PoE Trauma Support

PoE Trauma Support

Trauma Support is a new Strength Support Gem. It causes strike attack skills to grant stacks of Trauma on hit which causes attacks to deal added Physical Damage, but also inflicts escalating amounts of physical damage.

Tags: Physical, Support, Melee, Attack, Strike, Duration. Cost & Reservation Multiplier: 140%. Requires Level 38.

Supports 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 (5–6.9) seconds
  • Supported Skills can only be used with Axes, Maces, Sceptres or Staves

Additional Effects From Quality: Supported Skills have (0–10)% reduced Enemy Stun Threshold

This 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.

PoE Trauma Support


  • (Warstaves are considered Staves)

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Additional Effects From Quality

Trauma Support Supported Skills have (0–10)% reduced Enemy Stun Threshold50
Anomalous Trauma Support (0–10)% chance to not take Damage when you gain Trauma from Supported Skills50
Divergent Trauma SupportSupported Skills have (0–1)% increased Attack Speed per Trauma
Take (0–20) Physical Damage per Trauma when you gain Trauma from Supported Skills


Trauma is a stackable buff that increases the damage dealt by Boneshatter and strike skills supported by Trauma Support.

Gaining Trauma

Hitting an enemy with Boneshatter or an attack supported by File:Trauma Support inventory icon.pngTrauma Support 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 hit, regardless of the number of enemies hit. Repeated attacks from Multistrike Support will also not grant additional Trauma stacks and only inflict 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. Mantra of Flames therefore grants a damage bonus for each stack of Trauma. Linking Boneshatter or a Trauma skill with Increased Duration Support, cursing yourself/being cursed with Temporal Chains, 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*(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 Vengeance will trigger, Cast when Damage Taken Support 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 Embrace.

Trauma has no crit roll, and can only crit you if hits you take always crit you.

Build Guide

Trauma Support supports Strike Skills, allowing them to scale damage like Boneshatter. Be careful though, if you build up more Trauma stacks than you can handle, it won’t be the enemies’ bones you’ll be shattering!

PoE Trauma Support

Does Trauma Support work with Totems or Minions?

No, Trauma Support doesn't work with Totems or Minions.

How to get it?

  • Trauma Support is now offered to the Marauder and Duelist for completing The Eternal Nightmare, and can be purchased from Petarus and Vanja by the Templar and Scion.

Quest reward

This item is given as a quest reward for the following quests:

Class → Witch Shadow Ranger Duelist Marauder Templar Scion
Quest ↓
The Eternal Nightmare
Act 4

Vendor reward

This item can be bought at the listed NPC vendors, after completing the following quests:

Class → Witch Shadow Ranger Duelist Marauder Templar Scion
Quest ↓
The Eternal Nightmare
Act 4
Petarus and Vanja
Fallen from Grace
Act 6
Lilly Roth

