Trauma SupportPhysical, Support, Melee, Attack, Strike, Duration Icon: # Level: (1-20) Cost & Reservation Multiplier: 140%Requires Level 38Supports melee strike skills that do not inherently apply Trauma. Cannot support triggered skills, Vaal skills, or skills used by things other than you. Cannot modify the skills of minions.Supported Skills have (3-11) to (4-24) Added Attack Physical Damage per Trauma Supported Skills have 5% increased Stun Duration per Trauma Gain 1 Trauma the first time a Supported Attack Hits an Enemy Take (13-146) Physical Damage per Trauma when you gain Trauma from Supported Skills Trauma lasts (5.0-6.9) seconds Supported Skills can only be used with Axes, Maces, Sceptres or Staves
Additional Effects From 1-20% Quality: Supported Skills have (0.5-10)% reduced Enemy Stun ThresholdThis is a Support Gem. It does not grant a bonus to your character, but to skills in sockets connected to it. Place into an item socket connected to a socket containing the Skill Gem you wish to augment. Right click to remove from a socket.
Acquisition Drop level: 38Vendor Offer 1x Scroll FragmentMetadata Item class: Support Gem Metadata ID: Metadata/Items/Gems/SupportGemTrauma
Trauma Support is a support gem which causes strikeattack skills to grant stacks of Trauma on hit which causes attacks to deal added Physical Damage, but also inflicts escalating amounts of physical damage.
Trauma Support can only be used with Axes, Maces, Sceptres or Staves. Trauma Support cannot support totems or minions.[1]
BoneshatterBoneshatterAttack, Melee, Strike, AoE, Duration, Physical Level: (1-20) Cost: 5 Mana Attack Speed: 85% of base Attack Damage: (200-250)% of base Effectiveness of Added Damage: (200-250)%Requires Level 28Attack enemies with a forceful melee strike that also hurts you. Successive uses will raise the damage dealt both to enemies and you. Stunning an enemy with the strike releases a damaging pulse. Requires a Mace, Sceptre, Axe or Staff.(11-158) to (17-238) Added Attack Physical Damage +0.2 metres to Melee Strike Range Gain 1 Trauma the first time this Attack Hits an Enemy Take (6-194) Physical Damage per Trauma when you gain Trauma Trauma lasts 6.0 seconds (2-4)% more Damage per Trauma Pulse has 15% increased Area of Effect per 0.1s of Stun Duration, up to 400%
Additional Effects From 1-20% Quality: +(0.05-1)% more Damage per TraumaPlace into an item socket of the right colour to gain this skill. Right click to remove from a socket. cannot be supported by Trauma SupportTrauma SupportPhysical, Support, Melee, Attack, Strike, Duration Icon: # Level: (1-20) Cost & Reservation Multiplier: 140%Requires Level 38Supports melee strike skills that do not inherently apply Trauma. Cannot support triggered skills, Vaal skills, or skills used by things other than you. Cannot modify the skills of minions.Supported Skills have (3-11) to (4-24) Added Attack Physical Damage per Trauma Supported Skills have 5% increased Stun Duration per Trauma Gain 1 Trauma the first time a Supported Attack Hits an Enemy Take (13-146) Physical Damage per Trauma when you gain Trauma from Supported Skills Trauma lasts (5.0-6.9) seconds Supported Skills can only be used with Axes, Maces, Sceptres or Staves
Additional Effects From 1-20% Quality: Supported Skills have (0.5-10)% reduced Enemy Stun ThresholdThis is a Support Gem. It does not grant a bonus to your character, but to skills in sockets connected to it. Place into an item socket connected to a socket containing the Skill Gem you wish to augment. Right click to remove from a socket.. Skills that gain bonuses based on your Trauma stacks do not care about the source of that trauma; for example, if you use BoneshatterBoneshatterAttack, Melee, Strike, AoE, Duration, Physical Level: (1-20) Cost: 5 Mana Attack Speed: 85% of base Attack Damage: (200-250)% of base Effectiveness of Added Damage: (200-250)%Requires Level 28Attack enemies with a forceful melee strike that also hurts you. Successive uses will raise the damage dealt both to enemies and you. Stunning an enemy with the strike releases a damaging pulse. Requires a Mace, Sceptre, Axe or Staff.(11-158) to (17-238) Added Attack Physical Damage +0.2 metres to Melee Strike Range Gain 1 Trauma the first time this Attack Hits an Enemy Take (6-194) Physical Damage per Trauma when you gain Trauma Trauma lasts 6.0 seconds (2-4)% more Damage per Trauma Pulse has 15% increased Area of Effect per 0.1s of Stun Duration, up to 400%
