The image is a black and white drawing of a human face. The face is in a state of extreme horror, with its mouth wide open in a scream. The eyes are wide and staring, and the face is covered in sweat. The background is a dark, swirling mass of shadows. The drawing is done in a realistic style, and the artist has used shading to create a sense of depth and texture. The overall effect of the image is one of horror and dread.