Exsanguinate - Path of Exile

Exsanguinate Exsanguinate is a a new Strength/Intelligence skill gem. It releases several tendrils of blood from your character, targeting enemies in a narrow angle in front of you. The beams deal physical damage and inflict a physical damage over time debuff to enemies, which can stack up to 3 times. Effects which allow skills to chain can apply to these tendrils.

It requires level 12, 21 str, 14 int. Tag: spell, chaining, physical, duration. Cost: (16-46) life. Cast time: 0.80 sec. Critical Strike Chance: 6.00%. Effectiveness of added damage: (150-180)%.

  • Base duration is 1.00 seconds
  • Deals (17–807) to (25–1211) Physical Damage
  • Deals (23.4–1121.1) Base Physical Damage per second
  • Fires tendrils at up to (7–9) Targets
  • Modifiers to Spell Damage apply to this Skill's Damage Over Time effect
  • Additional Effects From Quality: (0–20)% increased Skill Effect Duration

Exsanguinate uses life instead of mana to shoot tendrils of blood in front of you, applying a strong Phys-damage hit and a Phys-damage over time debuff which can stack up to three times. You can also support it so that its tendrils chain from one target to the next.

Exsanguinate PoE

Buy PoE Currency Cheap

Exsanguinate Supports Build

Exsanguinate Support Gems Descripton Tag Requires Popularity
Brutality Support Brutality Support Grant more physical damage while losing the ability to deal elemental and chaos damage. Physical, Support Level 38 98%
Efficacy Support Efficacy Support Grant more spell damage, more damage over time, and increased skill effect duration. Support, Duration Level 8 92%
Controlled Destruction Support Controlled Destruction Support Increase the damage of linked spells but reduces their critical strike chance. Spell, Support Level 18 82%
Chain Support Chain Support Cause any projectiles created by the linked skill to chain when they hit an enemy. Support, Chaining, Projectile Level 38 78%
Empower Support Empower Support +(0-2) to Level of Supported Active Skill Gems Support Level 1 38%
Cruelty Support Cruelty Support Supports skills that hit enemies, causing them to deal more damage with hits. Support, Duration Level 18 28%

Exsanguinate Build Example

The Exsanguinate Skill shoots tendrils of blood in front of you, at the cost of life rather than mana. In addition to a strong physical-damage hit, it also applies a physical damage over time debuff which can stack up to three times. You can also support Exsanguinate so that its tendrils chain from one target to the next.

Exsanguinate Alternate Quality

Gem Quality Stats Price
(Level 20)
Exsanguinate Exsanguinate (0–20)% increased Skill Effect Duration 3 Chaos Orb 100
Anomalous Exsanguinate Anomalous Exsanguinate (0–10)% increased Cast Speed 29 Chaos Orb 50
Divergent Exsanguinate Divergent Exsanguinate Fires tendrils at up to +(0–2) Targets 30 Chaos Orb 50

Quest Rewards

Exsanguinate is now offered to the Scion for completing The Siren's Cadence, and can be purchased from Nessa by the Marauder, Templar and Witch.

Labyrinth Enchantment helmet

Level Name Mod Drop Rate
The Merciless Labyrinth Enchantment Exsanguinate Damage 1 Exsanguinate deals 25% increased Damage helmet(20%)
The Eternal Labyrinth Enchantment Exsanguinate Damage 2 Exsanguinate deals 40% increased Damage helmet(20%)
The Merciless Labyrinth Enchantment Exsanguinate Duration 1 20% increased Exsanguinate Duration helmet(20%)
The Eternal Labyrinth Enchantment Exsanguinate Duration 2 30% increased Exsanguinate Duration helmet(20%)
The Eternal Labyrinth Enchantment Exsanguinate Additional Chain Chance 1 Exsanguinate has a 25% chance to Chain an additional time helmet(20%)

Can increases to "damage with skills that cost life" still apply to skills that do not cost life? For example, triggering Exsanguinate or reducing its life cost by 100%?

Triggering a skill does not change its cost, you just avoid paying that cost. But a skill with a cost of 0 life does not cost life.

