Being born with Pisces as your Ascendant has Neptune as their chart ruler, the Mystical Transpersonal Planet of Spirit. This means the individual must serve the placement of Neptune as it will positively or negatively determine their health in life. A Pisces Ascendant must make sure to have frequent checkups with a doctor to prevent any hidden defects or diseases, both for the body and especially the mind. They should be extremely careful with any altering substances such as alcohol or drugs of any kind as their body is highly sensitive.
Neptune is the planet of Spirit and Self-Sacrifice, which an individual with a Pisces Ascendant can come across to others as dreamy, unaware, or unrealistic. They have a very magnetic and hypnotizing way of speaking that can draw another person in. This also can have an adverse and distrustful effect on others who are more practical in nature. A Pisces Ascendant must beware to stay mentally grounded in reality to balance their strong spiritual inclinations to prevent getting lost in fantasy and forget oneself. Those who do not possess this characteristic either have some internal grounding in their chart or had help from someone in their life to teach them how to keep in touch with the world.
Neptune instills a spiritual quality of self-sacrifice where "we" or "I" is more dominant in having a stronger sense of compassion towards others. Depending on the exact placement of Neptune could result in a natural-born Intuitive Empath. If not careful, an individual with Empathic abilities will automatically pick up the emotions of others and incorrectly identify with these emotions as their own which produces gullibility and lack of right discernment of the situation, being susceptible to manipulation of those who are cynical or ill-intentioned.
Neptune also carries with it a deep love and appreciation of the arts that could bring the gift of a natural artist. A Pisces Ascendant's passion for art is so broad that it transcends the material as they create for the sake of experience more than for notoriety or monetary gain. This extends not only through skill but in their identity as well. A Pisces Ascendant has a tendency to alter their style or appearance at times or perhaps hide certain physical traits they possess to avoid being labeled as anything. The boundary between them and the world blurs as they want to romantically connect with all aspects of life.
When describing a Pisces Ascendant, others will have a hard time describing exact details or incorrectly add non-existent information of the individual's appearance unless they see them on a regular basis. Strangers might also approach a Pisces Ascendant and believe they have met them before when they have not or mistake them for someone else.