If the thought of a blood test, a vaccine or an injection makes your heart race, you are far from alone. Needle phobia – a strong fear of medical procedures that involve needles – affects at least 1 in 10 people (Guy's and St Thomas' NHS Foundation Trust [GSTT], 2024). It is nothing to be ashamed of, and simple steps can help.
Key points
- Tell staff you are scared, and if you have ever fainted.
- Learn applied tension if you feel faint, or slow breathing if you feel panicky.
- Numbing creams such as EMLA and LMX4 can take away the sharp scratch.
- Face your fear in small steps with a fear ladder.
- Free NHS talking therapy can help.
What is needle phobia?
It often starts with bad experiences of needles in childhood. People tend to react in one of two ways:
- Feeling faint. Your heart rate and blood pressure rise, then drop quickly – and that drop can make you faint.
- Feeling panicky. Your heart races, your chest feels tight and your stomach churns, but you do not feel faint.
Knowing which sounds like you helps you pick the right technique (GSTT, 2024).
| How you react | What is happening | What to try |
|---|---|---|
| You feel faint, or have fainted before | Blood pressure rises, then drops suddenly | Applied tension, and ask to lie down |
| You feel panicky but not faint | Your body's alarm system kicks in | Breathing for relaxation |
| You avoid appointments altogether | Avoiding needles can keep the fear going | A fear ladder, or free NHS talking therapy |
Key insight
Staff will not think you are weak if you tell them you are scared. Knowing helps them help you – for example, by chatting to distract you (GSTT, 2024).
Technique 1: applied tension (if you feel faint)
This raises your blood pressure to help stop you fainting:
- Sit somewhere comfortable.
- Tense the muscles in your arms, upper body and legs. Hold for 10 to 15 seconds, or until you feel warmth rising in your face.
- Let go and sit normally.
- After 20 to 30 seconds, tense again.
- Repeat until you have done it 5 times.
Applied tension in four steps, based on GSTT (2024).
Practise 3 times a day for about a week. If you get headaches, do not tense your face. Take care with painful joints or other problem areas (GSTT, 2024).
Technique 2: breathing for relaxation (if you feel panicky)
- Sit upright but not stiff. Let your shoulders and jaw relax.
- Put one hand on your belly. Breathe in slowly through your nose and out through your mouth, as deeply as feels comfortable.
- Do this for 5 breaths.
Practise 3 times a day for a week. Both exercises are safe in pregnancy and with most medical conditions (GSTT, 2024).
Tips for the day of your appointment
- Book soon. Much of the anxiety comes from waiting, so a nearby date leaves less time to worry (Hobson, 2025).
- Mention fainting. If you have fainted or felt dizzy before, say so. Staff can help you lie down (British Heart Foundation, 2021).
- Eat and drink beforehand, unless you have been told not to (Hobson, 2025).
- Bring someone you trust. A partner, friend or relative can really help.
- Relax your shoulders and arms. The more relaxed you are, the less you will notice the needle (British Heart Foundation, 2021).
- Look elsewhere. Focus on a spot on the floor, your phone, a chat or music on your own headphones. You can ask for needles to be kept out of sight (Hobson, 2025).
And remember: the needle might hurt a little, but it is not unbearably painful (GSTT, 2024).
Not sure what to say? Try this
"I'm really anxious about needles and I've fainted before. Could I lie down, and could you talk me through it while I look away?"
Saying it early helps.
Numbing creams: what is available
Numbing creams contain a local anaesthetic that numbs the surface of your skin. They take away the sharp scratch, although you may still feel pressure and touch (Aspen, 2026). Some NHS services can offer one (East and North Hertfordshire NHS Trust, 2022), and you can buy them from a pharmacy or get them on prescription (British Heart Foundation, 2021).
NICE has not named one cream for needle fear, but two are licensed in the UK for numbing skin before needles (Aspen, 2026; Ferndale Pharmaceuticals, 2021).
| Cream | What is in it | When to put it on | Who can use it |
|---|---|---|---|
| EMLA (also sold as Nulbia) | Lidocaine and prilocaine | At least 60 minutes before, but no more than 5 hours | Adults and children – doses differ by age |
| LMX4 | Lidocaine 4% | At least 30 minutes before | Adults and children over 1 month |
Sources: Aspen (2026); Ferndale Pharmaceuticals (2021).
Using a numbing cream safely
- Ask a pharmacist, GP or nurse which cream suits you, and where the needle will go.
- Put a thick blob on – do not rub it in – and cover it with a dressing.
- Do not use it on broken skin, rashes or eczema, or near your eyes.
- Check with a pharmacist first if you are pregnant or breastfeeding, have a rare blood condition such as G6PD deficiency, or take heart rhythm medicines.
- Tell the nurse where you put it, especially before a live vaccine such as the TB vaccine.
(Aspen, 2026; British Heart Foundation, 2021)
Facing your fear with a fear ladder
Next, face your fear one small step at a time. A fear ladder is a list of needle-related situations, scored from 0 (easy) to 10 (hardest), with the easiest at the bottom.
An example fear ladder, adapted from GSTT (2024).
- Start with the easiest step and give yourself plenty of time.
- Use your applied tension or breathing exercise.
- Stay with it. Anxiety usually rises, levels off, then fades – and you learn that what you feared did not happen.
- Relax, then repeat until that step feels manageable before moving up (GSTT, 2024).