Physical damage reduction typically applies to hits e.g. Overwhelm. Poacher's mark, however, applies a debuff that lowers the enemy's physical damage reduction. Does this work with DOTs like Exsanguinate and bleeds?

Armour only gives Physical Damage Reduction against hits, but Physical Damage Reduction in general applies to all physical damage taken. You just need to get it from something other than armour.

[Extra clarification]: Physical Damage Reduction, unlike resistances, cannot go below zero - so the enemy must have some physical damage reduction that applies against DoT (i.e. not from armour which only provides it against hits) in order for Poacher's Mark lowering it to affect a DoT.

Exsanguinate Scion Ascendant Build

Character Class: Scion. Ascendancy: Ascendant.

1. Character: Level 99 Ascendant

Life: 7,491Strength:292
Energy Shield: 228Dexterity: 129
Mana: 1,338Intelligence: 264
Evasion Rating: 5,025Charges: E: 3 / F: 3 / P: 3
Armour: 1,878

2. Main Skills Build

Main skill: Exsanguinate Exsanguinate. DAMAGE OVER TIME: 821k.

Support Gems:

  • Awakened Controlled Destruction Support Awakened Controlled Destruction Support
  • Awakened Brutality Support Awakened Brutality Support
  • Efficacy Support Efficacy Support
  • Awakened Chain Support Awakened Chain Support
  • Empower Support Empower Support

3. Skill Gems Build

Body Armour: Exsanguinate Exsanguinate and its support gems

Main Weapon: Bone Offering Bone Offering, Tempest Shield Divergent Tempest Shield, Desecrate Desecrate

Offhand Weapon: Immortal Call Immortal Call, Cast when Damage Taken Support Cast when Damage Taken Support (trigger), Increased Duration Support Increased Duration Support

Helmet: Enlighten Support Pride, Enlighten Support Enlighten Support , Petrified Blood Anomalous Petrified Blood, Malevolence Malevolence

Gloves: Flame Dash Flame Dash, Second Wind Support Second Wind Support, Arcane Surge Support Arcane Surge Support, War Banner War Banner

Boots: Vitality Vitality, Maim Support Maim Support, Herald of Purity Herald of Purity, Arrogance Support Arrogance Support

4. Passive Skill Build

See Passive Skill Tree at Path of Exile website.

5. Equipment Build


  • Wand / Shield (69%)
  • Dagger / Shield (17%)

Body Armour: Dire Jack Astral Plate(This item has hunter influence)

Weapon: Foe Bite Imbued Wand(This item is fractured)

Offhand Weapon: Grim Badge Angelic Kite Shield(This item has shaper influence)

Helmet: Victory Shelter Bone Helmet(This item has elder influence)

Gloves: Asenath's Gentle Touch Silk Gloves

Boots: Carrion Sole Two-Toned Boots

Belt: Gloom Harness Stygian Vise(This item has elder influence)

Amulet: Dragon Rosary Jade Amulet(This item has hunter influence and warlord influence)

Ring: Woe Loop + Brimstone Band(This item has warlord influence)

Flasks: Perpetual Basalt Flask of Heat, Panicked Divine Life Flask of Staunching, Experimenter's Quartz Flask of Warding, Experimenter's Jade Flask of Grounding, Alchemist's Quicksilver Flask of Adrenaline

Exsanguinate Popularity in Different Classes

Class Exsanguinate Popularity

Exsanguinate & Chain Tag

Exsanguinate, mechanically, can chain.

Because of this, the Chain Support can support it - its supportability text says "Supports projectile skills, and any other skills that chain.", and Exsanguinate is in that second group. The tag has no effect on this.

Because Exsanguinate is a (non-projectile) skill that can chain, it is given the Chaining tag, primarily to make it clear to users that the skill is capable of chaining (I don't think we give out any bonuses to gems based on having the Chaining tag and I hope we never do because then we'd probably have to go back and add it to all the projectile gems that are currently assumed to be able to chain by default).

