Isaac's head becomes identical to that of Wrath's head.
Being used with Dr. Fetus the bombs gain the appearance of Super Troll Bombs. However, when leaving a room with such a bomb in it and re-entering it, the bomb will look like a normal bomb.
- Dr. Fetus - All bombs fired become larger with increased damage, and get a Super Troll Bomb appearance if the player has Wrath of the Lamb installed. This is purely aesthetic. This also causes Pride to take no damage from your tears. Normal bombs, however, will still damage him.
- When combined with the Item Bucket of Lard, it causes a flicker effect on the character (because of overlapping textures). This also happens if you use any kind of stats up pill.