Supported Gem

Double StrikePerforms two fast strikes with a melee weapon.
Elemental HitEach attack with this skill will choose an element at random, and will only be able to deal damage of that element. If the attack hits an enemy, it will also deal damage in an area around them, with the radius being larger if that enemy is suffering from an ailment of the chosen element. It will avoid choosing the same element twice in a row.
Dual StrikeAttacks with both weapons, dealing the damage of both in one strike. Dual wield only. Does not work with wands.
FrenzyPerforms an attack that gives the character a frenzy charge if it hits. Frenzy charges increase your attack speed.
Static StrikeAttack with a melee weapon, gaining static energy for a duration if you hit an enemy. While you have static energy, you'll frequently hit a number of nearby enemies with beams, dealing attack damage.
Flicker StrikeTeleports the character to a nearby monster and attacks with a melee weapon. If no specific monster is targeted, one is picked at random. Grants a buff that increases movement speed for a duration. The cooldown can be bypassed by expending a Frenzy Charge.
Infernal BlowAttacks with your weapon, applying a charged debuff to enemies hit by your strike, and an uncharged debuff to any other enemies hit. Upon reaching 6 charges, expiring, or the enemy's death, the charged debuff is removed, and it deals damage to that and other nearby enemies. Enemies with either debuff explode when they die, damaging other nearby enemies. Damage from this explosion cannot be reflected. Requires a Sword, Axe, Mace, Sceptre, Staff or Unarmed.
Glacial HammerHits enemies, converting some of your physical damage to cold damage. If an enemy is frozen and is on less than one third life, they will shatter when hit by Glacial Hammer. If striking three times in a row, the third strike will freeze enemies more easily. Requires a Mace, Sceptre or Staff.
Viper StrikeHits enemies, converting some of your physical damage to chaos damage and inflicting poison which will be affected by modifiers to skill duration. If dual wielding, will strike with both weapons. Requires a claw, dagger or sword.
Heavy StrikeAttacks enemies with a forceful blow, knocking them back. Requires a Mace, Sceptre, Axe, Sword or Two-Handed Weapon.
Dominating BlowAttacks enemies with a melee strike, applying a debuff for a short duration. If a non-unique enemy dies while affected by the debuff, the enemy's corpse will be consumed and a Sentinel of Dominance with the same rarity, prefix and suffix modifiers will be summoned for a longer secondary duration.
Lightning StrikeInfuses your melee weapon with electrical energies as you swing. In addition to converting some of your physical damage to lightning damage, the stored energy is released from the weapon as projectiles as you strike, flying out to hit farther-away enemies. The projectiles cannot miss if the melee attack hits a target.
PuncturePunctures enemies, causing a bleeding debuff, which will be affected by modifiers to skill duration. Puncture works with bows, daggers, claws or swords.
Molten StrikeInfuses your melee weapon with molten energies to attack with physical and fire damage. This attack causes balls of molten magma to launch forth from the enemies you hit, divided amongst all enemies hit by the strike. These will deal area attack damage to enemies where they land.
Frost BladesAttack enemies with increased range, releasing icy blades from the first enemy hit which fly at other enemies. Requires a Melee Weapon.
Vigilant StrikeAttacks enemies with a powerful melee strike which grants Fortification, reducing damage you take from hits. The cooldown can be bypassed by expending an Endurance Charge. Requires a Melee Weapon.
Wild StrikeYour melee weapon strikes enemies, converting physical damage to a random element. Then, depending on the element chosen, it releases a fiery explosion, an arcing bolt of lightning, or an icy wave. It will avoid choosing the same element twice in a row.
SmitePerforms a melee attack, and causes lightning to strike a targeted location or nearby enemy, dealing damage in an area. Each target can only be hit once by this skill. Hitting an enemy grants an aura, giving you and your allies additional lightning damage for a duration. Requires a Sword, Axe, Mace, Sceptre, Staff or Unarmed.
Pestilent StrikeAttacks with your weapon, inflicting a debuff on enemies hit by the strike. If a debuffed enemy dies while poisoned, Pestilent Strike inflicts a secondary chaos damage over time debuff on enemies around them, based on the poisons on the slain enemy. This damage is not affected by your damage modifiers. Requires a Claw or Dagger.

Level Effect /40

LevelRequires LevelStrengthGain 1 Trauma the first time a Supported Attack Hits an Enemy
Take 13 Physical Damage per Trauma when you gain Trauma from Supported Skills
Trauma lasts 5 seconds
Supported Skills have 3 to 4 Added Attack Physical Damage per TraumaExperience
138635, 133, 410
240665.1, 153, 510
342695.2, 184, 710
444725.3, 214, 810
546755.4, 244, 910
648785.5, 285, 9179,657
750815.6, 335, 11169,595
852845.7, 385, 12283,759
954875.8, 457, 14453,996
1056905.9, 527, 1412,186,050
1158936, 607, 153,017,327
1260966.1, 708, 163,576,232
1362996.2, 818, 184,231,667
14641026.3, 948, 182,395,078
15651036.4, 1019, 198,421,063
16661056.5, 1099, 2016,159,983
17671066.6, 1179, 2241,170,367
18681086.7, 12611, 2286,794,448
19691096.8, 13611, 23157,405,063
20701116.9, 14611, 24
21727, 16912, 26
22747.1, 19512, 26
23767.2, 22512, 27
24787.3, 26014, 28
25807.4, 30014, 30
26827.5, 34614, 30
27847.6, 39815, 31
28867.7, 45915, 32
29887.8, 52815, 34
30907.9, 60815, 34
31918, 65215, 35
32928, 69915, 35
33938.1, 75015, 35
34948.1, 80416, 36
35958.2, 86216, 36
36968.2, 92516, 38
37978.3, 99116, 38
38988.3, 106216, 38
39998.4, 113916, 39
401008.4, 122116, 39

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