A Lump of Coal is a passive item.
- Tears gain a flat damage bonus of about +0.5-0.6 per tile of distance travelled, unaffected by all multipliers. There is no upper limit to the bonus.
- A Lump of Coal can be found as a drop from Krampus, a possible payout of Mystery Gift, or using Spindown Dice on Guppy's Paw.
- The item has somewhat of an opposite effect of the item Proptosis, which makes Isaac deal more damage at close range. Proptosis is based on a shrinking multiplier instead of an increasing flat bonus, however.
- Godhead: Tears and more importantly their auras will increase in size and damage the farther they travel.
- Hook Worm: The movement pattern increases Coal's damage at the same effective distance.
- The Ludovico Technique: Increases the tear's damage and size the farther the tear is from Isaac. Even at close range, it will still do about +3.5 damage.
- My Reflection: Hitting enemies with tears that initially missed will grant possibly considerable extra damage.
- Pop!: Tears will increase their damage and size as they travel, and they are not limited by range.
- Soy Milk: Coal's flat damage increase is not affected by Soy Milk's multiplier, so tears gain the full benefit from Coal.
- Tiny Planet: The movement pattern allows much longer airtime and reasonably easy way to hit enemies with the powered-up tears.
- Anti-Gravity: Despite the tears visually growing while they hover, they will still only deal bonus damage based strictly on how far they travel. If the enemy hits the tears by running into them, Coal will add no damage.
- Tears no longer grow while hovering.
- Athame: Damage of the Athame ring is halved.
- The ring deals normal damage.
- Brimstone: +2 flat damage.
- Beam will gradually increase in size and damage the farther it travels, on a multiplier that is roughly +20% per tile of distance.
- Brimstone + The Ludovico Technique: Makes the Brimstone circle widen and deal damage based on how far away it is from your character. At very close ranges, the damage is reduced to about 73% (unlike normal Coal effects).
- Diplopia: No benefit from an additional Lump.
- If multiple Lumps of Coal are acquired, the damage scaling will stack with itself, allowing it to scale faster in a shorter amount of time.
- Dr. Fetus: No benefit though the bombs appear darker.
- Epic Fetus: No benefit.
- Lachryphagy: Tears will grow until they burst, though their actual damage bonus is only based on distance traveled. Burst tears will also grow as they travel.
- Maw of the Void: Damage of the Maw ring is halved.
- The ring deals normal damage.
- Mom's Knife: No benefit. The Knife becomes a very dark brown.
- Ouroboros Worm/ Ring Worm: The peculiar movement patterns result in overall less damage from the same effective distance.
- Proptosis: Proptosis scales with Isaac's damage while the Coal does not. At base damage, tears will have approximately the same damage at any range; with increased damage, tears do more damage up close.
- Technology / Technology 2: No benefit.
- Damage increases the further away the enemy is, on a multiplier that is roughly +20% per tile of distance.
- Tech X: The laser ring will grow as the ring distances itself from the player, but will shrink as the player approaches it. Damage increases the further away the enemy is.
- The damage increase per tile is significantly lower.
- Trisagion: The damage of the blasts is increased by a negligible amount.
- In Western culture, children are commonly told that if they behave badly during the year, they will receive a piece of coal for Christmas.
- This makes A Lump of Coal a fitting item for Krampus to drop, based on his origins.
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