Additional Effects From 1-20% Quality: +(0.05-1)% more Damage per TraumaPlace into an item socket of the right colour to gain this skill. Right click to remove from a socket. to generate trauma, skills supported by Trauma SupportTrauma SupportPhysical, Support, Melee, Attack, Strike, Duration Icon: # Level: (1-20) Cost & Reservation Multiplier: 140%Requires Level 38Supports melee strike skills that do not inherently apply Trauma. Cannot support triggered skills, Vaal skills, or skills used by things other than you. Cannot modify the skills of minions.Supported Skills have (3-11) to (4-24) Added Attack Physical Damage per Trauma Supported Skills have 5% increased Stun Duration per Trauma Gain 1 Trauma the first time a Supported Attack Hits an Enemy Take (13-146) Physical Damage per Trauma when you gain Trauma from Supported Skills Trauma lasts (5.0-6.9) seconds Supported Skills can only be used with Axes, Maces, Sceptres or Staves
Additional Effects From 1-20% Quality: Supported Skills have (0.5-10)% reduced Enemy Stun ThresholdThis is a Support Gem. It does not grant a bonus to your character, but to skills in sockets connected to it. Place into an item socket connected to a socket containing the Skill Gem you wish to augment. Right click to remove from a socket. will still be granted added Physical Damage even if they themselves did not generate the trauma.
Gaining Trauma
Hitting an enemy with BoneshatterBoneshatterAttack, Melee, Strike, AoE, Duration, Physical Level: (1-20) Cost: 5 Mana Attack Speed: 85% of base Attack Damage: (200-250)% of base Effectiveness of Added Damage: (200-250)%Requires Level 28Attack enemies with a forceful melee strike that also hurts you. Successive uses will raise the damage dealt both to enemies and you. Stunning an enemy with the strike releases a damaging pulse. Requires a Mace, Sceptre, Axe or Staff.(11-158) to (17-238) Added Attack Physical Damage +0.2 metres to Melee Strike Range Gain 1 Trauma the first time this Attack Hits an Enemy Take (6-194) Physical Damage per Trauma when you gain Trauma Trauma lasts 6.0 seconds (2-4)% more Damage per Trauma Pulse has 15% increased Area of Effect per 0.1s of Stun Duration, up to 400%
Additional Effects From 1-20% Quality: +(0.05-1)% more Damage per TraumaPlace into an item socket of the right colour to gain this skill. Right click to remove from a socket. or strike skill (other than Boneshatter) supported by Trauma SupportTrauma SupportPhysical, Support, Melee, Attack, Strike, Duration Icon: # Level: (1-20) Cost & Reservation Multiplier: 140%Requires Level 38Supports melee strike skills that do not inherently apply Trauma. Cannot support triggered skills, Vaal skills, or skills used by things other than you. Cannot modify the skills of minions.Supported Skills have (3-11) to (4-24) Added Attack Physical Damage per Trauma Supported Skills have 5% increased Stun Duration per Trauma Gain 1 Trauma the first time a Supported Attack Hits an Enemy Take (13-146) Physical Damage per Trauma when you gain Trauma from Supported Skills Trauma lasts (5.0-6.9) seconds Supported Skills can only be used with Axes, Maces, Sceptres or Staves
Additional Effects From 1-20% Quality: Supported Skills have (0.5-10)% reduced Enemy Stun ThresholdThis is a Support Gem. It does not grant a bonus to your character, but to skills in sockets connected to it. Place into an item socket connected to a socket containing the Skill Gem you wish to augment. Right click to remove from a socket. will grant you a Trauma stack, giving more Damage or added Physical Damage respectively. However, you will also take Physical Damage per Trauma stack upon gaining a new one. Only one stack can be obtained per attack, regardless of the number of enemies hit. Repeated attacks from Multistrike SupportMultistrike SupportAttack, Melee, Support Icon: 3 Level: (1-20) Cost & Reservation Multiplier: 150%Requires Level 38Supports melee attack skills, making them repeat twice when used, targeting a random enemy each time. Cannot support Vaal skills, channelling skills or triggered skills.Supported Skills Repeat 2 additional times Supported Skills have (35-44)% more Melee Attack Speed Supported Skills deal (30-20)% less Attack Damage First Repeat of Supported Skills deals 22% more Damage Second Repeat of Supported Skills deals 44% more Damage
Additional Effects From 1-20% Quality: Supported Skills deal (0.5-10)% increased Melee DamageThis is a Support Gem. It does not grant a bonus to your character, but to skills in sockets connected to it. Place into an item socket connected to a socket containing the Skill Gem you wish to augment. Right click to remove from a socket. will also not grant additional Trauma stacks and only inflicts self-damage every 3rd hit. This can be used to reduce the gain and impact of Trauma for builds incapable of tanking high stacks of Trauma.
