If a player dies too often it's back to the start for another attempt. You're warned about this early on when you die your first painful, unavoidable death, and various aspects of the game are meant to confuse you and trick you into thinking you're safe, only to have that curse mark grow just a little bit closer to Senua's head. The game claims that when the rot reaches Senua's head, the player loses all their progress in the game, although PCGamesN tested it out and never hit the permanent death meter even after more than 50 deaths.
On Senua's right arm, there's an oily corruption that keeps track of this.
Ninja's Theory's stylish Hellblade: Senua's Sacrifice is out tomorrow! If they reach your head, it's game over forever. This permadeath mechanic is introduced in order to force the player to approach each encounter with a genuine sense of fear, and while I have yet to play it in order to see if it achieves this goal, there are already a lot of hot takes being posted online discussing whether or not it's a worthwhile or frustrating addition to the game.
Ninja Theory released the final installment in the studio's series of developer diary videos for Hellblade today in anticipation of the game's release for PS4 and PC tomorrow, with the 29th episode capping off almost three years of documentation of the game's creation.
If the permadeath is in fact a bluff, it could be a part of Senua's psychosis, and players believing in the permadeath may be another layer in which Hellblade brings players closer to understanding Senua. Most games either decide to initiate permadeath for every death, or they let you save without worrying about most of your progress being lost. While a typical Game Over screen allows the player to pick back up from a recent checkpoint, repeated deaths in Hellblade: Senua's Sacrifice add a new level of tension to the experience.