Red health and containers
A container is capacity; its red filling is current health. Red Heart pickups refill existing containers rather than creating new ones.
A full-heart pickup can waste healing if only half a heart is missing.
Red Heart pickupBamboo Gaming · Updated
Isaac hub / Run mechanics
Repentance health guide
Hearts and health
A full-looking heart, an empty container, and a shield are different resources. Learn what heals your character and what your next hit will spend.
Three separate questions
Capacity
Is there a container or slot to fill?
Current health
How much health is actually filled?
Protection
Is a shield available for an eligible hit?
Character pickup helper
Will this pickup help my health?
Choose the character and current form, then the pickup. These are normal character rules. Your current items, available slots, and temporary effects still matter.
Isaac · Red Heart
Refills existing red health
A Red Heart refills an empty red container, up to its capacity. It does not add a new container or replace lost Soul Hearts.
Useful decision: Check for eligible missing red filling before collecting. If only half a heart is missing, part of a full-heart pickup can be wasted.
Red pickups refill existing containers. Soul and Black Hearts add temporary health. A run's items can change these normal rules.
Read the health bar
What each kind of health means.
Most characters share a twelve-slot health limit, with special-character and item exceptions. Capacity, temporary health, and attached reward effects occupy the bar in different ways. HUD symbols and pickup examples below use original game art.
Soul Hearts
Temporary health added after red containers. Once lost, there is no empty Soul Heart container to refill with red healing.
Soul damage still counts as being hit, even when it protects a deal opportunity.
Soul Heart pickupBlack Hearts
Temporary health similar to Soul Hearts, with a room-damage burst when the Black Heart is depleted.
A partly filled Soul or Black Heart can interact with the other type when collected.
Black Heart pickupBone Hearts
A shell that can hold red filling. After its filling is emptied, a further hit can break and permanently remove the shell.
Refill the shell before it breaks. It is not an ordinary permanent red container.
Bone Heart pickupEternal Hearts
A white half-heart that can become a new container when paired with another or carried to the next floor. Special characters can receive converted health.
It can be lost to damage before converting. Health caps and character rules still apply.
Eternal Heart pickup
Gold Hearts
A golden outline attached to existing health. It produces coins when the attached health breaks instead of adding a protective hit.
Its reward triggers when the attached health is lost. The gold outline does not make a risky hit safe.
Gold Heart pickup and appearanceRotten Hearts
Red filling that generates two friendly flies per Rotten Heart after a room clear. It cannot be half-filled and is lost whole when damaged.
A Rotten Heart absorbs half a heart's worth of damage. A full-heart hit can remove two, or spill into other eligible filling.
Rotten Heart pickupBroken Hearts
Unusable slots that reduce available health capacity. They are not missing red health and ordinary healing cannot refill them.
Removal needs a special effect, such as a successful Confessional outcome. Extra Broken Hearts can make a run fatal.
Confessional removal chance
Coin health
Keeper and Tainted Keeper use Coin Hearts. Picking up money can refill missing coin health rather than adding that money to the counter.
Coin damage uses whole Coin Hearts. The Wafer does not create half-coin protection.
Keeper health rulesWorked examples
The same bar can change in different ways.
These use ordinary red-health characters with no modifying items. The game's original HUD symbols show the before and after states.
A Red Heart refills capacity
Before
After
Picking up one full Red Heart fills the empty container. It does not create a fourth container.
An enemy hit spends temporary health
Before
After
For an ordinary one-heart hit in Womb, the rightmost Soul Heart is spent. The red containers are still full. This example assumes no special damage-order effect.
A payment can spend red health first
Before
After
An ordinary early-floor Blood Donation Machine payment uses half a red heart first. The Soul Heart does not have to be spent. Later-floor costs and character rules can change this.
Choose healing for the health you are missing.
Red healing refills
Yum Heart, Full Health and The Sun mainly help eligible red filling. They do not recreate lost Soul Hearts just because the bar is shorter.
HP ups change capacity
A new container can change your maximum health. Characters who cannot use normal red containers often convert an HP up into another health type.
Charges and shields are separate
Bethany charge reserves pay for active-item uses. Holy Mantle absorbs eligible damage. Neither is an extra red container you can refill.
Useful healing and protection items
Check the item's effect and exceptions before treating it as a cure for every health problem.
Curse of the Unknown hides health without changing the damage you can take. Track healing and hits before spending health on a machine or deal. Read the curse rules.
Before the next sacrifice
Check the complete spike-payment sequence, angel fights, health exceptions and Dark Room travel before spending more health.
Sacrifice Room rewards and step reference →Learn the character's special rules
Learn unusual inventories, resources, combat and survival systems through 34 illustrated guides and 102 before-and-after examples.
Character mechanics and action examples →Repentance rules, reviewed October 6, 2026. Repentance+ and mods can differ. Sources: health reference and versioned character reference. The helper describes normal interactions and does not read your save or simulate a live health bar.