Tumor

You have a noticeable tumor or growth on your face with a radius of (IE × 1 inch). This growth may match your skin color or be red, dark brown, or a different color caused by magic. Consequently, when people who don’t know you see you, they usually only see your face. This gives you +(IE) to Dexterity (Sleight of Hand) checks but −(IE) (up to −4) to disguise checks or Dexterity (Stealth) checks to blend into a crowd as well as a −(IE) penalty on Charisma (Persuasion) checks due to many people’s discomfort around those with unexpected appearances. Note that this is usually a permanent condition and does not fluctuate, but the player and GM are welcome to determine a magical version that fluctuates based on the Frequency Table above.

Real-world Examples

Cystic Hygroma, Fibrous Dysplasia, Dermoid Cysts, Hemangiomas, Neurofibromatosis

Assistive Options

Surgery (IE × 50 gp) can reduce the IE by 2, requiring a successful DC (IE) + 10 Wisdom (Medicine) check. Reducing the IE to 0 will still leave a noticeable scar, giving a −1 to any charisma checks related to physical attractiveness.