As Derby's Vaillant Live arena prepares to host a Bare Knuckle Fighting Championship (BKFC) event, BBC Sport looks at the debate around the controversial combat sport.
Bare-knuckle boxing is a raw, bloody relic of a sport known as 'the noble art'.
The controversial relative of boxing in its traditional gloved guise is both the oldest form of the fight game, but also a newly recognised sanctioned sport in the United Kingdom.
On Saturday, Derby's Vaillant Live arena will host a Bare Knuckle Fighting Championship (BKFC) event – the first of its type to be held in the region.
Headway, a charity that supports people with brain injuries, has renewed its calls for the sport to be banned and condemned the show as "irresponsible".
Promoters, fighters, and some medical professionals, however, say dangers faced in the ring need to be put into context.
Bare-knuckle bouts have provided gritty movie moments – be it Brad Pitt in 'Snatch' and 'Fight Club', or Disney+ series 'A Thousand Blows' starring Stephen Graham.
But BKFC UK president Andrew Bakewell says the sport is much more than the unregulated fights that have been brutally portrayed or the underground scraps which have spawned such stories.
"I think it's lack of knowledge," Bakewell told BBC Radio Derby, when asked about the safety concerns around bare-knuckle boxing.
"People hear about it and the stigma it's got."
With Irish mixed martial arts fighter Conor McGregor a part owner of BKFC, and Olympic gold medallist and former two-time IBF super-middleweight champion James DeGale fighting bare-knuckled earlier this year, the sport has grown in popularity and attitudes towards it have shifted.
'There is only so much a fighter can take'
The safety and dangers of bare-knuckle boxing - a sport where gory, claret stained injuries are not only accepted but treasured for its primal appeal – is something that is debated fiercely by its detractors and supporters.
A 2021 study published in 'The Physician and Sportsmedicine' journal, whose lead author was BKFC's chief medical officer Dr Don Muzzi, stated that 2.8% of the 282 bare-knuckle fighters studied experienced concussions with symptoms after a bout.
That number is up to 12.3% for gloved boxers, according to an investigation into "21st-century boxing specific injury rates" published in 2023 and covered in the Guardian last year.
The study headed by Dr Muzzi did find that cuts, be it facial lacerations and 'superficial hand' injuries, were significantly more frequent in bare-knuckle boxing.
Dr Louis Durkin, an emergency medical expert who is president of the association of ringside physicians, says "as far as safety goes it's significantly different" when bare-knuckle boxing is compared to its gloved relative.
The impacts of being hit with a bare fist are more forceful and painful to take, but the time fighters are exposed to those blows in the ring is significantly less, with bouts typically made-up of five two-minute rounds.
By comparison, when Jeamie 'TKV' Tshikeva beat Frazer Clarke in Derby two weeks ago to win the British heavyweight title, it was a 12-round fight that lasted 36 minutes.
"The other part of bare-knuckle boxing is that only a minority of fights actually go the distance, so not only is the whole thing timed for a shorter amount, the average bout only lasts 2.7 rounds of those five rounds," said Dr Durkin, who has worked in ringside medicine for more than two decades and been involved in around 30 bare-knuckle events in recent years.
"Mostly that is because there is only so much the fighter can take.
"Once one fighter is winning, usually they just take a knee and the fight is over as opposed to a true knockout or in traditional boxing where it doesn't quite elicit that pain response, so you can take a lot more shots."
'No corners cut on safety', but is it 'irresponsible'?
Bare-knuckle boxing bills itself as the "fastest-growing combat sport" having emerged from the shadows to host regulated and legal events in parts of the United States and many places across the world, with the first BKFC event in Britain at London's Wembley Arena in 2022.
It was only in 2018 that the first sanctioned fight for 130 years took place in the US state of Wyoming.
BKFC events in Britain, such as the one in Derby on Saturday, come under the remit of International Sport Karate and Kickboxing Association (ISKA) - a global body that regulates much of the mixed martial arts (MMA) events in Europe.
The British Boxing Board of Control (BBBC), which oversees the gloved form of the sport, is not involved.
Luke Griggs, chief executive of Headway, says the brain injury association he represents calls for all forms of boxing to be outlawed, but added that legitimising and promoting bare-knuckle fights is "irresponsible" and of "particular concern".
"Headway has always been clear on its position on all forms of boxing - we think the risks are too great. It's too obvious and all forms of boxing should be banned," Griggs told BBC East Midlands Today.
"And it's particularly concerning that bare-knuckle boxing is coming to the fore and increasing in popularity. It's hugely dangerous and we do not believe this sort of event should be sanctioned.
"Irresponsible is a very good word. There are lots of questions that need to be asked about these fights being sanctioned, these fights being allowed to go on, to be promoted."
Bakewell is BKFC's figurehead in Britain and says his aim as a promoter - and the desire of those involved in the sanctioned strand of bare-knuckle fighting - want the sport to be seen at the "top end of pro combat sports".
And he adds that events are "run accordingly" with the safety of its athletes paramount – with each fighter undergoing pre and post-fight health checks, while three doctors, two paramedics, two crewed ambulances are on-site for fight nights.
"We don't cut any corners in terms of production or the medical care," Bakewell said.
"We expect a lot from the fighters, but we also want to look after the fighters."
'It can look brutal, but it's entertaining'
Luke Brassfield, a 38-year-old middleweight fighter from Long Eaton in Derbyshire, will be making his BKFC debut on Saturday but already has previous experience as a bare-knuckle fighter.
He took up boxing 18 years ago when in the British Army, establishing himself as an amateur before going professional.
It was his struggles with mental health that prompted him to take his first bare-knuckle bout as he sought a quick way to get back into the ring.
That fight was over in one punch.
Brassfield says he does not see himself as "a violent person", insisting bare-knuckle fights - as well as the professional gloved boxing bouts he had juggled along the way - have been a physical release that have helped through hard times.
"I want to get onto a big platform to spread the word about mental health and positivity, to let people know that they could be at rock bottom, but there is a way out and the rise is beautiful," he said.
"I never really got going in boxing, but now in bare-knuckle I'm at the right age where I have the strength, maturity and boxing IQ and skills where I believe I can go far.
"I've boxed with gloves on for all these years and now they've taken them off. It's opened up a new market for me now.
"I've not taken a punch yet in bare-knuckle, but I have taken a lot of punches in boxing and you can feel the knuckles through the gloves.
"The look on someone's face when you have had a fight with no gloves on and there is not as much protection, there is a lot more swelling and cuts and that is the brutal part of it. But it makes it entertaining as well."
Category: General Sports