The dragon glared at Sven through its one good eye; the other was cloudy and gray from the huge scar that ran down its face. The dragon snarled and said, "This time you won't get away." Sven pointed to the red mark on his arm. "You nearly ruined my adventuring career from this wound, dragon," he said. "I lost a lot of gold because of it." He then unsheathed his longsword. "I think it's time for you to repay me."
This scene might be over exaggerating, but scars are a common trope in fiction. Many popular villains (Scar from The Lion King immediately pops to mind) and heroes (Harry Potter, almost every character from the webcomic Goblins) have a permanent deformation that can range from a plot device to a minor annoyance to simply cool-looking. It goes to follow that such a common trope should be in D&D!
Many D&D players and DMs probably want their characters to have cool scars. If they do, they are often there from the beginning of the game, and the origin of the scar is included in the character's background. Scars that come from events actually played out in the game, however, are much rarer. Wounds are healed completely after every extended rest. The player or DM could decide that a character gets a scar from a particularly eventful confrontation with a main villain, but this is purely a roleplaying device that gives the character a nemesis on whom to get revenge and a cool scar.
Another thing in storytelling that's left up to roleplaying is where attacks hit. When you swing a sword or fire a magical bolt, you simply record the damage and describe how it hits, but your description doesn't affect the mechanics of the attack. This goes hand in hand with acquiring scars, because the location you hit is the location where the scar forms.
In order to put these two ideas into the mechanics, I have made a critical hit subsystem using the following charts. Not every attack matters where it hits; if you had to roll for every attack, combat would slow down much more than it already is. Instead, it only matters when you score a critical hit. This subsystem makes critical hits much more dangerous, especially for the player characters, because if you get a scar, it becomes a permanent debilitation.
When a creature scores a critical, roll to see where they hit on the following chart (labeled Body) and apply the corresponding effect on the target. Sometimes, the location isn't determined randomly. If the target was helpless when the critical hit was scored, then the attacker can choose where the attack hits. The DM may decide that certain monsters, particularly gargantuan-sized solos, can only be hit like this in certain spots, if at all. The specific power that you use could also determine the location (or locations, at the DM's discretion; for example, the rogue attack blinding barrage likely has to hit the eyes or forehead, and blast or burst attacks could hit multiple spots if the DM decides, maybe by rolling a saving throw for the creature).
If a critical hit brings a creature to or below its bloodied value, they also acquire a scar in the location that the attack hit. Scars are permanent unless you have powerful enough magic to remove it (Remove Affliction should take care of any normal scar). You cannot acquire a scar in the same place where you already have a scar; instead, if you were to get another scar in the same place as a previous one, the location could be cut off (or out, as the case may be).
BODY
d20 - Location and Effect
1 - Heart: The attack deals extra damage equal to the dice that were maximized (but this extra damage is not maximized). If you get a scar from this attack, you die.
2 - Lung: You must make Endurance checks as if you were holding your breath in a strenuous situation (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you can only regain the use of your second wind at a milestone.
3 - Back: You are knocked prone. You are also immobilized and can't stand up from being prone (save ends both). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you are permanently immobilized and prone.
4 - Groin: You are stunned (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you lose a healing surge after every extended rest.
5 - Stomach: You take ongoing 5 damage per tier (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you lose a healing surge after every extended rest.
6 - Gut: You are dazed (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you must take one less action per turn.
7 - Chest: You grant combat advantage (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you take a -1 penalty to all defenses.
8 - Right Hand: You drop whatever you are holding in this hand (it lands in your square). In addition, you are weakened for attacks you make with this hand (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you require a move action to use this hand for tasks that would normally require a minor action, and you are permanently weakened when using this hand.
9 - Left Hand: You drop whatever you are holding in this hand (it lands in your square). In addition, you are weakened for attacks you make with this hand (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you require a move action to use this hand for tasks that would normally require a minor action, and you are permanently weakened when using this hand.
10 - Right Lower Arm: You drop whatever you are holding with his arm (it lands in your square). If you get a scar from this attack, you require a move action to use this hand for tasks that would normally require a minor action.
11 - Left Lower Arm: You drop whatever you are holding with this arm (it lands in your square). If you get a scar from this attack, you require a move action to use this hand for tasks that would normally require a minor action.
12 - Right Upper Arm: You are weakened for attacks you make with this arm (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you are permanently weakened when using this arm.
