So, I do not know if this has been suggested before, but scars didn't show up much in search so...
Scars!! and loss of limbs, and hands, and fingers, and other bloody stuff.
We already have diseases, bleed effects and broken or lost limbs. Why not take it a bit further... with possibility to get/ear scars.
Scars from fighting bears or dark creatures that give you affluence or terror effects/bonuses.
Or scars from fighting turkeys, or rabbits, or disease that decrease affluence and make you grotesque. Getting scars from turkeys and rabbits decrease affluence if you are not a new player (i.e scalp score above certain level)
Also, balms, herbs, or spells that cure scars.
Scars heal over time so you have to keep fighting bears to keep your terror effects. However, witches gain scars or decay over time and become grotesque, and have to keep sucking youth by using curses and hexes. Also, it would be interesting to see people mistake a grotesque person for a witch while all they have done is fight a **** ton of bears.
I dunno if this would be possible but just a suggestion.