Health Systems in Videogames


Health, Medkits, Hit Points, Regenerating Health... lets explore how healing in video games evolved from early arcade titles to modern times, and how different  health systems in videogames affect gameplay and player engagement.

Health Bar or Hit Points

The very representation of our character's well-being has its origins in fantasy tabletop role-playing game Dungeons & Dragons that was first published in 1974. While developing the tabletop RPG, co-creator Dave Arneson created a "hit point" system to allow characters to survive multiple attacks. Hit points were represented with a simple number that would decrease with each suffered blow.

Fast forward to 1980 we have one of the first video games to use Hit Points, Rouge-a dungeon crawler originally developed for Unix-based mainframe systems, represented Hit Points with numbers.


In 1983, Nintendo's arcade title Punch-Out!! introduced one of the first examples of graphical health indicators instead of numbers. The game featured a stamina scale that would decrease each time the player failed to dodge punches and fill up with successful strikes, and if fully depleted, the player character would be KO'd.

The first game that popularized the use of a health bar was Dragon Buster, a dungeon crawling rpg/platformer released in 1985 on Namco Pac-Land hardware, and later ported to NES and MSX systems.

Dragon Buster popularized the use of Health bar

Back to the present, health bars and hit points are still used by a large majority of video games and are mostly unchanged in their functionality. Today they come in all shapes, colors, and sizes sometimes even in creative ways like in Visceral Games' survival horror classic Dead Space. To support an immersive experience, Visceral ditched the standard industry idea of making the health bar part of the hud. Instead, they smartly placed it on the back of the player character as part of the armor design. In a way they made the health bar a part of the game world, while still providing crucial health status info.

No hud cluttering the screen in Dead Space, health is represented along the spine, while weapons come with hologram projected ammo count


The medkit, a staple of video game healing, is still widely used across almost all genres of video games. Its first video game appearance is hard to pinpoint, but for FPS games we can trace it all the way back to Wolfenstein 3D released in 1992. Since then its functionality remained mostly the same. Medkits still restore your character's lost hit points either instantaneously or over a short period of time.

Wolfenstein 3D Medkit

When comparing games with medkit based health systems to games using regenerating health, the former comes with some clear advantages, mainly in player engagement and tension during combat. Players are more engaged as they have to manage their health to avoid death, while the need for medkits incentivizes exploration. Combat also is more exciting when you have resource management and real penalties for sloppy play.

The main disadvantage of the medkit based health system is that it takes quite a long time to balance properly. Many old FPS games had a problem where players could end up in unwinnable situations with low health and no medkits in sight. To minimize the problem, over the years developers implemented some solutions in addition to thorough balancing. In Half Life 2, Valve programmed the supply crates to give you whatever you need most at that moment, while games like BioShock and FEAR allowed you to carry a set number of medkits on your character.


Half Life 2 supply crates would always drop you a medkit if you need it

Regenerating Health

First appearance of regenerating health in video games can be traced back to 1984 with the release of Hydlide. Developed and published by T&E Soft, Hydlide was released for PC in the Japanese market only. In game, your character would slowly regain health by standing still for a set amount of time. As the years went by, games using regenerating health were few and far between. It wasn't until early 2000s that they started to flood the market left and right.


Hydlide pioneered the regenerating health mechanic

The game responsible for the popularization of regenerating health, ironically didn't even feature regenerating health. When Halo Combat Evolved released back in 2001, it used a traditional health system with medkits paired with the regenerating shields that filled up when the player would avoid damage. The successive iterationsin the Halo franchise went full health regen, just like Call of Duty, another juggernaut of the industry that switched from medkits to regen health with second entry, released in 2005. The commercial success of those two franchises cemented health regen as the dominant system used in most games for better or worse.

Call of Duty 2

Suddenly, health regen was everywhere and it managed to creep in everything from first person shooters to RPG's. Health regen usage solved the problem of unwinnable situations that would sometimes crop up in games with medkit based systems, while another advantage for developers is that it's much easier to balance and develop. The problem with regen health for start is that passively waiting for your health to recharge isn't very engaging, it removes resource management from the equation, while combat loses some of it's edge when you have almost no penalty for making mistakes.

Fragmented Health bar, and partial regeneration

To solve both medkit based and health regen system problems, some game developers took the best of both and combined it into the Fragmented Health Regen. One of the first games with combined system was Starbreeze Studios' The Chronicles of Riddick: Escape from Butcher Bay released in 2004. The game featured a fragmented health bar where each of the health fragments would regenerate as long as it wasn't completely depleted. If it were, players would need to heal the character via health dispensers to restore the lost fragments.

The Cronicles of Riddick: Escape from Butcher Bay, each white square is a mini regenerating health bar

Another solution employed by some titles was to pair the traditional medkit based system with partial regeneration. Games like Prey, Prey 2017, Dishonored, and F.E.A.R among other titles would regenerate your health bar up to roughly 25% ensuring that you have a fighting chance until you find another medkit.

Limb Based Health System

Then, we have some games that went the extra mile and added some more depth to the traditional medkit based system. The most notable examples are Fallout series, and the original Deus Ex game released in the year 2000.

Health screen in Deus Ex, notice how each body part has a dedicated heath bar

In Deus Ex the player character has separate health bars for each body part: head, torso, both arms and legs. Head and Torso are critical, and losing all hit points in either would result in player death, while player could survive losing a limb or two, as long as torso and head had some hitpoints left.

The fun part of this health system is the effect it has on gameplay. Loss of health on arms and/or head results in reduced accuracy with weapons, while health loss in legs would bring on some movement-related penalties. Losing all health in both legs in Deus Ex forces you in crouch position, prevents you from running or jumping and reduces your movement speed to a crawl. Luckily you can always regrow your legs back with some medkit magic.

All this combined can lead to some interesting situations, where you maybe lose too much health in an arm, and your accuracy plummets forcing you to improvise your way out by means other than shooting. Deus Ex also featured health regen via augmentation upgrade, but in contrast to a lot of lazy examples of the mechanic, in Deus Ex health gain via regen was balanced by requiring loads of bio electrical energy that is used for powering augmentations.

It's interesting how some game mechanics like Hit Points, Medkits or Health regen survived mostly unchanged from conception to the days of modern gaming. While we all have preferences, some systems are simply a better fit for certain genres. While regen health works in multiplayer shooters, it's very much out of place in RPG's or survival horror games where resource management is one of the pillars of gameplay. Likewise, limb based system won't work as well in a run and gun shooter where the gameplay pace is faster. Luckily the examples of shoehorning health regen into every genre died out quite a lot in the last five years, and developers are much better at picking the right system to enhance their title's gameplay experience.

The articles content, opinions, beliefs and viewpoints expressed in SAPPHIRE NATION are the authors’ own and do not necessarily represent official policy or position of SAPPHIRE Technology.

Marin Madunic
A long-time PC gamer with passion for single-player story driven games of various genres. Some of my favorites include old PC classics such as Thief, Deus Ex, and System Shock 2; their modern counterparts from the Immersive Sim genre, and a host of western RPG's and FPS games from the last two decades and beyond.