What does "need like a hole in the head" mean?

Have neither a need nor a desire for something, as in I needed that extra work like I need a hole in the head. This expression has such ancestors as “As much need of it as he has of the pip [a disease] or of a cough,” from John Ray's English Proverbs (1678), and “As much need of it as a toad of a side pocket,” from Francis Grose's Dictionary of the Vulgar Tongue (1785). [Slang; c. 1940]