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For certain artists and bands, visual imagery plays a large role in heavy metal. In addition to its sound and lyrics, a heavy metal band's "image" is expressed in album sleeve art, logos, stage sets, clothing and music videos. Some heavy metal acts such as Alice Cooper, Kiss, Lordi, Slipknot and GWAR have outrageous performance personas and stage shows.

Down-the-back long hair, according to Weinstein, is the "most crucial distinguishing feature of metal fashion". Originally adopted from the hippie subculture, by the 1980's and 1990's heavy metal hair "symbolised the hate, angst and disenchantment of a generation that seemingly never felt at home", according to journalist Nader Rahman. Long hair gave members of the metal community "the power they needed to rebel against nothing in general".

The classic uniform of heavy metal fans consists of "blue jeans, black t-shirts, boots and black leather or jeans jackets". The t-shirts are generally emblazoned with the logos or other visual representations of favourite metal bands. Metal fans also "appropriated elements from the S&M community such as chains, metal studs, skulls, leather and crosses". In the 1980's, a range of sources , from punk and goth music to horror films, influenced metal fashion. Many metal performers of the 1970's and 1980's used radically shaped and brightly coloured instruments to enhance their stage appearance. Fashion and personal style was especially important for glam metal bands of the era. Performers typically wore long, dyed, hairspray-teased hair (hence the nickname "hair metal"), make-up such as lipstick and eyeliner, gaudy clothing, including leopard-skin-printed shirts or vests and tight denim, leather or spandex pants, and accessories such as headbands and jewellery. Pioneered by the heavy metal act X Japan in the late 1980's, bands in the Japanese movement known as visual kei, which include many non-metal groups, emphasise elaborate costumes, hair and make-up.