Altars
An altar is...
a conduit for an exchange of communication and energy between the physical and spiritual planes.
Do you have to have an altar?
No
Will an altar help you grow spiritually?
Definitely, if you use it regularly.
Where does it need to be?
Anywhere you think it should be. Consider the environment you live in (pets, young children, hostile household members, nosy neighbors, etc.), consider how you'll use it (open flames, food, clothing optional...) consider who it will primarily be for, other than you (ancestors, specific deities, nature spirits, your children on this plane...) An altar doesn't have to be in a permanent location, but it will function best if it is. An altar can be within a closed space (cabinet, closet, drawer....)
What does it need to look like?
It's about your interpretation. It can be a picture or group of pictures on a wall, a flat surface, a chair, a pile of pine cones outside, or a box that moves from place to place (more about that later), or an entire bookshelf, cupboard, dresser, or desk.
What does it have to have?
Whatever you are inspired to put on it. There are kits to buy, but they're completely unnecessary. It can hold objects of significance to you, pictures, water, plants, stones, candles, tools (cards, wands, knives, cups...) statues, incense, or whatever or not. Over time, you will be inspired to put things on your altar, trust yourself and go with it. If you work with ancestors, you probably want objects that were theirs or things that remind you them or pictures. If you work with elements, you probably want a representation of your elements. If you work with deities, yo probably want an image or object that reminds you of them. Ditto for nature spirits. Because it's a conduit for energy (it allows and exchange of energy between you and those yo work with on the spiritual plane) it's good to have something on it that acts like a battery (a stone, vessel of water, plant, candle, pyramid...). Because it facilitates communication, it's helpful to have a focal point for communicating with that individual(s) (a likeness of some sort, an object, etc)
Does appearance matter?
It should be maintained and cared for and clear of objects that don't belong. (Don't put objects on the altar that are not tied to your spiritual beliefs.) It doesn't have to look impressive or "witchy" or anything else. It should please you. Being mismatched is perfectly fine, as long as everything there has a purpose.
How do you use it?
It's up to you and it will probably change over time. It can be a place of meditation or prayer, a place to charge objects or spiritually cleanse them, a place to make offerings, a place to keep spiritual tools, a place to find peace, a place to talk with those on the spiritual plane who mean something special to you, a place to put objects you want to understand better spiritually, a place for spell work, or whatever you need.
A word about safety
Physical safety
Many people use candles on their altar. Make sure you consider all possible hazards. I personally leave candles burning 24/365 on my altar, but I only use safety candles (glass devotional candles that will extinguish themselves if knocked over). They sit on or within a container that will protect everything around it if the glass breaks. Nothing is above them that could fall on them. There are no flammable objects nearby. I do not have small children or people in my home that will mess with my altar. I do not have pets that will mess with my altar. I do not have pets that will disturb them. Please remember physical safety with your altar.
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Spiritual safety
It is a good idea to set apart/bless each object before you put it permanently on your altar. Do not share pictures of you altar with people you don't trust. If you want to share your altar publicly, rearrange or remove a few objects before you take your picture.
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Box altars
There are many people who are "in the closet" about their spiritual practices and keep their altar in a box out of site. This is an option. But, as your altar is a conduit (like a water or electrical conduit pipe that allows for the flow of energy) it works best if it's fixed in one place. Here's a suggestion, when you use it, have a regular place (or 2-3 places) where it's used. Having a stationary object in that place that can maintain the energy there will help. It could be a potted plant, a large stone (just a rock is fine), a cup of water you "keep forgetting to put in the kitchen," or whatever works in your situation. Leave a space clear next to it to put your box when you need your altar, if you can't leave it there permanently. If possible, keep a twin object in the box. For example, if you have a stone on your altar space, keep a small stone with it, after 1 moon cycle, move the small stone to the box altar. If you're using a plant, keep a small amount of the dirt in the box. If you're using water, maybe put a small stone in the water for a month that can be moved to the or alter or have a small bowl you pour water into from the permanent cup each time you set it up, then pour it back in the cup.