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I did not see any new skin the achievement offers, so it does not matter that much I guess. The difficulty setting should in theory be able to be edited in your .dat file, but unless you know your way around editing stuff like that I would not recommend it to not destroy your save. I wonder if they would add an official way, since that can very much make the difficulty requirement in there a bit pointless, since anybody could flip the game on hard for that one + the zombie skin achievement and then go back.
Edit: there does seem to be a new emblem for that achievements.
Another thing is the "this as an early access title" I guess. Afaik they never broke saves on updates, but they at least add new cities and a whole new biome that did not show up for old saves. It is a bit hard with games like these though, since people can put in a ton of hours into a single save and then updates can hurt. At least it was not like with Oxygen Not Included, where bases could break on updates to do changes (e.g. abysallite pipes not being a 0% conductive anymore) or when people used mods: the save not working anymore with no way to go back unless you make an effort to get Steam to not update your copy and still play it ~~