Players must not be wearing headgear in order to use the Dragon Head Stone. In addition, they must not be suffering the egghead status effect. Once used, the player's head takes on the appearance of a dragon. The effect is permanent until the player's death.
Pressing and holding the [USE] button while the stone is in the current belt slot (X for Xbox 360, Square for PS3) emits fire breath at the cost of 50 stamina regen per second squared. The direction the stream of fire travels in is perpendicular to the player's body, rather than the direction their head is actually facing. This means that unlike other ranged attacks, when using lock-on, the player must continue to move to update their direction in order to hit moving targets. The base damage the fire breath deals per tick increases along with the player's rank in the Path of the Dragon covenant—120 at +0, 125 at +1, 130 at +2, and 140 at +3.
Unlike most other covenant-related items, the Dragon Head Stone does not require membership of its parent covenant to use. Leaving the Path of the Dragon covenant does not affect usage of the head stone in any way, though the player will lose any covenant rank-dependent benefits (the increased fire damage from the head stone, as well as the increased buff power and roar range of the Dragon Torso Stone).
- Prior to Patch 1.06, there was a bug associated with the Dragon Head Stone where if a person faced away from the camera and then right as they were about to breathe fire, turn toward the camera and change the item equipped at the bottom, they would instead use that item, allowing many uses of it.