Each Trauma stack counts as an individual buff, with each Trauma stack having its own duration. The (now drop-disabled) Mantra of FlamesMantra of Flames Crimson JewelLimited to: 1Adds (3-5) to (8-12) Fire Attack Damage per Buff on you Adds (2-3) to (5-8) Fire Spell Damage per Buff on youThe strong grow stronger still.Place into an allocated Jewel Socket on the Passive Skill Tree. Right click to remove from the Socket. Jewel therefore grants a damage bonus for each stack of Trauma. Linking Boneshatter or a Trauma skill with Increased Duration SupportIncreased Duration SupportSupport, Duration Icon: D Level: (1-20) Cost & Reservation Multiplier: 130%Requires Level 31Supports any skill with a duration.Supported Skills have (45-64)% increased Skill Effect Duration
Additional Effects From 1-20% Quality: Supported Skills have (0.5-10)% increased Skill Effect DurationThis is a Support Gem. It does not grant a bonus to your character, but to skills in sockets connected to it. Place into an item socket connected to a socket containing the Skill Gem you wish to augment. Right click to remove from a socket./Efficacy SupportEfficacy SupportSupport, Duration Icon: a Level: (1-20) Cost & Reservation Multiplier: 130%Requires Level 8Supports any skill that deals damage or has a duration.Supported Skills deal (15-24)% more Damage over Time Supported Skills have (15-24)% increased Skill Effect Duration
Additional Effects From 1-20% Quality: Supported Skills deal (0.5-10)% increased Damage over TimeThis is a Support Gem. It does not grant a bonus to your character, but to skills in sockets connected to it. Place into an item socket connected to a socket containing the Skill Gem you wish to augment. Right click to remove from a socket., cursing yourself/being cursed with Temporal ChainsTemporal ChainsSpell, AoE, Duration, Curse, Hex Level: (1-20) Cost: (16-33) Mana Cast Time: 0.50 secRequires Level 24Curses all enemies in an area, lowering their action speed and making other effects on them expire more slowly.Base duration is (5.00-8.80) seconds +(0-1) metre to radius 50% less Effect of Curse against Players Cursed Normal and Magic Enemies have (15-29)% less Action Speed Other effects on Cursed enemies expire 25% slower Cursed Rare and Unique Enemies have (9-18)% less Action Speed
Additional Effects From 1-20% Quality: (1-20)% increased Curse DurationPlace into an item socket of the right colour to gain this skill. Right click to remove from a socket., or gaining skill effect duration elsewhere will increase the duration of each Trauma buff stack, reducing the need for high attack speed to maintain high Trauma.
