What’s So Bad About A Hickey?

A turtleneck in the summer. Layers upon layers of color-correcting make up. A perfectly coiled scarf. A popped collar, over a decade post-2005. You might be familiar with all of the ways to hide a hickey for a Monday morning meeting, but you might be surprised by the range of side effects that hickeys can cause (beyond a sweaty neck in the office). Hickeys are generally not bad for you — but experts say there are some rare cases where they can be dangerous or even life-threatening.

"Love bites, or hickeys, are a red mark or bruise caused by kissing or sucking on the skin," Dr. Diana Gall, M.D., of Doctor-4-U, a confidential online doctor service, tells Bustle. "The mark is caused by blood vessels underneath the skin rupturing — this is why the longer or harder you suck on the skin, the darker and longer the mark lasts, as more blood has been drawn."

According to Dr. Gall, hickeys can last up to two weeks, depending on the severity, slowly dulling in color as each day passes. Before long, you have a nasty looking yellow-brown spot that eventually fades completely, like any other bruise. Sure, they might be unsightly or sore after the fact, but in the heat of the moment, a hickey can also feel pretty damn good. “All the places that can be kissed are also places that can be bitten,” the Kama Suta reads. And if you’re not scheduled to have face time with your boss or parents any time soon, having a hickey can be a pretty fun badge of honor to wear. It’s like little (or not so little) reminder of good times past — something to make you smirk or blush when you catch your reflection, days (or weeks) after the act.

But how are hickeys dangerous, exactly? The appearance of a hickey may not be the biggest concern for you, as the trauma they can cause, though rare, is not always superficial. Here are six things you may not know about hickeys.

1. Hickeys Are Just Bruises

Although they require much more effort to get than, say, walking into a coffee table or face-planting it on the sidewalk, hickeys really are just bruises. In some cases, hickeys are intentional bruises, as either a way of "marking" one's territory or because of certain types of sexual play that both partners agree to. Other times, hickeys happen by accident, like when a make out sesh gets a little too heated.

"When the skin experiences suction (similar to cupping in Chinese medicine) some of the surface blood vessel burst from the pressure," dermatologist Dr. Sandy Skotnicki, M.D., tells Bustle. "The blood escapes the vessel and deposits in the skin — this is a hickey.”

2. Some People Are More Susceptible To Hickeys Than Others

Hickeys aren’t always the result of strong-willed lips — some people might bruise from even gentle kisses. "Just how some people bruise more easily than others, the same goes for hickeys as they are essentially the same thing," Gall says. "This can be from a number of reasons such as having weaker blood vessels, thinner blood, or vitamin deficiencies."

According to Skotnicki, people with thinner or more sensitive skin also end up with hickeys much easier than others, especially if their partner is sucking hard. With thin skin, blood vessels are closer to the surface, so it doesn’t take much to injure them. This also means that blood pools closer to the surface, which can make the hickey look even more dramatic.

But as Gall explains, hickeys are usually nothing to be concerned about "unless you start suddenly bruising more easily, or start noticing other symptoms, too." If that's the case, then it's time to see a doctor.

3. Hickeys Can Transmit Oral Herpes

According to the World Health Organization, 3.7 billion people under the age of 50 have HSV-1, or what's commonly known as oral herpes. This strain of herpes, which causes cold sores, affects 67% of the world population. It’s also so easily transmissible that you don’t even need mouth-to-mouth contact to pass it on.

"If your partner has oral herpes, they can pass the virus on through a hickey," Gall says. "Though the hickey-giver would have to have an active cold sore and shouldn’t be engaging in sexual contact anyway!" Skotnicki adds that it’s the pressure of the kiss that can increase transmissibility. If your partner has an active cold sore, oral herpes can become active in places other than the mouth, like the neck or face.

4. There Is No Cure For Hickeys

If there's no cure for bruises, then you better believe there's no cure for hickeys either. All you can do is treat it like you would a normal bruise.

"An ice pack or the back of a cold spoon applied soon after getting the hickey can help reduce swelling and the amount of blood rising to the surface of the skin to avoid it becoming as dark as it could be," Gall says. "Do this for the first couple of days before moving to a heat pack which will then do the opposite and promote blood flow to the area and speed up healing."

If you weren't able to get to the freezer quickly enough to ease the swelling, then Skotnicki suggests trying arnica, which is a topical treatment made from an herb that aids in pain and bruising.

5. Hickeys Can Lead To A Scar

When it comes to whether not a hickey can leave a scar, experts are divided. While Skotnicki says no, Gall says that, in very rare cases, a scar can be left behind or at least some sort of reminder that the hickey once occupied that spot.

"Although they aren’t usually permanent, on rare occasions they can be," Gall says. "This is usually caused by excessive sucking, the use of teeth, or picking at it while it’s healing. The scar is usually small and (hopefully) in an unnoticeable place."

Picking at your skin can aggravate or prevent the healing process, causing scar tissue to form, which can look and feel different than the skin that was there pre-hickey.

6. Hickeys Can Cause Strokes

It’s incredibly rare for hickeys to have fatal or near-fatal effects, but there were few incidences in which a love bite inspired a series of medical events that took a turn. In 2011, a New Zealand woman suffered a non-fatal stroke from a hickey. In 2016, Inverse reported that the location of the hickey was above a major artery; the blood vessel breakage created a blood clot in her neck, which led to the stroke, and caused paralysis of her left arm. And in 2016, a 17-year-old in Mexico died from a stroke after a hickey. According to local reports, the hickey created a blood clot that traveled to the brain and triggered seizures. The incident was the first-ever reported fatal stroke resulting from a hickey. This is how hickeys can be dangerous, though such an extreme case is rare.

Experts:

Dr. Diana Gall, M.D., doctor and consultant at Doctor-4-U

Dr. Sandy Skotnicki, M.D., dermatologist and author