It is basically the ultimate badge of teenage awkwardness, though adults certainly aren't immune. You've probably seen one—that telltale purple or reddish smudge on someone's neck that looks suspiciously like they got into a fight with a vacuum cleaner. It's a love bite. A kiss mark. Whatever you call it, the definition of a hickey is technically a bruise, but with a much more specific origin story than tripping over the coffee table.
Hickeys are weird. They're intentional injuries that we sort of just accepted as a rite of passage. But biologically, what is actually happening under the skin? It isn't just "sucking on skin." It is a localized trauma event. When someone applies strong suction to a soft area of your body—usually the neck because the skin there is thin and the blood vessels are close to the surface—they create a vacuum. This vacuum is strong enough to rupture the capillaries. Those are your tiniest blood vessels. Once they pop, blood leaks out into the surrounding tissue. That trapped blood is what you’re looking at when you see that dark mark in the mirror.
The Biology Behind the Definition of a Hickey
Let's get clinical for a second, even if the topic feels a bit middle school. Doctors refer to a hickey as an ecchymosis. That is just the medical term for a bruise that results from the rupture of blood vessels under the skin. Unlike a hematoma, which involves a larger pool of blood and often a lump, an ecchymosis is flat.
It starts red. That is the fresh oxygenated blood spreading out. As the body begins to break down those blood cells, the color shifts. You’ll see it turn a deep purple or blue, eventually fading into a sickly greenish-yellow. This is the exact same process that happens when you bang your shin. Your immune system sends in white blood cells called macrophages to clean up the "trash"—the dead red blood cells—and recycle the iron.
Why the neck? Honestly, it's mostly about accessibility and skin density. You could get a hickey on your arm, but the skin is tougher there. It takes way more pressure. The neck is a perfect storm of thin dermis and high vascularity. Plus, it's an erogenous zone, which is why things get heated enough for someone to forget they're literally bursting your veins.
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Not All Marks Are Equal: The Risk Factor
Most of the time, a hickey is just an embarrassing social hurdle. You wear a scarf. You buy some high-coverage concealer. You move on with your life. But there are rare, documented cases where these marks have caused genuine medical emergencies.
In 2011, a woman in New Zealand suffered a minor stroke after receiving a hickey. It sounds like an urban legend, but it was reported in the New Zealand Medical Journal. The suction was so intense that it caused a blood clot in her carotid artery. That clot traveled to her heart and caused a stroke. It’s incredibly rare. Like, lightning-strike rare. But it happens.
Most people just deal with the "skin trauma" aspect. If you have a blood clotting disorder or you're on blood thinners like aspirin or warfarin, a hickey is going to look much more dramatic and stay much longer. Your body just isn't as good at "plugging" those tiny leaks.
Cultural Perception vs. Reality
In some cultures, marks similar to hickeys are actually therapeutic. Ever heard of "gua sha" or "coining"? In Traditional Chinese Medicine, practitioners use a smooth tool to scrape the skin to intentionally cause "sha"—which looks exactly like a hickey. The idea is to stimulate blood flow and healing. So, while your boss might find your neck mark unprofessional, a TCM practitioner might just think you're treating a cold.
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How to Get Rid of One (And What Doesn't Work)
People get desperate. They try the "cold spoon" trick. They rub it with a coin until the skin is raw. They use toothpaste.
Here is the truth: you cannot "erase" a hickey. You have to wait for your body to metabolize the blood. However, you can speed up the peripheral swelling if you catch it early.
The Cold Phase
If the mark is fresh—within the first 12 hours—use cold. A bag of frozen peas or a cold spoon. This constricts the blood vessels and might limit the amount of blood that leaks out. It won't make the mark disappear, but it might keep it from getting huge.
The Warm Phase
After two days, cold is useless. Switch to heat. A warm compress increases blood flow to the area. More blood flow means more "cleanup" cells arriving to carry away the debris of the bruise.
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The Pineapple Myth
Some people swear by eating pineapple or applying it topically. Pineapple contains bromelain, an enzyme that has anti-inflammatory properties. While some studies suggest bromelain can help with bruising, eating a single slice of pizza with pineapple isn't going to fix your neck by tomorrow morning. You'd need concentrated doses.
Topical Helpers
- Arnica gel: This is a go-to for many athletes and plastic surgery patients. It can help reduce the appearance of bruising.
- Vitamin K cream: Vitamin K plays a role in blood clotting and skin healing.
- Concealer: Green-tinted primers are your best friend here. Green neutralizes the red/purple tones.
Moving Past the Mark
The definition of a hickey is essentially a temporary tattoo of a moment of passion that your skin didn't quite have the structural integrity to handle. It usually lasts anywhere from five to twelve days. If it's still there after two weeks, or if you notice you're bruising easily in other places without cause, that is when you actually need to see a doctor.
Don't panic about the rare stroke stories. Just be mindful. If you're the one giving the hickey, maybe take it down a notch. If you're the one receiving, keep a turtleneck or some Dermablend on standby.
Immediate Actions for a New Hickey
- Apply a cold compress immediately for 10-15 minutes to minimize the spread of the bruise.
- Avoid "massaging" the area roughly; you'll just irritate the skin and potentially cause more inflammation.
- Check your supplement intake. Things like fish oil, ginger, and garlic can thin the blood slightly, making the mark look more prominent.
- Invest in a color-correcting palette—specifically one with peach or green tones—to mask the various stages of the bruise's "rainbow" as it heals.
- Hydrate. Healthy skin heals faster than dehydrated, sallow skin.