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Naked and Afraid is one of many reality TV shows where contestants try to overcome nature’s most brutal conditions in a survival format. Since its premiere in 2013, the Discovery original series has grown in popularity by leaps and bounds, with multiple spin-offs emerging, like Naked and Afraid: Last One Standing.

As the survivalists compete against their extreme environments, many contestants suffer cuts, bruises, and more. Here are the worst injuries in franchise history … so far.

7. Burned genitals (Season 15, New Mexico)

Season 15 of Naked and Afraid saw Sam Mouzer suffer a serious injury to his penis. According to TMZ, Mouzer and his partner were sleeping beside a fire. The fire suddenly burned his “little soldier’s helmet.”

Fortunately, the show’s medic was able to treat the injury and prevent an infection from developing. Despite Mouzer’s report of feeling lighthearted during the ordeal, the burn wasn’t too severe for him to quit, and he could keep filming.

6. Hypothermia (‘Naked and Afraid: Last One Standing,’ Season 1, South Africa)

This happened in the first season of Last One Standing. Spending some chilly nights in South Africa resulted in Amber Hargrove experiencing hypothermia. This condition happens when the body’s core temperature drops below 95 degrees Fahrenheit.

Shivering, slurred speech, and shallow breathing are signs of the condition. Symptoms worsen if a person does not treat hypothermia right away. Hargrove’s body temperature was 93.3 degrees Fahrenheit, so she had to leave the competition.

5. Scrotum stitches (‘Naked and Afraid XL,’ Season 7)

E.J. is another survivalist who experienced an injury to his penis in Season 7 of Naked and Afraid XL. According to Yahoo!, he fell from a tree and into a swamp. The fall caused a few lacerations on his genitalia, requiring eight stitches.

E.J. had two options: He could get a nurse to patch him up at a hospital safely. Alternatively, he could stay and let the medics stitch the injury then and there. E.J. wanted to remain on the show, so he risked the chance of infection. Of course, he couldn’t do anything that would undo the stitches.

4. Pit viper bite (Pre-season 1 production)

The elements are not the only thing people must deal with on the show. Contestants face various bugs and animals regularly. However, crew members also face risks when filming. In 2013, a pit viper bit producer Steve Rankin in the foot while they were preparing to film.

Rankin described the feeling as “a sharp pain like being stabbed.” The pain only got worse, and he had to go to the hospital right away. Doctors were able to treat the bite, but Rankin had to get five surgeries. Photos of his foot are gruesome and showcase the seriousness of his condition.

3. Stage 2 hypothermia (Season 8, Croatia)

Fans saw Samantha Ohl in the mountains in Season 8. She refuses to share body heat with her partner during a rainstorm. Huddling for warmth can make a difference. Ohl risked her health by not doing so.

Ohl’s body temperature got so low that she reached the second stage of hypothermia. At this stage, a person stops shivering and has symptoms like lethargy. In Ohl’s case, medics became concerned that her organs would fail. They took her to a hospital, where she recovered.

2. Flesh-eating bacteria (‘Naked and Afraid XL,’ Season 3)

In Season 3 of Naked and Afraid XL, Matt Wright once got a bug bite on his foot. At first, he used antibiotics from the medical staff to treat it. The bite did not develop any ordinary infection. He later discovered he had a flesh-eating bacteria in the injury site.

The bacteria started to spread, and Wright risked losing his foot, his leg, or possibly his life. He tapped out for that season but would return for later ones. Recently, he suffered another leg injury.

1. Dengue hemorrhagic fever (Season 2, Panama)

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Manu Toigo had an extreme health emergency when a mosquito bit her in Season 2. This mosquito was carrying dengue fever. Toigo developed a severe form of the illness called dengue hemorrhagic fever.

Symptoms of dengue hemorrhagic fever include vomiting and signs of shock. The disease can be fatal, so immediate medical treatment is necessary. Toigo has been able to recover from it.