As a new player of this game, I've been really trying to get into it, but there was always something... missing. And through many hours of contemplation, I have finally managed to put a finger on it. The problem I discovered was the lack of acne. Acne is a fundamental part of life that accompanies the common person, and leaving it out of the game would be an act of treason against what makes us human. A survival game striving for utmost realism without acne is like a home without a roof. To many of the player base with acne, they would feel tremendously misrepresented by the perfect skin that the in-game characters display. This is why I feel it is important that acne is added to the game immediately.
The default character not modified by any acne-related traits will have an increasing probability of getting acne if they have blood on their face and do not wash it. However, there will be positive and negative traits that modify this probability, with each of them worth 1 point. Acne will make your face more vulnerable to bleeding and infections, and you will be able to remove it using sharp objects such as knives. Removing it however, comes at a price; the character will feel pain from the surgical procedure, and there will be immediate bleeding. If these are too ambitious, acne should at least be a cosmetic feature that the player can select in the character creation page.
Acne would bring to this game what it has always been missing. It WILL cement Project Zomboid as the greatest game of the 21st century.