🔸DOTs are harmful effects inflicted on Heroes and enemies via skills and combat items. Typical DOT effects include Bleed, Blight, and Burn (excluding Strangle, a unique DOT). These effects can stack and deal a fixed amount of damage on the targets whenever they start their turn. Similar to most Debuffs, DOT effects last for 3 turns and has a 100% chance to be inflicted via all skills by default. Heroes can increase said chance by equipping certain trinkets. If a DOT attack is a critical hit, the DOT effect of the attack will ignore 20% DOT Resistances of the target and last for 2 additional turns if it manages to bypass Resistances. Unlike physical damage, DOT values can not be reduced by any means - it can only be completely negated by DOT Resistances. Due to its damage-per-turn mechanic, DOT is particularly handy for wearing down enemies with multiple actions per turn and killing ones with Death Blow Resistance (who are already on Death's Door). DOT will not take effect when a target it affects uses skills that does not expend an action (Worship of Evangelist and Cherub, for example).
🔸DOT Resistances[]
The Bleed, Blight, and Burn Resistances (RES) are displayed as BLD, BLGT, and BURN, respectively. DOTs have a chance to be negated by respective DOT Resistances of targets they affect. For example, an enemy or Hero with 20 BLD Resistance has 20% chance to resist a Bleed effect whenever they are hit by a skill with default DOT chance (100%) that inflicts Bleed.
The DOT Resistances, seen at the bottom left, can be found in the Combat Skills section of a Hero's info panel
It is important to increase the DOT Resistances of Heroes as many DOT effects can easily wear Heroes down if stacked several times. Some enemy skills can inflict particularly huge DOT effects, such as Deacon's Exultation (10) or Lord's Bilious Cannon ( 6). Heroes can boost their DOT Resistances via skill Buffs (Plague Doctor's Ounce of Prevention), trinkets (Heat Shield) as well as combat and Inn items (Clotting Poultice). In addition, the DOT Resistances of a Hero can be increased or decreased depending on their positive or negative Relationship with other Heroes. As such, achieving multiple positive Relationships gives Heroes a much better chance of withstanding DOT attacks. Each positive/negative Relationship will increase/decrease all DOT Resistances of a Hero by 5.
A penalty of BURN Resistance caused by a negative Relationship
DOT Resistances can be reduced by Debuffs from certain skills (such asOccultist's upgraded Malediction or Whipper's Infernal Taskmaster) and combat items (such as Toxic Ichor).
🔸DOT Removal[]
All DOT effects will be automatically removed from all Heroes whenever a battle ends. DOTs can also be removed by combat items and certain skills. In combat, Heroes can entirely remove Bleed, Blight, and Burn from themselves when they use Bandages, Antivenom, and Burn Salve, respectively. Medicinal Herbs can remove all DOTs at once.
Plague Doctor and Hellion are so far the only Heroes that possess skills capable of curing DOTs (Battlefield Medicine and Adrenaline Rush, respectively). Some enemies, such as Evangelist and Cherub, can use Worship onDeacon and Cardinal to clear all DOTs from them.
🔸Forced DOT Triggering[]
Typically, DOT only deals damage at the start of its target's turn. However, some Heroes and enemies can use their skills to force DOT to deal most (or all) of its damage instantly (and remove the DOT in some cases). The damage dealt is counted as physical damage. For example, if an enemy is currently suffering from a Bleed effect for 3 turns (5 damage for each turn), a skill capable of triggering 100% of Bleed amounts will instantly deal 15 physical damage to said enemy.
Plague Doctor andRunaway are so far the only Heroes that can instantly trigger DOT on targets by using Cause of Death (affects all basic DOT types) and Backdraft (only affects Burn), respectively. Cause of Death can trigger 75 - 100% of DOT amounts, while Backdraft can trigger 50 - 75% of said amounts. Unlike Cause of Death, Backdraft does not remove DOT and its damage dealt to a target does not directly derive from the DOT amount on the target, but rather from the DOT on an enemy standing in front of the target. Her Ladyship, a unique variant of the Immolatist, possesses the Combustion skill which can trigger and remove all Burn amounts on a target.
The unique DOT effect, Strangle, has differrent mechanics and is exclusive to the Dreaming General's Tap Root. Strangle can not be resisted and will only affect Heroes if they stand on a Rank with 3 Tangled Growth effects applied to it. After the first turn of combat, Tap Root will use Creeping Growth to apply 1 Tangled Growth on 2 random Ranks. Once applied on a Hero, Strangle deals 2 damage per turn, increased by 2 for each turn it remains on said Hero. After being removed and re-applied, the damage value will reset back to 2.
Tap Root will apply the first Tangled Growth effect on all Ranks (rather than Heroes) on the first turn of combat
The main way to remove Strangle is hitting the Tap Root with any skill or combat item - for each hit, Tap Root will use Receding Growth to remove 2 Tangled Growths from a random Rank with at least 2 Tangled Growths. The other way, which is far more dangerous, is letting the Dreaming General use Nightmare, which will remove 2 Tangled Growths from all Hero Ranks at once. Nightmare will only be used if all said Ranks have 3 Tangled Growth effects. The first Tangled Growth effect inflicted on all Ranks on the first turn of combat can not be removed and will last for the entire duration of the battle against the Dreaming General.
3 levels of Tangled Growth
🔸Reginal DOT Focus[]
Depending on regions that Heroes traverse, they will encounter regional enemies with different focuses on DOT and DOT Resistances. The Plague Eaters in the Foetor region possess particularly high Blight Resistances and primarily inflict Blight via their skills. The Lost Battalion in the Tangle focuses on dealing Bleed while having high Bleed Resistance. In the Sprawl, Burn will be a dominant DOT threat as all Fanatics are Burn-resistant and can inflict Burn, mostly after they use Ignite!. In the Mountain region, the Cultists will mostly inflict Bleed and have low DOT Resistances overall.
Many Heroes introduced in Darkest Dungeon II possess skills that can inflict DOT on enemies, while some completely lack said skills (Man-at-Arms andLeper). Each Hero has their own focus on a DOT effect. For example, thePlague Doctor's skillset places emphasis on Blight, while theRunaway entirely focuses on dealing Burn. ThePlague Doctor and theOccutltist are so far the only Heroes capable of inflicting all basic DOT effects.
Some Heroes can apply DOT effects on themselves or their teammates using their skills, which only include Ruin (Leper) (upgraded) and Wyrd Reconstruction (Occultist).
In some cases, a skill does not directly apply DOT on enemies. Instead, it allows other skills and item uses to inflict DOT. The only skills with such mechanic are Firestarter (Runaway) and Malediction (Occultist). Firestarter enables a Hero to inflict Burn on enemies through their own skills and items, while Malediction forces an enemy target to receive a random DOT effect each time it takes damage.
Bleed, 
Blight, and 
Burn
HP to a 
Strangle, a unique DOT). These effects can stack and deal a fixed amount of damage on the targets whenever they start their turn. Similar to most 
Debuffs, DOT effects last for 3 turns and has a 100% chance to be inflicted via all skills by default. Heroes can increase said chance by equipping certain trinkets. If a DOT attack is a critical hit, the DOT effect of the attack will ignore 20% DOT Resistances of the target and last for 2 additional turns if it manages to bypass Resistances. Unlike physical damage, DOT values can not be reduced by any means - it can only be completely negated by DOT Resistances. Due to its damage-per-turn mechanic, DOT is particularly handy for wearing down enemies with multiple actions per turn and killing ones with 
Death Blow Resistance (who are already on 
Bleed, 