Damage taken from Trauma
With a level 20 gem and N current Trauma stacks, you will take (194(BoneshatterBoneshatterAttack, Melee, Strike, AoE, Duration, Physical Level: (1-20) Cost: 5 Mana Attack Speed: 85% of base Attack Damage: (200-250)% of base Effectiveness of Added Damage: (200-250)%Requires Level 28Attack enemies with a forceful melee strike that also hurts you. Successive uses will raise the damage dealt both to enemies and you. Stunning an enemy with the strike releases a damaging pulse. Requires a Mace, Sceptre, Axe or Staff.(11-158) to (17-238) Added Attack Physical Damage +0.2 metres to Melee Strike Range Gain 1 Trauma the first time this Attack Hits an Enemy Take (6-194) Physical Damage per Trauma when you gain Trauma Trauma lasts 6.0 seconds (2-4)% more Damage per Trauma Pulse has 15% increased Area of Effect per 0.1s of Stun Duration, up to 400%
Additional Effects From 1-20% Quality: +(0.05-1)% more Damage per TraumaPlace into an item socket of the right colour to gain this skill. Right click to remove from a socket.)/497(Boneshatter of Complex TraumaBoneshatter of Complex TraumaAttack, Melee, Strike, AoE, Duration, Physical Level: (1-20) Cost: 5 Mana Attack Speed: 85% of base Attack Damage: (200-250)% of base Effectiveness of Added Damage: (200-250)%Requires Level 28Attack enemies with a forceful melee strike that also hurts you. Successive uses will raise the damage dealt both to enemies and you. Stunning an enemy with the strike releases a damaging pulse. Requires a Mace, Sceptre, Axe or Staff.(11-158) to (17-238) Added Attack Physical Damage +0.2 metres to Melee Strike Range Lose all Trauma on reaching 10 Trauma Gain 1 Trauma the first time this Attack Hits an Enemy Take (18-582) Physical Damage per Trauma when you gain Trauma Trauma lasts 6.0 seconds (8-15)% more Damage per Trauma Pulse has 15% increased Area of Effect per 0.1s of Stun Duration, up to 400%
Additional Effects From 1-20% Quality: +(0.25-5)% more Damage per TraumaPlace into an item socket of the right colour to gain this skill. Right click to remove from a socket.)146(Trauma SupportTrauma SupportPhysical, Support, Melee, Attack, Strike, Duration Icon: # Level: (1-20) Cost & Reservation Multiplier: 140%Requires Level 38Supports melee strike skills that do not inherently apply Trauma. Cannot support triggered skills, Vaal skills, or skills used by things other than you. Cannot modify the skills of minions.Supported Skills have (3-11) to (4-24) Added Attack Physical Damage per Trauma Supported Skills have 5% increased Stun Duration per Trauma Gain 1 Trauma the first time a Supported Attack Hits an Enemy Take (13-146) Physical Damage per Trauma when you gain Trauma from Supported Skills Trauma lasts (5.0-6.9) seconds Supported Skills can only be used with Axes, Maces, Sceptres or Staves
Additional Effects From 1-20% Quality: Supported Skills have (0.5-10)% reduced Enemy Stun ThresholdThis is a Support Gem. It does not grant a bonus to your character, but to skills in sockets connected to it. Place into an item socket connected to a socket containing the Skill Gem you wish to augment. Right click to remove from a socket.)) *(N+1) physical damage (before damage mitigation) upon your next attack.
The damage taken per Trauma stack counts as a hit, which means that skills like VengeanceVengeanceTrigger, Attack, AoE, Physical, Melee Level: (1-20) Cooldown Time: 1.20 sec Can Store 1 Use(s) Attack Damage: (170-255)% of base Effectiveness of Added Damage: (170-255)%Requires Level 24Chance to perform a swift counter-attack against all enemies around you when you are hit. Weapon range increases the area of this attack. Requires a Melee Weapon.(8-56) to (12-85) Added Attack Physical Damage 30% chance to Trigger this Skill when Hit
Additional Effects From 1-20% Quality: (1-20)% chance to Trigger this Skill when HitPlace into an item socket of the right colour to gain this skill. Right click to remove from a socket. will trigger, Cast when Damage Taken SupportCast when Damage Taken SupportSupport, Spell, Trigger Icon: ! Level: (1-20) Cost & Reservation Multiplier: 250% Cooldown Time: 0.25 sec Can Store 1 Use(s)Requires Level 38Each supported spell skill will track damage you take, and be triggered when the total damage taken reaches a threshold. Cannot support skills used by totems, traps, or mines. Vaal skills, channelling skills, and skills with a reservation cannot be triggered.This Gem can only Support Skill Gems requiring Level (38-70) or lower Supported Skills deal (65-27)% less Damage Trigger Supported Spells when you take (528-3272) total Damage from Hits
Additional Effects From 1-20% Quality: Supported Skills require (0.5-10)% reduced amount of Damage taken to TriggerThis is a Support Gem. It does not grant a bonus to your character, but to skills in sockets connected to it. Place into an item socket connected to a socket containing the Skill Gem you wish to augment. Right click to remove from a socket. will trigger, etc. It also allows your armour and/or physical damage reduction to prevent some of the physical damage taken. However, the damage cannot be blocked or evaded via evasion rating/dodge. "Avoid damage from hits" effects (e.g. Elusive) do work, however.
