So, in release 6 there will be the opportunity to get tattoos. These will be permanent and will either have an effect when applied, or more likely, have a constant effect from now on. This ranges from minor stat changes, to monsters much preferring taking you anally, to having a chance to aggro friendly monsters just by talking to them.
Currently tattoos are obtained from an automated tattoo machine in the hotel. The machine accepts an item as payment, and then tries to base its decision on what tattoo to give you based on the item you gave away. If the game decides that tattoo is not appropriate for you right now, it'll give you a random different tattoo instead.
Whilst on average most tattoos are bad for you, there are some useful ones available so it's probably worth experimenting with chucking different items in there and seeing what happens.
I have plans to soon have this machine able to apply some kind of permanent make up as well.