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Health Damage Tears Range Shot Speed Speed Luck Hidden Attributes

Damage Stat Icon.png Damage refers to the amount of damage each tear deals to enemies, and is represented by a sword. As damage increases, the size of the tears increases as well. However, tear size is not always a valid indication of how much damage your tears will do. Tears will grow and shrink when your damage changes, but tears of a certain size do not have a specific damage value, and two tears of the same size (in two different runs) are likely to have different damage values.

  • Polyphemus is an example of an item which provides a very high Damage stat.

Effective Damage[edit | edit source]

The formula for damage is: Effective Damage Formula.png


  • CharBaseDmg = 3.5 multiplied by a particular Character Modifier,
  • TotalDmgUps = the total of all regular damage ups collected (not including special exceptions or damage multipliers),
  • FlatDmgUps = the total of all damage ups that are excluded from the above (for example, Curved Horn or Ipecac), and
  • EffectiveDmg = the approximate damage that can be expected per tear, or per 'tick' when using Brimstone or Technology 2.

This formula makes most damage upgrades less potent the more that Isaac has. For example, a Pentagram on Isaac would make his total damage (1 * 1.2 + 1)^0.5 = 1.48 * 3.5 = 5.19. Another Pentagram increases this to 6.45 (a 1.26 increase instead of a 1.69 increase). The higher a character's base damage, the more effective Damage Ups will be for that character. Flat damage modifiers and special adjustments like Polyphemus or Sacred Heart happen after the main formula.

Character Modifier[edit | edit source]

The character base damage of each tear is calculated multiplying the base damage of 3.50 with each character's damage modifier. These character modifiers are:

: Whore of Babylon has the unique effect of increasing Eve's damage modifier from 0.75 to 1.00 when active. This does not apply to other characters, however.

Damage Multipliers[edit | edit source]

Some items multiply damage rather than simply adding to it. Damage multipliers do not simply multiply the character's damage once; the damage stat is constantly recalculated and the damage multipliers are multiplied with the end result. This means that if a character starts with 3.50 damage and gets a 2x multiplier, their effective damage will be 3.5*2 = 7.00. If an item that grants +1 damage is picked up, the character's effective damage will be 3.5*(1*1.2+1)^0.5*2 = 3.5*(2.2)^0.5*2 = 3.5*1.48*2 = 10.38, and not 7.00 + 1.

Most damage multipliers stack; for example, Proptosis and Eve's Mascara both provide a 2x multiplier, and picking up both will give a total multiplier of 4x. The exception to this is the 1.5x damage multipliers provided by Cricket's Head, Magic Mushroom, and the combination of Blood of the Martyr and The Book of Belial. These multipliers do not stack; for example, picking up both Cricket's Head and Magic Mushroom will result in an overall 1.5x multiplier rather than the expected 2.25x.

Items that affect damage[edit | edit source]

Activated Items[edit | edit source]

Name ID Icon Quote Description
The Book of Belial 34
The Book of Belial
3 rooms
Temporary DMG up Upon use increases damage by 2 for the current room and by a further +50% if the character also has the Blood of the Martyr.
Removed in Afterbirth Guarantees a Devil Room or Angel Room will be open after beating a boss while holding it, or Added in  Afterbirth increases the chance by 12.5%.
Added in  Afterbirth D8 406
4 rooms
Reroll stats Re-rolls Isaac's speed, range, tears, and damage.
Added in Afterbirth † Dataminer 481
4 rooms
109 Displaces enemy sprites for the current room, randomly increases one stat and decreases another.
The Nail 83
The Nail
6 rooms
Temporary demon form Adds one soul heart and allows the breaking of rocks and damaging enemies by simply walking over them. Increases damage and decreases speed. All effects except for the Soul Heart wear off upon leaving the room.
Added in Afterbirth † Potato Peeler 487
Potato Peeler
A pound of flesh Removes a heart container, increases damage and range, and grants a Cube of Meat.
Razor Blade 126
Razor Blade
Feel my pain Upon use, deals one heart of damage to Isaac and grants +1.2 damage for the current room.

