But then, open-palm strikes are very effective and virtually riskless for the attacker. If you are good at it, you can at the same time strike the opponent's chin and put your fingers in his eyes, but here we are obviously way out of sport's territory and way into aggressive self-defense / violent street fight.
Does boxing cause brain damage? This article says: "Almost certainly": https://www.livescience.com/1519-boxing-brain-damage.html
There's also forms of karate that allow full contact.
But I look at Thai Boxing matches with flying knees, elbows, etc and that recent video where a fighter footswept someone and then kneed them in the head on the way down and I think "Fuck that."
One area that is different to a lot of other sports is that fights aren't stopped for bleeding often as it is very common for thai style elbows to open gashes on the face. A lot of experienced fighters will have scarring around the eyes from getting cut with elbows.
That said in the west fights are split into 3 classes (4 if you include novice fights) C which has no elbows or knees to the head, B which has no elbows to the head and A which uses All legal thai techniques
I practiced thai boxing for many years and it may sound odd, but I don't really see boxing as a violent sport, no more than let say soccer. I've never hit anyone (other than on a ring) and never will, and I hate violence as much as most people. In the context of boxing I see hitting as a technical move.
Besides the occasional bruises, rare broken ribs or black eyes, I've never injured myself. Most of the time, you practice with control and with various protections, wary of your partner level.
Competitions are more violent, but even there, there's a gradation. Fighters are matched by skills and weight, depending on their level use protections (helmet, shin guards), and the referee is there to stop the match if needed.