Damage conversion modifiers do not affect the damage from Trauma. However, damage taken as modifiers such as #% of Physical Damage from Hits taken as Cold Damage will shift the damage you take, allowing mitigation via elemental resistances. Additionally, it is possible to chill, freeze, or shock yourself this way; it is not possible to self-inflict damaging ailments unless you have a source of All Damage from Hits can Ignite/Poison you such as Mokou's EmbraceMokou's Embrace Ruby RingRequires Level 16+(20-30)% to Fire Resistance+(25-40)% to Cold Resistance (25-40)% increased Attack Speed while Ignited (25-40)% increased Cast Speed while Ignited +25% chance to be Ignited All Damage Taken from Hits can Ignite youFire makes the perfect blossom in the endless night..
Recoup is a valuable stat to have due to the escalating damage quickly exceeding and overpowering other forms of recovery, whereas Recoup will always recover the same percentage of damage received.
Gem level progression
Level
Physical Damage per Trauma
Damage Taken per Trauma
Trauma Duration
Exp.
Total Exp.
1
38
63
3 to 4
13
5.0
0
0
2
40
66
3 to 5
15
5.1
388734
388734
3
42
69
4 to 7
18
5.2
477437
866171
4
44
72
4 to 8
21
5.3
583786
1449957
5
46
75
4 to 9
24
5.4
710359
2160316
6
48
78
5 to 9
28
5.5
1355511
3515827
7
50
81
5 to 11
33
5.6
1138877
4654704
8
52
84
5 to 12
38
5.7
1368233
6022937
9
54
87
7 to 14
45
5.8
1638338
7661275
10
56
90
7 to 14
52
5.9
1956648
9617923
11
58
93
7 to 15
60
6.0
3655184
13273107
12
60
96
8 to 16
70
6.1
3017327
16290434
13
62
99
8 to 18
81
6.2
3576232
19866666
14
64
102
8 to 18
94
6.3
4231667
24098333
15
65
103
9 to 19
101
6.4
2395078
26493411
16
66
105
9 to 20
109
6.5
8421063
34914474
17
67
106
9 to 22
117
6.6
16159983
51074457
18
68
108
11 to 22
126
6.7
41170367
92244824
19
69
109
11 to 23
136
6.8
86794448
179039272
20
70
111
11 to 24
146
6.9
157405063
336444335
21
72
114
12 to 26
169
7.0
N/A
N/A
22
74
N/A
12 to 26
195
7.1
N/A
N/A
23
76
N/A
12 to 27
225
7.2
N/A
N/A
24
78
N/A
14 to 28
260
7.3
N/A
N/A
25
80
N/A
14 to 30
300
7.4
N/A
N/A
26
82
N/A
14 to 30
346
7.5
N/A
N/A
27
84
N/A
15 to 31
398
7.6
N/A
N/A
28
86
N/A
15 to 32
459
7.7
N/A
N/A
29
88
N/A
15 to 34
528
7.8
N/A
N/A
30
90
N/A
15 to 34
608
7.9
N/A
N/A
31
91
N/A
15 to 35
652
8.0
N/A
N/A
32
92
N/A
15 to 35
699
8.0
N/A
N/A
33
93
N/A
15 to 35
750
8.1
N/A
N/A
34
94
N/A
16 to 36
804
8.1
N/A
N/A
35
95
N/A
16 to 36
862
8.2
N/A
N/A
36
96
N/A
16 to 38
925
8.2
N/A
N/A
37
97
N/A
16 to 38
991
8.2
N/A
N/A
38
98
N/A
16 to 38
1062
8.3
N/A
N/A
39
99
N/A
16 to 39
1139
8.3
N/A
N/A
40
100
N/A
16 to 39
1221
8.4
N/A
N/A
Gem quality
Type
Additional Effects per 1-20% Quality
Weight
Superior
Supported Skills have (0.5-10)% reduced Enemy Stun Threshold
1
Item acquisition
Trauma Support can drop anywhere.
