!).

But how to get epinephrine? That turned out to be pretty easy - that’s just the drug in epi-pens. I got a friend to send me an epi-pen, I calculated the ratio (1:100000), and injected the epi-pen directly into the lidocaine vial. I was very lucky that the full epi-pen matched up perfectly with the vial size (30mL).

I figured the error margins with the epinephrine here were okay. If I fucked up, the worst that could possibly happen couldn’t be worse than giving yourself an epi-pen shot, which is unpleasant but people do all the time. And you have to inject a lot of lidocaine for it to start getting dangerous - without epinephrine, danger zone starts around 15mL of 2%, which was half of my entire vial. And with gradual administration, you’d start noticing symptoms before it got serious. I was going to use ~2mL of the solution max, and only like 20-30% of this gets absorbed through the skin anyway. I was well within safety margins.

The device

By sheer chance, I happened to already have an iontophoresis machine, sent to me for free by Dermadry as the one and only influencer product I’ve shilled (I have hyperhidrosis).

It’s not hard to get a prescription - all you have to do is tell them you sweat excessively from the hands and feet and you’ve had it since you were a child and you don’t sweat when sleeping at night - but the device itself is pretty expensive, around $500. You could prob find a tens unit for cheaper, but make sure the current is direct and not alternating. You need the current to be flowing stable in one direction, and not going back and forth.

If you do go with Dermadry, they do alternate the current (when on hand or feet mode), but only every five minutes. I just set a timer and reset the device every five minutes. I also had to figure out which outlet started out putting out the positive charge. You can do this by sticking both metal leads into a cup of salty water for a few minutes and seeing which lead develops bubbles. If it’s got bubbles, it’s negative!

You can easily control the intensity with this device, which turned out to be really important!

Make sure to get connection conversion things to help you connect the leads to smaller pads.

Connection Locations

How to administer??

There are iontophoresis drug patches available online, but they are expensive and I’m suspicious of them.

You’re supposed to place the negative patch - the one that all the current flows into - a few inches away from the positive one, but I was suspicious about this. My egg freezing medications need to go at least 6mm in there, and the medication itself burns like a wasp sting. I really need the current to go deep. And if it’s moving mostly sideways - wouldn’t that not be deep?

But if you place the negative connection far away, it might result in less concentrated dispersal. Like, it might spray loosely downwards into your fat like a sprinkler in a garden, while if you put the connection close it might at least operate like a hose, even if the hose shape is curved.

I tried both, but ended up picking the far away patch because it hurt less.

The pain of the current was weirdly variable, and super sensitive to exactly where I placed the patches. I found the least painful spot for the negative connection was on my hip, slightly towards the back of my body, in the direction of my butt.

If you’re going to be trying this, I would experiment a lot with placement, and don’t get discouraged too fast if it seems uncomfortable. I tried like 8 uncomfortable placements before I miraculously found an arrangement that for some reason didn’t hurt. I don’t know why this is.

How Do Lidocaine

I had a bunch of basic tens unit patches already for weird sex stuff. I figured I should attach it to some kind of absorbent sponge, saturate the sponge, push it onto my skin, and see if that worked.

I started out using a very thin sponge, like this

This was bad. The holes in the sponge meant the current got applied in irregular spots, it hurt much more, and I got tiny little electrical burns.

I ended up just cutting out pieces from puppy pads:

If you do this, make sure you peel the plastic layer off.

I found that two layers of the puppy pad absorbent material is best. Your goal is to get a very even distribution of current, all of which is going through a good amount of lidocaine. One layer ended up being slightly spotty, but two was much better.

I pressed the absorbent material onto the electrode pad. I cut the electrode down to be smaller. I don’t recommend this, because it’s easy to accidentally fuck with the connectivity of the pad itself. You should get 1”, which are smaller than what’s usually sold. I usually get mine from here, I just happened to be out during this egg freezing round.

I left a little outline of the absorbent material around the edge of the pad, so that I wouldn’t be in danger of the pad accidentally touching my skin itself. This happened during one of my experiments, and I got a cute lil electrical burn again <3

I then take a needle and syringe, pull roughly 1-2mL (depends a LOT on how big your pad is and how much absorbency you have), and squirt it onto the pad until it’s saturated. I usually saturate it until I see it start to drip, and then I know I’m ready.

