Is it possible to ever alter your appearance in the game, or are you stuck with the appearance you picked when you first started? Just curious how hard i should consider the appearance access.

Well I reckon this feature may be implemented one day. It's also something I've done a lot on other MMO's after It became available there. I've spent quite a lot of gold visiting the Barber Shop in WOW

 

Would love to see something similar appear here. But I guess it's not on the top priority list of the devs right now.

Direct answer: at this time, no, you cannot change any of your appearance options (including things like jewelry and masks for the blind race) after fianlized character creation. So, if your looks matter to you, consider it carefully.