It features a number of appearance options that can be cycled through to make characters resemble whatever the player desires (within game's limits). In addition to this, the player can assign a Perk and a Trait upon creation which will impact the character's starting Stats / Weapon.
Once created the player can save the character to a roster of Custom Characters saved locally with the game.
When playing on Familiar Characters Mode, most encountered Characters during the game will be Custom Characters that have been created and saved using the creator. Custom Characters can also appear in all other modes, but not as frequently.