13 - Left Upper Arm: You are weakened for attacks you make with this arm (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you are permanently weakened when using this arm.
14 - Right Foot: You are knocked prone. You cannot stand up from being prone (save ends). Aftereffect: You are slowed (save ends). You take a -5 penalty to saving throws against both these effects. If you get a scar from this attack, you are permanently slowed.
15 - Left Foot: You are knocked prone. You cannot stand up from being prone (save ends). Aftereffect: You are slowed (save ends). You take a -5 penalty to saving throws against both these effects. If you get a scar from this attack, you are permanently slowed.
16 - Right Lower Leg: You are knocked prone. You cannot stand up from being prone (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you take a -2 penalty to speed.
17 - Left Lower Leg: You are knocked prone. You cannot stand up from being prone (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you take a -2 penalty to speed.
18 - Right Upper Leg: You are slowed (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you take a -1 penalty to speed.
19 - Left Upper Leg: You are slowed (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you take a -1 penalty to speed.
20 - Head: Consult the chart labeled Head.
HEAD
d10 - Location and Effect
1 - Neck: The attack deals extra damage equal to the dice that were maximized (but this extra damage is not maximized). You also must make Endurance checks as if you were holding your breath in a strenuous situation, and you can only make incomprehensible noises, so other creatures are treated as not being able to hear you (save ends both). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you die.
2 - Back of Head: You fall unconscious (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you require 2 additional hours to benefit from an extended rest, and take a -2 penalty to saving throws against effects that make you dazed, stunned, or unconscious.
3 - Forehead: You are stunned (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you must take one less action per turn.
4 - Top of Head: You are dazed (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you lose a healing surge after every extended rest.
5 - Right Eye: You are blinded (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you are permanently blinded in this eye, and you take a -2 penalty to Perception checks and a -1 penalty to attack rolls.
6 - Left Eye: You are blinded (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you are permanently blinded in this eye, and you take a -2 penalty to Perception checks and a -1 penalty to attack rolls.
7 - Right Ear: You are deafened (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you are permanenlty deafened in this ear, and you take a -2 penalty to Perception checks and a -1 penalty to defenses.
8 - Left Ear: You are deafened (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you are permanently deafened in this ear, and you take a -2 penalty to Perception checks and a -1 penalty to defenses.
9 - Nose: You grant combat advantage and take a -2 penalty to attack rolls (save ends both). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you cannot smell, and you take a -1 penalty to Perception checks.
10 - Mouth: You can only make incomprehensible noises, so other creatures are treated as not being able to hear you (save ends). You take a -5 penalty to saving throws against this effect. If you get a scar from this attack, you are permanently hard to understand, and you take a -5 penalty to Diplomacy and Streetwise checks.
This system results in grittier gameplay that could kill creatures prematurely or cause creatures to become useless even though they're not dead. If a player character gets a serious debilitation this way (such as being blinded in both eyes or paralyzed from a broken spine), you should have a talk with that character's player. If the player does not think that the penalty is worth the character development, allow the character to spend a feat slot or gain a magic item to let the character overcome the scar.
Scars heal a little over time, so you can slowly relieve penalties from characters until the scars become just there for looks. However, scars never fade completely. If the character takes another hit in the same location, the scar should flare back up with old pains and penalties.
SCARS ON EQUIPMENT
If you like the idea of scars but want to tone it down a bit, you could rule that the scar only applies to the equipment on that area of the character. When this happens, the character does not suffer the permanent effects of the scar, but their equipment is permanently damaged (though it could be repaired with the Make Whole ritual). This could inflict a small penalty (-1 to AC if it was armor, attack rolls if it was a weapon, or it could make magic items less effective if magic is capable of being disrupted by physical damage in your world), but not necessarily. However, when the character gets another scar in that location and is still only wearing the scarred equipment, if goes past the equipment and inflicts the scar on the character.
If you like the grittiness of scars but also want equipment to be effective, then go for it! Even if you don't make a tear in the armor have a penalty attached to it, it's still a cool roleplaying feature for the character.
Gettins scars from gameplay makes them mean much more to a player. When asked about the scar, they can launch into the whole story that unfolded that one night, and the rest of the players can nod as they too remember what happened. I hope this subsystem can not only toughen up the game for seasoned players who want a challenge, but make it more exciting to roleplay the attacks as well!
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