I use a washable marker to draw a circle around the area I’m going to administer it (so that my friend who’s actually injecting me can see clearly where to go, and so I can replace the pad exactly correctly if I need to remove it for some reason), I press it down on my skin, and put a bandaid on top so I don’t have to worry.

It looks like this:

I’ve been trying to do as much as possible - around 25 minutes, as high as I can go. I can often hit 5mA, but spend a lot of time on 4mA too. It took a while to figure out placement and electrode type; when I first started doing this, I was stuck on 2-3mA.

I don’t think there’s safety issues with this; dirt molecules are, I think, too big to get drawn down with the current. The iontophoresis machine itself is cleared by the FDA, which is way overly conservative, and I use it regularly on my hands and feet with zero sterilization requirement and zero side effects.

The amount the numbing works seems to vary. I think it achieves around 50% numbing - which is pretty impressive given that my injections require a deep needle and a burning medication. It achieves 80-90% numbing for smaller, normal injections.

I know this because the level of numbing allows me to do a lidocaine injection. With one of the extra vials of lidocaine (I’m using a separate one to ensure it’s sterile, because I wasn’t very careful to keep the one to saturate the electrode pad sterile) I had my friend draw up about 0.4mL and inject me. It was very faintly uncomfortable but I barely felt it. After waiting a few more minutes, we did two more injections, and those were 90% reduced from the typical pain. The injection was lidocaine only, not epinephrine, partly because I didn’t have another epi-pen and partly because I didn’t need to wait too long like I had to do with the iontophoresis.

Also remember that you prob shouldn’t go over ~1.5mL of injection volume in one area, so make sure you factor your lidocaine volume into that.

The lidocaine+epinephrine from the iontophoresis alone lasts a while, and would probably be reasonable to try if you live 10-15 minutes away from a doctor. You could also get an external battery to run the iontophoresis in the car on the way there. It does last longer than ice - the internet says 1-3 hours, which I haven’t tested but to the touch it does seem to go for a while.

One downside is that the lidocaine, at least for me, itches pretty badly for about 2 hours afterwards. Not sure how to fix this, but I’d rather take that than needle pain.

I’ve also used ice on top of iontophoresis, but this is a little dangerous because you can’t feel the ice as well, and it’s harder to notice when you’re getting frostbite. I accidentally burned myself again this time, despite trying to be careful, because I couldn’t really feel my skin.

I have zero medical training, but most (not all!) medicine stuff that nurses do seem pretty easy. Just make sure you sterilize everything - I use alcohol pads to wipe down my skin before each step of the process, make sure you know how to inject (I’m not doing my own injections, but my friend is, and she takes the proper steps with no airbubbles, being slow and clean, etc.). Don’t be an idiot about this, when in doubt, triple check and err on the side of caution. I’m partially inferring this is all safe to experiment with because it’s common to have women do their own egg freezing injections, which means it can’t be too hard to fuck up.

---

I am still figuring some stuff out here. Some questions, which I might come back to update in this article as I discover the answers:

1. Can I figure out a way to place the electrodes closer and have it not hurt as bad? If so, will this be more or less effective placement for pain reduction?

2. Is 25 minutes really the best time? Can I go up to 6 or even 7mA? If so will it be just as effective in a shorter period?

3. Electrical current is real hard to predict when it’s inside the body, as it flows differently around organs, fat, muscle, bones, etc. Are there unintuitive placement shifts that would cause better numbing?

4. How much does the size of the pad matter? If the current is drawing the medication down in a very unconcentrated way, maybe a larger pad would help mitigate this (by just dosing a higher total amount)?

I have found that, in general, the more I figure out how to reduce pain from needles, the less my body panics in anticipation of it. It’s not perfect, but overall my anxiety is learning that needles are less bad than they used to be; it’s starting to trust the numbing.

Anyway, I wish you the best of luck. I am pretty infuriated that the medical field seems to not take needle phobia seriously, and I hope we get better tech to make this not immense torture.