Your skin is soft and thin like velvet. It bruises, scars, and tears easily and heals slowly. You heal (IE) × 20% less hit points from a rest (minimum 1). If you have multiple traits, you may choose Dislocation or Flexibility as one or more of them.

Real-world Examples

Ehlers-Danlos Syndrome, Marfan’s Syndrome, Pseudoxanthoma Elasticum, Osteogenesis Imperfecta, Down Syndrome

Assistive Options

Skin hyperelasticity doesn’t have standard assistive help, but extra time for healing when needed is helpful.

Magical Assistance

Damage taken while affected by a hardening effect such as Barkskin and Stoneskin will heal at the normal rate.

The blood vessels in your skin constrict, leaving you feeling cold and numb. The area affected depends on IE as follows: 1, digits (fingers and toes); 2, extremities (hands and feet); 3, limbs (arms and legs); 4, whole body. You take an additional (IE) × 10 percent cold damage. If the trait is degenerative, it will eventually lead to Thrombosis and amputation.

Real-world Examples

Raynaud’s Disease, Scleroderma, Lupus, Vasculitis, Ehlers Danlos Syndrome

Assistive Options

Wrapping the affected areas in heavy insulating clothing for warmth will reduce the IE by 1 while worn.

Magical Assistance

Spells and magic items that provide resistance to cold damage reduce the IE by 1 while in effect. If you have immunity to cold damage through magic protection, you will still take (IE) × 5 percent of the original cold damage.

Your tendons and joints are pliable, making basic tasks like sitting upright or moving painful. You take (IE) × 10 percent less damage from all bludgeoning damage. Your movement rate is reduced by (IE) × 10 percent, and you have a +(IE) bonus on all saving throws against bludgeoning, force, or thunder damage, but when you take bludgeoning, force, or thunder damage, you must succeed on a Dexterity saving throw to avoid falling prone as your joints buckle. The DC equals 8 + (IE) or half the damage you take, whichever number is higher. If you take damage from multiple sources, such as a club and a ram, you make a separate saving throw for each source of damage. You also can benefit from a +(IE) bonus to all rolls against being restrained or grappled, although this also causes (IE) psychic damage if you use this bonus due to the pain. You’ve learned a lot about your own bones and joints, so you have a +(IE) bonus to Wisdom (Medicine) checks related to bones and joints. If you have multiple traits, you may choose Dislocation and Hyperelasticity as one or more of them.

Real-world Examples

Ehlers-Danlos Syndrome, Joint Hypermobility Syndrome, Hypophosphatasia, Osteoporosis

Assistive Options

Braces over your limbs and joints can give you a +1 to the Dexterity saving throws to avoid falling prone but also cause a −1 penalty on all Dexterity (Acrobatics) checks.

(IE) of your joints dislocate(s) easily. Whenever you make a Strength ability check or attack roll or melee attack, stand or walk for 20 ÷ (IE) minutes, walk on difficult terrain or stairs for 10 ÷ (IE) minutes, or take bludgeoning, force, or thunder damage, you must succeed on a DC 8 + (IE) Strength saving throw. If these rolls or damage happen multiple times in consecutive rounds, or for each 10 minutes of difficult standing or walking, the IE increases by 1 until you rest for 1 round per added IE. On failure, a joint subluxates (partially dislocates). If you fail by more than 5, the joint dislocates. Use the following table to determine which joint.

After a subluxation, you experience a −1 penalty on all rolls with that joint until you take a long rest. After a dislocation, you must succeed on a subsequent DC 8 Strength check to put the joint back together, using 1 action. (You can receive help resetting it.) On a successful attempt to reset it, you can use the limb, but you experience a −(IE) penalty on all rolls with that joint due to post-dislocation pain until you take a short rest. Following a long rest or getting up from being prone, you must succeed on a DC 8 + (IE) Strength saving throw or have another subluxation or dislocation as above from the way you were laying on the joint. If you have multiple traits, you may choose Pain, Skeletal Flexibility or Hyperelasticity as one or more of them.

Real-world Examples

Ehlers-Danlos Syndrome, Hypermobility Syndrome

Assistive Options

Wearing a brace can reduce the IE by 1 but causes a −1 penalty on Dexterity checks using that limb. Surgery (IE × 100 gp), requiring a successful DC (IE) + 10 Wisdom (Medicine) check, may prevent Dislocation, but it limits joint movement afterward, giving you a permanent −2 penalty on applicable Strength (Athletics) and Dexterity (Acrobatics) checks.

Magical Assistance

Healing magic specifically applied to the limb, once reset, can remove the penalty for the post-dislocation pain instead of restoring hit points.