You could be forgiven for thinking Steve-O's unusual voice might be something do with his 'alternative' lifestyle, shall we say. But it turns out it isn't actually the result of any self-inflicted damage.
Watch him explain here:
Speaking on his Steve-O's Wild Ride podcast, the 48-year-old admitted he has mixed feelings about his unusual voice, and concerned that it may be deteriorating, he decided to see a doctor.
"I've gone back and forth about being like insecure about it and proud of it being a very distinctive and trademark," he said.
"In moments when I was feeling insecure about it, feeling that it deteriorates and it's getting worse, I found a voice doctor to go and look.
"I thought maybe I had like nodules on my vocal cords, maybe this and that."
Steve-O continued: "Maybe I've done damage to it, like huffing nitrous oxide, I thought might be part of it.
"The voice doctor put a camera up there and he said that I'm using, to speak, I'm using like the muscles above my vocal cords, which is making this you know, weird thing.
"And I was like, 'Wow, doc, like you're telling me after everything I've been through, I just suck at talking?' And really it's that simple."
He added that he'd worked with a vocal coach and made progress altering his voice, but it sounds like these sessions are going to be sacked off.
"My girl loves it," he explained.
"She says, 'Don't f***ing change it'. Just when I was working with the vocal coach, my girl, she wasn't happy. She said, 'F***ing, this is bulls**t'."
It's understandable though that Steve-O suspected he may have done some damage to himself - after all, that's what he's done for a living for years.
And when he says he 'huffed nitrous oxide', he really means it.
Speaking on The Joe Rogan Experience, he said he went through 600 cartridges in a day.
"That was when all the crazy s**t would go down because I would be like awake on cocaine for three days and inhaling nothing but nitrous oxide," he said.
"And at that point is when s**t starts popping off and people are walking around my apartment who are never physically there."