Reminds me of the artwork from the game Layers of Fear.

Is it supposed to be a take on the Joker?

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Probably Medusa with the serpents for hair.

I saw that after I got a downvote and was like why? Then I saw the snakes and was like ohhhh...

Layers of Fear

Why is this flagged as nsfw

I wasn’t sure if it was as half of the face is decade into a skull, but there’s only one person with snakes for hair so maybe it's a take on her look today? Or possibly medusa after being dug up for a portrait.