A hickey is a bruise caused by suction on the skin, most commonly on the neck or arm. When someone presses their lips against the skin and sucks, the vacuum force ruptures tiny blood vessels called capillaries just beneath the surface. Blood leaks out of those vessels and pools in the surrounding tissue, creating the familiar red or purple mark. The medical term is ecchymosis, which literally translates from Greek as “to squeeze the juice out.”
How a Hickey Forms
Your skin is filled with tiny capillaries that carry blood close to the surface. These vessels are fragile enough that sustained suction can break them open. When they rupture, blood escapes into the soft tissue underneath the skin but has nowhere to go. That trapped blood is what you see as the discolored mark. The neck is especially prone to visible hickeys because the skin there is thinner and the capillaries sit closer to the surface.
Color Changes During Healing
A hickey goes through a predictable sequence of color shifts as your body breaks down and reabsorbs the trapped blood. On the first day, the spot appears red from fresh blood sitting just under the skin. Within a day or two, the hemoglobin in that blood loses oxygen and the mark turns dark purple, blue, or nearly black. Over the following days, enzymes in your body break the hemoglobin down into different compounds, shifting the color to green, then brownish yellow, and finally fading to match your normal skin tone.
Most hickeys heal faster than deeper bruises like black eyes because the damage is superficial. The full cycle from fresh mark to invisible typically takes one to two weeks, depending on the severity of the suction and your individual healing speed.
Why Some People Bruise More Easily
Not everyone gets hickeys with the same intensity. If you bruise easily in general, you’ll likely get more dramatic hickeys from less pressure. Several factors play into this. People taking blood thinners have reduced clotting ability, which means more blood escapes from broken capillaries before the body can seal them off. Common over-the-counter pain relievers like aspirin and ibuprofen also reduce clotting and can make bruises, including hickeys, darker and longer-lasting.
Steroids like prednisone thin the skin over time, making capillaries more vulnerable. Iron deficiency and low vitamin C levels can weaken blood vessels or slow healing. Age matters too: as skin loses collagen and becomes thinner, the capillaries underneath have less cushioning and break more readily.
How to Help a Hickey Fade Faster
There is no instant fix for a hickey. It’s a bruise, and bruises take time. But a few approaches can modestly speed up the process.
Cooling the area early on helps slow the initial blood flow out of damaged capillaries. Wrapping ice or a cold pack in a cloth and pressing it against the hickey for 10 to 15 minutes in the first day or so can limit how much blood pools under the skin. After the first 48 hours, switching to a warm compress encourages your body’s cleanup process by increasing circulation to the area. The warmth helps enzymes break down the trapped blood cells and carry the debris away.
Topical creams with arnica may offer a small benefit. A 2014 review of the evidence found that arnica applied at concentrations above 10 percent had a modest effect on bruise healing, so look for products with at least 20 percent arnica if you want to try it. Creams containing vitamin K have also shown some promise. In one study, people who applied vitamin K cream to bruised skin after a medical procedure healed with less discoloration than those who used a plain moisturizer. Vitamin C creams have less evidence behind them but are unlikely to cause harm.
What Doesn’t Work
The internet is full of hickey hacks, and most of them are useless or actively counterproductive. Rubbing toothpaste on a hickey, scraping the skin with a coin or fork, or scratching at the discoloration won’t reach the trapped blood beneath the surface. A dermatologist at the Cleveland Clinic has noted that these abrasive tricks can irritate the already-damaged skin, causing scratches, additional redness, bleeding, or even scarring. The hickey becomes more noticeable, not less.
Rare but Serious Risks
In extremely rare cases, a hickey on the neck can cause a more dangerous problem. The carotid arteries, which carry blood to the brain, run along both sides of the neck. Intense suction directly over one of these arteries can damage the vessel wall and trigger a blood clot. A case study published in the New Zealand Medical Journal documented a woman who suffered a stroke after a hickey partially blocked blood flow through her carotid artery. This is not something most people need to worry about, but it’s worth knowing that aggressive, prolonged suction on the neck carries a small vascular risk.
Marks That Look Like Hickeys but Aren’t
Several skin conditions can produce round, red or purple marks that resemble a hickey. Ringworm, a common fungal infection, creates circular red patches that can appear on the neck or chest. The key difference is that ringworm patches are typically itchy and have a raised, scaly border, while a hickey is flat and painless. Contact dermatitis from an allergic reaction to jewelry, perfume, or fabric can also leave red marks in spots where a hickey might appear.
Petechiae, which are tiny pinpoint-sized red or purple dots, can cluster together and mimic the look of a light hickey. These are caused by broken capillaries too, but they appear without any suction or trauma and can signal issues with blood clotting or platelet counts. Lupus can produce rashes on the face and neck that look bruise-like, but these are usually accompanied by other symptoms like joint pain, fatigue, and fever. A hickey on its own causes no symptoms beyond the visible mark.