By her own accounts, Kathy Griffin has endured all kinds of hell.

A recent sighting of the fiery comedian strolling through her Malibu neighborhood indicates that her various professional, mental health, and medical challenges have impacted her appearance.

Griffin, now 64, appeared nearly unrecognizable when photographed for the first time since undergoing a hysterectomy in early April to address a pre-cancerous condition.

Though she appeared to have regained her energy after the surgery, walking alongside a female companion, her pale complexion was almost as shocking as the bloody, severed Donald Trump head she posed with in a controversial 2017 satire that almost derailed her career.

Contrasting with the jarring paleness of her skin, her signature bright red hair fell loose around her shoulders while it seemed her hairline was receding, and she had either a scalp condition or bald spot. 

Known for her biting humor and criticism of Republicans, the Catholic League and celebrity culture, Griffin has opened up about her history of health struggles, starting with a binge eating disorder as a teen. 

 She also has spoken out about her long string of cosmetic procedures ranging from a breast augmentation, nose job and lip tattoo to a botched LASIK surgery in 2003 that partially blinded one of her eyes and complications from a 1999 liposuction that nearly killed her.

She also has struggled with her mental health, especially since a photo of her holding what looked like Trump’s hacked-off head triggered heavy pushback starting in 2017.

Trump, tweeting about the image at the time, wrote, ‘Kathy Griffin should be ashamed of herself. My children, especially my 11-year-old son, Barron, are having a hard time with this. Sick!’ 

Donald Trump Jr. told Good Morning America that ‘She deserves everything that’s coming to her.’

Griffin, along with her then-elderly mother and dying sister, received death threats during the biggest controversy of her controversial career.

The Trump administration placed her on its no-fly list and its Justice Department spent at least two months investigating whether the photo she posed for constituted a conspiracy to assassinate the president. Nothing became of that probe, at least legally.

Still, the image caused her career to nosedive, at least temporarily. Talk shows and theaters canceled her appearances, and CNN ended her annual stint co-hosting its New Years Eve show with Anderson Cooper from 2009 to 2017.

‘I wasn’t canceled,’ she told the New York Times. ‘I was erased.’

Griffin ended up apologizing for the Trump effigy, posting on Twitter that, ‘I went way too far. The image is too disturbing. I understand how it offends people, it wasn’t funny, I get it.’

She financed and produced ‘Kathy Griffin: A Hell of a Story,’ a 2019 documentary about the Trump photo and how it changed her life.

Meanwhile, her anxiety and chronic back pain triggered a pill addiction, which spiraled into severe depression and an attempt to end her life in 2020.

Then in 2021, she was diagnosed with lung cancer, even though she never smoked. A surgery to remove half of her left lung damaged her vocal cords, causing her to undergo at least one more operation to improve her ability to speak.

Griffin came forward on social media in 2023 to say that her cancer fight and years of Trump backlash contributed to extreme post-traumatic stress disorder (PTSD) and caused severe anxiety attacks that at times had her writhing in bed for eight hours. 

She talked about the ordeal in a video posted to her TikTok account.

She said at the time that she managed her anxiety partly by pushing herself to do daily tasks such as feeding her dog or taking walks.

Griffin took small, but brisk steps on her recent trek in Malibu wearing a gray top, black leggings and designer purse.

Such details are the kind of fodder she has used in her brand of caustic comedy aimed at everyone from Barbara Walters to the Octomom to Jesus Christ.

Raised in Oak Park, a suburb of Chicago, Kathleen Mary Griffin attended acting school and launched her acting and comedy career in Los Angeles in the late 1970s and early 1980s. 

Her supporting role on the Brooke Shields sitcom Suddenly Susan and starring role in Kathy Griffin: My Life on the D-List — winner of two Emmys for Outstanding Reality Show — marked her big breaks on TV. 

She was a regular on late night talk shows, has performed in 20 stand-up comedy specials on HBO, Comedy Central and Bravo, and has appeared in 45 movies.

Griffin finalized her divorce from marketing executive Randy Bick in January after four years of marriage.