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An ailment is a detrimental effect associated with one or more damage types.

Ignite, chill, freeze and shock are collectively referred to as elemental ailments.

List of ailments

Ailment Associated with Effect

Bleed status icon.png

Physical Bleed causes the affected target to take physical damage over time. The amount of damage is greater while the target is moving. Bleed can only be inflicted by physical damage from attacks.

Poison status icon.png

Physical and chaos Poison causes the affected target to take chaos damage over time. Poison can stack multiple times on a single target.

Ignite status icon.png

Fire Ignite causes the affected target to burn, taking fire damage over time.

Chill status icon.png

Cold Chill slows all actions of the affected target. Cold damage always inflicts chill.

Freeze status icon.png

Cold Freeze prevents the affected target from taking actions.

Shock status icon.png

Lightning Shock causes the affected target to take increased damage from all sources.


Ailments are in many ways similar to debuffs. The most notable difference is that ailments are associated with damage types, whereas debuffs are associated with skill effects. Modifiers to skill effect duration affect the duration of debuffs applied by skills, but not the duration of ailments.[1]

There is no limit on the number of different status ailments a target can have at any given time.

Application by damage

Ailments can be applied by hits of damage.

Each ailment is associated with one or more damage types. A damaging hit has the potential to inflict any ailments associated with the types of damage dealt. For example, a hit of physical and fire damage has the potential to inflict bleed, poison and ignite. Bleed has an additional restriction: It can only be applied by attacks.

The damage type associations for ailments may be changed by certain effects. As an example, The Three DragonsThe Three Dragons
Golden Mask
Quality: +20%
Evasion: 115
Energy Shield: 22
Requires Level 35, 40 Dex, 40 Int+(26-30)% to all Elemental Resistances
Your Fire Damage can Shock but not Ignite
Your Cold Damage can Ignite but not Freeze or Chill
Your Lightning Damage can Freeze but not Shock
"The ice seared his naked feet
As the lightning stilled his heart,
But it was the flames upon his lover's face
That roused him to vengeance."
- From 'The Three Dragons' by Victario of Sarn
changes which damage types have the potential to inflict elemental ailments.

A hit of damage also carries a property for each ailment that gives the hit a chance to inflict that ailment. By default, the chance to inflict most ailments is 0%. Any damaging hit has a 100% chance to inflict chill.[2] Critical strikes have a 100% chance to inflict ignite, freeze and shock. Some skill and support gems include modifiers that grant additional chance to inflict certain ailments. Additional chance to inflict ailments can also be gained from passive skills and equipment.

Targets may also have immunity or a chance to avoid certain ailments.

To summarize, an ailment is applied to the target if:

  • The hit of damage consists of damage types that have the potential to inflict the ailment
  • The chance to inflict the ailment is successful
  • The target fails to avoid the ailment
  • The target is not immune to the ailment
  • Any other conditions are met

Application by other means

Ailments can be applied in ways other than direct hits of damage.

  • Elemental proliferation causes elemental ailments to spread to other targets within a radius.
  • Certain ground effects apply ailments.
  • Slaying a poisoned enemy with Bino's Kitchen KnifeBino's Kitchen Knife
    Slaughter Knife
    Quality: +20%
    Physical Damage: (72 to 84)(247.2 to 271.2)
    Critical Strike Chance: (8.82% to 9.45%)
    Attacks per Second: 1.40
    Weapon Range: 8
    Requires Level 65, 81 Dex, 117 Int30% increased Global Critical Strike Chance30% increased Damage over Time
    Adds (50-60) to (120-140) Physical Damage
    (40-50)% increased Critical Strike Chance
    +(15-25)% to Global Critical Strike Multiplier
    +(8-12)% to Chaos Resistance
    On Killing a Poisoned Enemy, nearby Enemies are Poisoned
    and nearby Allies Regenerate 200 Life per second
    Calling it poison would imply
    that it was even edible.
    equipped spreads poison to other targets within a radius.
  • Arctic ArmourArctic ArmourSpell, Duration, Cold
    Mana Reserved: 25%
    Can store 1 use(s)
    Cooldown Time: 0.50 sec
    Cast Time: 0.50 sec
    Requires Level 16Summons an icy barrier that chills enemies when they hit you. You drop chilled ground while moving, and take less Fire and Physical damage while stationary.Per 1% Quality:
    1% increased Skill Effect Duration
    Chill Enemy for 0.5 seconds when Hit
    (8-13)% less Physical Damage taken when Hit
    (8-12)% less Fire Damage taken when Hit
    Base duration is (2.5-4.4) seconds
    Place into an item socket of the right colour to gain this skill. Right click to remove from a socket.
    Arctic Armour skill icon.png
    chills enemies when hit.
  • A strongbox with the "Incandescent" prefix ignites the character that activates it.


Name Description
Elemental Trinity

Elemental Trinity achievement icon.jpg

Slay an enemy that is simultaneously Ignited, Shocked, and Frozen.

Version history

Version Changes
  • Bleeding and Poison are now both considered 'Ailments'. This means their durations are only affected by increased bleeding/poison duration modifiers, and the new ailment duration modifier (they are not elemental ailments, so are not affected by the existing modifier to elemental ailments).
  • We now only refer to 'Ailments' rather than the longer 'Status Ailments'. The pre-existing 'Elemental Status Ailments' are now referred to as 'Elemental Ailments', and cases where 'Elemental' was left off because there were previously no non-elemental ailments have been corrected.
  • There are now separate reminder texts for Elemental Ailments and for Ailments.


  1. Rory (May 3, 2017). "Damage Over Time Changes - Part 2". Official Path of Exile Forums. Retrieved August 6, 2017.
  2. Bex_GGG (August 2, 2017). "Path of Exile 3.0.0: The Fall of Oriath Patch Notes". Official Path of Exile Forums. Retrieved August 6, 2017.