Ah, a jovial party clown—what a treat for little ones! Until you hear the primal screams, that is. "To a toddler, there's nothing funny about a clown—he's a monster," says David Kaye (a.k.a. Silly Billy), a New York City children's entertainer. The whitened face, bulbous nose and large lips all violate a child's basic idea of how a human should appear. "I don't wear makeup or a fake nose for this very reason," Kaye says. "My jumbo-size glasses are the only thing that makes me a clown and not just a guy who is badly dressed."

Many grown-ups find jesters creepy, if not repellent, as well. Because reading facial expressions has long been a key to survival, our inability to discern a clown's expressions (and true intentions) underneath the accoutrements raises automatic suspicions. Among the 8 percent of adults who suffer from phobias, coulrophobia—a debilitating fear of clowns—is fairly common.

Coulrophobia can be easily treated with exposure therapy, which "sends in the clowns" in a controlled manner to ease their terrifying grip, says Frederic Neuman, director of the Anxiety and Phobia Treatment Center in White Plains, New York. The patient is first shown pictures of clowns and is then presented a small toy clown. The final phase of the therapy is, well, sort of funny: "Ultimately, I'll ask her to dress herself as a clown and to look in the mirror," says Neuman. "She may get frightened, but at least she'll know she's looking at herself."

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