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The Psycho Jester Makeup is an additional face makeup card included with the See the Future downloadable content. It is given to the hero by Murgo at his caravan in Bowerstone Market. Attractiveness is lowered by 5% while scariness is increased by 10% when applied.
Jesters are notoriously prone to losing their minds and going on horrific killing sprees. It's the bells on their hats that catalyze it. Use this makeup in your inventory to apply it.
This makeup can be used from the items menu, as "black" makeup, for The Goth achievement.