If you need to inject yourself at home
Many people with inflammatory arthritis take weekly methotrexate injections. A health professional will usually give the first one and show you how to inject yourself. Arthritis UK advises telling them if you think you will find injecting yourself difficult (Arthritis UK, n.d.).
You do not have to self-inject. Nurses should tell you that you can choose not to, and a carer may be trained to do it instead (Royal College of Nursing, 2021). You can also call the Arthritis UK helpline free on 0800 5200 520 (Monday to Friday, 9am to 6pm). If methotrexate side effects are also a struggle, read our guide to the 'methotrexate hangover'.
If it is your child who is scared
- Be honest. Explain why the test is needed, in words that suit their age.
- Offer real choices – what to bring, whether to sit on your knee or lie down, and whether to watch or look away.
- Practise through play. Act it out with a teddy, and practise slow breathing by blowing bubbles.
- Plan a treat for afterwards, and praise what went well, even if it was hard.
- Mind your own nerves. If needles scare you too, bring another trusted adult.
(Leeds Teaching Hospitals NHS Trust, 2026)
Children's services may also use numbing cream (from 1 month old) or a cold spray that numbs skin within seconds (Evelina London Children's Hospital, 2020).
Getting more help
If fear is stopping you getting healthcare, speak to your GP (British Heart Foundation, 2021). Cognitive behavioural therapy (CBT) – a talking therapy that helps you change unhelpful thoughts and habits – is usually recommended for needle phobia (GSTT, 2024).
If you live in England and are 18 or over (16 or 17 in some areas), you can refer yourself to free NHS talking therapies. You do not need a diagnosis, and phobias are one of the things they help with (NHS, 2025). Elsewhere in the UK, or if you are under 18, ask your GP. You might also find our self-help guide to managing anxiety useful.
Know your rights
If you are disabled – for example, autistic or living with a learning disability – the Equality Act 2010 means NHS services must make reasonable adjustments so care works for you. In England, these can be flagged on your health record (NHS England, 2025). Just ask.
Frequently asked questions
Can I ask to lie down for a blood test or injection?
Yes. If you feel faint, staff can help you lie down (British Heart Foundation, 2021).
Do numbing creams really work?
They numb the surface of the skin, so the sharp scratch is dulled, but you may still feel pressure and touch (Aspen, 2026).
Can needle phobia be cured?
Many people overcome it with practice and support. CBT is usually recommended and is free on the NHS (GSTT, 2024).
References
Arthritis UK (n.d.) Methotrexate. Available at: https://www.arthritis-uk.org/information-and-support/understanding-arthritis/arthritis-treatments/drugs/methotrexate/ (Accessed: 2 October 2026).
Aspen (2026) EMLA Cream 5% (5g pack): patient information leaflet. Electronic Medicines Compendium. Available at: https://www.medicines.org.uk/emc/product/871/pil (Accessed: 2 October 2026).
British Heart Foundation (2021) Needle phobia: how to get over your fear of needles. Available at: https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/phobia-of-needles (Accessed: 2 October 2026).
East and North Hertfordshire NHS Trust (2022) Needle phobia: patient information, Women's Services. Available at: https://www.enherts-tr.nhs.uk/wp-content/uploads/2022/06/Needle-phobia-v1-06.2022-web.pdf (Accessed: 2 October 2026).
Evelina London Children's Hospital (2020) Pain relief during blood tests. Guy's and St Thomas' NHS Foundation Trust. Available at: https://www.evelinalondon.nhs.uk/resources/patient-information/pain-relief-during-blood-tests.pdf (Accessed: 2 October 2026).
Ferndale Pharmaceuticals (2021) LMX4 Lidocaine 4% w/w Cream: patient information leaflet. Electronic Medicines Compendium. Available at: https://www.medicines.org.uk/emc/product/5938/pil (Accessed: 2 October 2026).
Guy's and St Thomas' NHS Foundation Trust (GSTT) (2024) Needle phobia and overcoming your fear. Available at: https://www.guysandstthomas.nhs.uk/health-information/needle-phobia-and-overcoming-your-fear (Accessed: 2 October 2026).
Hobson, U. (2025) Vaccinations and how to overcome a fear of needles. Sussex Partnership NHS Foundation Trust, 24 January. Available at: https://www.sussexpartnership.nhs.uk/about-us/news-events/blogs/vaccinations-and-fear-needles (Accessed: 2 October 2026).
Leeds Teaching Hospitals NHS Trust (2026) Worried about needles – top tips for parents. Available at: https://www.leedsth.nhs.uk/patients/resources/worried-about-needles-top-tips-for-parents/ (Accessed: 2 October 2026).
NHS (2025) Find NHS talking therapies for anxiety and depression. Available at: https://www.nhs.uk/nhs-services/mental-health-services/find-nhs-talking-therapies-for-anxiety-and-depression/ (Accessed: 2 October 2026).
NHS England (2025) Reasonable Adjustment Digital Flag. NHS Standards Directory. Available at: https://standards.nhs.uk/published-standards/reasonable-adjustment-digital-flag (Accessed: 2 October 2026).
Royal College of Nursing (2021) Administering subcutaneous methotrexate for inflammatory arthritis. Clinical professional resource. Available at: https://www.rcn.org.uk/-/media/Royal-College-Of-Nursing/Documents/Publications/2021/October/009-675.pdf (Accessed: 2 October 2026).
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Important medical disclaimer
The content provided in this blog post is for educational and informational purposes only and does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your GP, psychiatrist or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Never start, stop or change a prescribed medicine without speaking to your prescriber first.
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