Hirst stated the idea for the work came from an Aztec turquoise skull at the British Museum. However, artist John LeKay, a friend of Hirst's in the early 1990s, said the work is based on a skull covered with crystals which LeKay had made in 1993. LeKay said, "When I heard he was doing it, I felt like I was being punched in the gut. When I saw the image online, I felt that a part of me was in the piece. I was a bit shocked."