Recipes
Trauma Support can be created from the following recipes:
Gift of the Gemling QueenGift of the Gemling Queen9Level 20 Support GemOur Lady Dialla, as a symbol of our progress, shines greater than all the gems.
Random level 20 support gem
A
7
Dialla's SubjugationDialla's Subjugation7Support Gem Quality:+23% CorruptedA symbol of beauty and innocence The gems corrupted her mind Malachai corrupted her gems All but a glimmer of greatness lost in madness
Random corruptedsupport gem with 23% quality
A
6
The FoxThe Fox6Level 20 Gem"Masters of wit, strength and cunning. To survive the harsh winters, you must be like the fox." - Ezomyte Proverb
Random level 20 gem
A
3
Gemcutter's PromiseGemcutter's Promise3Gem Quality:+20%"I swore to use my position to help the people. What good is power when it just accumulates on the already-powerful?" - Erasmus, Imperial Gemcutter
Random gem with 20% quality
A
1
Gemcutter's IncubatorGemcutter's IncubatorStack Size: 10Adds an incubated Quality Gem item to an equippable item Item drops after killing {0} monstersRight click this item then left click an item to apply it. The Incubated item drops after killing a specific number of monsters.
Random gem with 1–20% quality
A
1
The VoidThe Void1Reach into the Void and claim your prize.
Random divination card set exchange
A
Quest reward
This item is given as a quest reward for the following quests:
Trauma on hit which causes attacks to deal added Physical Damage, but also inflicts escalating amounts of physical damage.
BoneshatterBoneshatterAttack, Melee, Strike, AoE, Duration, Physical
cannot be supported by 
Trauma SupportTrauma SupportPhysical, Support, Melee, Attack, Strike, Duration
. Skills that gain bonuses based on your Trauma stacks do not care about the source of that trauma; for example, if you use 
Multistrike SupportMultistrike SupportAttack, Melee, Support
will also not grant additional Trauma stacks and only inflicts self-damage every 3rd hit. This can be used to reduce the gain and impact of Trauma for builds incapable of tanking high stacks of Trauma.
Mantra of FlamesMantra of Flames
Jewel therefore grants a damage bonus for each stack of Trauma. Linking Boneshatter or a Trauma skill with 
Increased Duration SupportIncreased Duration SupportSupport, Duration
/
Efficacy SupportEfficacy SupportSupport, Duration
, cursing yourself/being cursed with 
Temporal ChainsTemporal ChainsSpell, AoE, Duration, Curse, Hex
, or gaining skill effect duration elsewhere will increase the duration of each Trauma buff stack, reducing the need for high attack speed to maintain high Trauma.
Boneshatter of Complex TraumaBoneshatter of Complex TraumaAttack, Melee, Strike, AoE, Duration, Physical
)146(
VengeanceVengeanceTrigger, Attack, AoE, Physical, Melee
will trigger, 
Cast when Damage Taken SupportCast when Damage Taken SupportSupport, Spell, Trigger
will trigger, etc. It also allows your armour and/or physical damage reduction to prevent some of the physical damage taken. However, the damage cannot be blocked or evaded via evasion rating/dodge. "Avoid damage from hits" effects (e.g. 
Elusive) do work, however.
Mokou's EmbraceMokou's Embrace
.
BitterdreamBitterdream
Gift of the Gemling Queen
Gift of the Gemling Queen
9Level 20 Support GemOur Lady Dialla,
Dialla's Subjugation
7Support Gem
The Fox
6Level 20 Gem"Masters of wit, strength and cunning. To survive the harsh winters, you must be like the fox."
Gemcutter's Promise
3Gem
Gemcutter's IncubatorGemcutter's IncubatorStack Size: 10Adds an incubated Quality Gem item to an equippable item
The Void
1Reach into the Void and claim your prize.