Passive Items[edit | edit source]

Name ID Icon Quote Description
Added in  Afterbirth 8 Inch Nails 359 8 Inch Nails Stick it to 'em! +1.5 Damage Up. Replaces Isaac's tears with nails, which have increased knockback.
Abaddon 230 Abaddon Evil + DMG up + fear shot Increases damage and speed, removes all red heart containers, grants six black hearts, and adds a chance to shoot fear tears.
Added in Afterbirth † Adrenaline 493 Adrenaline Panic = power Increases damage based on how many empty heart containers Isaac has.
Blood Clot 254 Blood Clot DMG + range up Increases damage by 1 and range by 5 for tears fired from the left eye.
Blood of the Martyr 7 Blood of the Martyr DMG up Increases Damage by 1, and turns Isaac's tears into blood tears.
Bloody Lust 157 Bloody Lust RAGE! Increases damage as Isaac receives damage. Damage increase stays for the whole floor.
Added in Afterbirth † Bozo 513 Bozo Party time! Increases damage by a flat 0.1 and grants a soul heart. Enemies can randomly become briefly charmed or feared. Taking damage has a chance to spawn a rainbow poop.
Capricorn 307 Capricorn All stats up All stats up.
Cat-O-Nine-Tails 165 Cat-O-Nine-Tails Shot speed + damage up Increases Shot Speed and damage.
Ceremonial Robes 216 Ceremonial Robes Sin up Adds 3 black hearts and increases Damage by 1.
Champion Belt 208 Champion Belt DMG + Challenge Up Increases damage, but also increases the chance of champion enemies appearing.
Chemical Peel 154 Chemical Peel DMG up Tears fired from left eye do increased damage.
Cricket's Head 4 Cricket's Head DMG up Increases damage by 0.5, and multiplies it by 1.5x.
Added in  Afterbirth Crown of Light 415 Crown of Light The untainted gain power Gives Isaac a crown that glows blue when active, and turns gray when inactive. While Isaac has no empty red heart containers, Isaac's tears are replaced with blue diamond tears that deal double damage. Regardless of health, the crown will deactivate for the current room when Isaac takes damage.
Dark Matter 259 Dark Matter Fear shot Increases Damage by 1 and adds a chance to shoot fear tears.
Added in  Afterbirth Dead Eye 373 Dead Eye Accuracy brings power! Isaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.
Added in Afterbirth † Death's List 530 Death's List Just hope you're not next... Grants a reward if all enemies in a room are killed in the order they are marked.
Death's Touch 237 Death's Touch Penetrative shot + damage up Increases Damage by 1.5, reduces Tears by 0.3 and increases tear size. Grants piercing tears. Tears are replaced by Death's scythes, which is a cosmetic effect only.
Added in Afterbirth † Dog Tooth 445 Dog Tooth Bark at the moon! Increases damage and speed. Upon entering a room adjacent to a secret room, a howl sound effect will play.
Eve's Mascara 310 Eve's Mascara Shot speed down + DMG up Doubles damage, halves tears stat, and greatly reduces shot speed.
Experimental Treatment 240 Experimental Treatment All stats up, then shuffled Randomly increases and decreases some of the character's stats.
Godhead 331 Godhead God tears Increases damage and range while reducing tears and shot speed. Grants homing tears and tears gain a damaging halo.
Growth Hormones 70 Growth Hormones Speed + DMG up Increases damage by 1 and speed by 0.4.
Guillotine 206 Guillotine An out-of-body experience Isaac's head is removed from his body and floats around him. Increases Damage by 1 and grants -1 Tear Delay.
Added in Afterbirth † Haemolacria 531 Haemolacria I'm seeing red... Tears are now fired in an arc. Upon hitting the floor, an obstacle, or an enemy, they burst into many smaller tears in all directions. Increases tear delay.
The Halo 101 The Halo All stats up Grants one Heart Container, +0.3 Damage, +0.2 Tears, +0.25 Range, +0.3 Speed, and +0.5 Tear Height.
Ipecac 149 Ipecac Explosive shots Replaces tears with explosive and poisoning projectiles fired in an arc from the mouth.
Iron Bar 201 Iron Bar Concussive tears Increases damage by 0.3 and adds a chance to shoot concussive tears, causing enemies to walk around randomly.
