Item: Torn Photo
Grants 2 Heart Containers and completely restores health.
Grants 1 heart container and increases tears, but decreases shot speed.
Dark Prince's Crown
Increases range, tears, and shot speed when at exactly one red heart.
Spawns a familiar that charges forward when shooting tears and explodes upon contact with an enemy, damaging and poisoning them. The familiar respawns after a few seconds.
Isaac emits a beam from his face. Isaac's tears travel in the path of the beam.
Guppy's Hair Ball
Loosely follows behind Isaac. Can be swung like a flail by rapidly spinning Isaac in a circle. Grows bigger by killing enemies.
+1 luck. Spawns a fairy familiar that points out secret room entrances and tinted rocks.
Increases all stats and enlargens Isaac.
Isaac can hold 2 cards at once and all pills are replaced by cards.
Grants flaming tears that deal burning damage over time. Tears have a chance to explode on impact with an enemy, which creates a fire at the location of the explosion.
Transforms Isaac's tears into a wide arc shape which gives them a much larger hitbox. Gives Isaac spectral tears which allows them to travel through objects in the environment (i.e. rocks).
A red attack fly circles further out than the Halo of Flies / Pretty Flies, but closer than Forever Alone. Deals more damage than Forever Alone.
A portable beggar who follows Isaac, picks up coins for himself, and occasionally drops a pickupafter collecting a coin. Does not spawn collectibles.
Pickups, trinkets, and monsters are magnetically attracted to Isaac's tears.
Familiar that follows Isaac, leaving blood creep on the ground.
Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals.
All standard bomb pickups become 1+1 bomb pickups.
A trail of blue creep is left behind Isaac, which damages enemies.