The supportability and the tag do not affect each other. Both are there because the skill works in a way that allows it to chain. The tag is not needed for supportability, the supportability is not needed for the tag - they are two independant consequences of the mechanics of the skill.

Life-costing Skills Builds 3.14

Low life, Low Mana and Low Energy Shield now all count as being on 50% or below. This new threshold is large enough a value that a player could survive for a long time on Low Life with the help of the new Petrified Blood Petrified Blood skill. As a result, certain skills, passives and items have been rebalanced to compensate. For example, the Punishment Punishment curse’s effect that causes enemies to take more damage while on low life has been reduced in power as it now takes effect for a larger portion of the monster’s life. It has made similar changes to the Assassin’s “Ambush and Assassinate” passive, Infernal Mantle Infernal Mantle, and Replica Last Resort Replica Last Resort.

The Blood Magic Support Blood Magic Support gem has been split into Arrogance Support Arrogance Support and Lifetap Support Lifetap Support gems, as the lack of a damage multiplier made it a poor choice for primary skills. Now each of these new supports is balanced for the appropriate use case.

There are a small number of new passive clusters on the Passive Skill Tree for generic physical damage, as well as Physical Damage over Time Multiplier to better support the new skills. Certain sources of Bleeding Damage and Damage over time Multiplier for Bleeding have been changed to Physical Damage over Time to let them apply to Corrupted Blood and the new Reap Reap and Exsanguinate Exsanguinate skills. These include The Gladiator’s Gratuitous Violence passive and the Ascendant’s Gladiator notable. Not all bleed related passives and modifiers on items have been changed, so a full Bleed invested build and a build using both Bleeding and Corrupted Blood won’t always look the same.

Corrupted Blood now never counts as Bleeding damage, so reductions to bleeding damage taken no longer affect it. The Staunching flask modifier and Pathfinder’s Master Surgeon notable now state that they apply to both Bleeding and Corrupted Blood. Corrupted Blood’s damage has been rebalanced so it is more consistent between sources, so specific monsters that had very high Corrupted Blood damage will no longer be as strong, while others that dealt almost no damage will be dealing a more noticeable amount.

Bladestorm Bladestorm now has a multiplier to Bleeding damage while in Blood Stance, similar to the multiplier on Lacerate Lacerate, to enable Bleeding builds on the blood themed skill.The Elder-influenced Weapon modifiers that grant a chance for Poisons or Bleeds inflicted with this Weapon to deal 100% more Damage have been removed. In their place, Elder-influenced Weapons can now roll a new Local Poison or Bleed Damage over Time Multiplier modifier. The double damage chance modifiers were too multiplicatively powerful for these builds, providing power that only the modifier granted, so they’ve been changed to an effect that is additive with other Bleed/Poison damage multipliers.

The way skills specify costs has been refactored. Skills now specify what resource they use. Consequently, stats can specify whether they affect all costs/reservations, or some combination. For example, the Righteous Decree notable on the Templar now reduces Mana Costs of Skills, while the Tireless notable affects all skill costs. Some existing passive skills and items have been updated to affect all costs or reservations, but many effects are now resource specific where appropriate, like the Inspiration Support Inspiration Support. These changes also open up new possibilities for alternate costs. For example, the Chainbreaker keystone no longer removes rage on Hit, instead adding a small Rage cost to all skills (which would then be affected by skill cost modifiers). This has allowed us to keep Chainbreaker functional with spells while still losing rage when used alongside skills that don’t hit like Damage over Time spells.

As a major benefit of these changes, reservation skills no longer have an associated cost by default, so you don’t need the current mana available to reserve a skill. Even when your mana is completely depleted, you can still enable an aura, making it much easier to swap out auras or turn one on again if you accidentally disabled it.

Because of this, Mine skills now have both a mana cost and mana reservation. This means that both modifiers to costs and reservation both affect their appropriate parts of mine costs, so Indigon Indigon no longer provides spell damage without affecting mine costs at all.

Exsanguinate Screenshots

Exsanguinate Screenshots

PVP Changes

Exsanguinate has an attack time override of 2.0 seconds.

Path of Exile Guides & Tips