Jesus Juice 197 Jesus Juice Damage + range up Increases Damage and Range.
Libra 304 Libra You Feel Balanced Gives 6 coins, 6 bombs, and 6 keys and balances out all attributes.
A Lump of Coal 132 A Lump of Coal My Xmas Present The more distance tears travel, the more damage they will do.
Added in  Afterbirth Lusty Blood 411 Lusty Blood Their blood brings rage! Each time Isaac kills an enemy, Isaac's damage increases for the current room.
Magic Mushroom 12 Magic Mushroom All Stats Up! Increases all stats and enlargens Isaac.
The Mark 79 The Mark DMG up Increases Damage and Speed, plus adds one Soul Heart.
Added in  Afterbirth Maw of the Void 399 Maw of the Void Consume thy enemy! +1.0 Damage Up. After continuously firing tears for 2.5 seconds, a red cross appears on Isaac's head that, upon releasing the fire button, creates a black ring that rapidly deals damage equal to Isaac's tear damage to any enemies in contact with it.
MEAT! 193 MEAT! DMG + HP up Adds a heart container and increases damage.
Missing No. 258 Missing No. Syntax error Randomizes all passive items upon pickup and at the start of each succeeding floor.
Odd Mushroom 121 Odd Mushroom DMG up Grants an empty heart container. Increases damage, range and shot height while reducing speed.
Odd Mushroom 120 Odd Mushroom Fire rate up +1.7 tears, +0.3 speed, reduces damage.
The Pact 80 The Pact DMG + Tears UP Increases damage by 0.5, tears by 0.7 and grants two soul hearts upon pickup.
Pentagram 51 Pentagram DMG up Increases damage and increases the chance for a Devil or Angel Room to appear.
Polyphemus 169 Polyphemus Mega Tears Makes Isaac shoot one huge tear. Also reduces Tears to minimum. Damage increased . If tear does more damage than an enemy's life, the tear continues to travel with the extra remaining damage.
Proptosis 261 Proptosis Short range mega tears Tears start out massive with high damage, and then shrink down and become weaker over a short range.
Added in  Afterbirth Purity 407 Purity Aura stat boost This item will boost one of Isaac's stats depending on the color of the aura around him. The aura will disappear upon taking damage and will reappear with a random color upon entering a new room. A red aura boosts damage, a blue aura boosts rate of fire, a yellow aura boosts speed, and an orange aura boosts range.
Sacred Heart 182 Sacred Heart Homing shots + DMG up Increases damage and range while reducing shot speed and grants homing tears. Grants a Heart Container and replenishes all Red Hearts.
The Small Rock 90 The Small Rock DMG up Increases damage by 1, increases tears by 0.2, and decreases speed by 0.1.
SMB Super Fan 189 SMB Super Fan All stats up Increases all stats.
Soy Milk 330 Soy Milk DMG Down + Tears Way Up Tears shrink and do much less damage, but fire in very rapid succession.
Steven 50 Steven DMG up Increases Damage by 1.
Stigmata 138 Stigmata DMG + HP up Increases damage, and adds 1 heart container.
Added in Afterbirth † Sulfuric Acid 463 Sulfuric Acid Acid tears! Increases damage. Adds a chance to fire acidic tears which can destroy obstacles.
Synthoil 345 Synthoil DMG up + range Increases damage by 1, range by 5.25, and tear height by 0.5.
Technology 2 152 Technology 2 Laser Decreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.
Whore of Babylon 122 Whore of Babylon Curse up Increases damage and speed whenever Isaac has half a red heart or less (one red heart for Eve), ignoring any soul or black hearts.

Trinkets[edit | edit source]

Name ID Icon Quote Description
Added in  Afterbirth Black Feather 80 Black Feather With darkness comes power Increases Isaac's damage for possessing certain evil items.
Curved Horn 35 Curved Horn DMG up Increases damage by 2.
Red Patch 40 Red Patch Your rage grows Grants a chance of increasing damage by 1.8 for the current room upon taking damage.
Samson's Lock 58 Samson's Lock Your rage grows 1/15 chance to increase damage by 0.5 for the current room each time an enemy dies.

Other[edit | edit source]

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