A rash that resembles a hickey appears as discolored spots on the skin. While visually similar to a hickey, a bruise caused by suction, these rashes stem from various underlying causes that do not involve external pressure. Their appearance can range from small, pinpoint red or purple dots to larger, more diffuse patches, sometimes accompanied by other skin changes.
Common Causes of Hickey-Like Rashes
Rashes that mimic hickeys often involve bleeding under the skin, categorized as petechiae or purpura. Petechiae are tiny, pinpoint red, purple, or brown spots, typically less than 2 millimeters, caused by broken capillaries. Purpura refers to larger spots, usually between 3 and 10 millimeters, resulting from blood pooling under the skin due to burst blood vessels. Both are symptoms of underlying conditions rather than standalone diseases.
Minor trauma and physical straining are common causes of petechiae. Prolonged coughing, vomiting, intense crying, or heavy lifting can increase pressure in small blood vessels, leading to their rupture and the formation of these spots, especially on the face, neck, and chest. Tight clothing or excessive friction on the skin can also induce petechiae. Larger bruises (ecchymoses) can also result from minor impacts or pressure, appearing as purplish discoloration.
Beyond minor physical causes, medical conditions can also cause hickey-like rashes. Certain infections, including viral infections (mononucleosis, cytomegalovirus, rubella, viral hemorrhagic fevers) and bacterial infections (strep throat, scarlet fever, meningococcemia), can lead to petechiae. Endocarditis, an infection of the heart’s inner lining, may also present with these spots.
Medication side effects are another cause. Blood thinners, nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics (like penicillin), antidepressants, and certain heart rhythm drugs can interfere with blood clotting or vessel integrity, leading to petechiae or purpura.
Blood disorders, especially those affecting platelets (thrombocytopenia), can cause bruising and bleeding. Conditions such as leukemia, an infection in the bloodstream, or autoimmune disorders like lupus or vasculitis (inflammation of blood vessels) can also cause these rashes. Deficiencies in certain vitamins, like Vitamin C (scurvy) or Vitamin K, can weaken blood vessels or impair clotting, contributing to the appearance of these spots. Allergic reactions, such as contact dermatitis or hives, can also cause localized redness and swelling that may resemble hickey-like marks.
Differentiating from a Hickey
Distinguishing a hickey-like rash from a hickey involves several factors beyond appearance. A hickey is a localized bruise caused by suction, typically from kissing or biting, leading to broken capillaries. In contrast, a hickey-like rash arises from internal medical conditions, minor trauma, or external irritants, not suction.
Hickeys often have a more defined, concentrated shape and are commonly found on the neck or other easily accessible areas. Rashes, however, can be more diffuse, clustered, or spread across various body parts, including areas not typically associated with hickeys. While a hickey is usually painless or mildly tender, a rash may be accompanied by itching, pain, a burning sensation, or even a scaly texture. Hickeys typically fade within a few days to two weeks and are generally isolated marks without other associated symptoms. Conversely, a hickey-like rash might persist longer, spread, or be accompanied by other systemic symptoms like fever, fatigue, or widespread skin changes.
When to Seek Medical Advice
Seek medical advice if a hickey-like rash appears, especially if its cause is unclear. Immediate medical attention is advisable if the rash develops suddenly and spreads rapidly, as this could indicate a serious underlying condition. If the rash is accompanied by fever, chills, confusion, dizziness, or profound fatigue, these signs warrant prompt evaluation.
Any rash that does not fade or improve within a few days, or changes, becoming more painful, itchy, or widespread, should be examined by a healthcare professional. Bleeding from other areas, such as the gums or nose, alongside the rash, is also a serious warning sign. Individuals taking blood-thinning medications should also consult a doctor if they develop hickey-like spots, as these medications can increase bleeding risk.
Managing the Rash and Prevention
Once the cause of a hickey-like rash is understood, or while awaiting a diagnosis, general care can help manage symptoms. Observe the rash for any changes in size, color, or accompanying symptoms. Keeping the affected skin area clean with mild soap and water and gently patting it dry can help prevent irritation. Applying a cold, wet cloth or compress to the rash may help reduce itching and discomfort.
If the rash is suspected to be due to an irritant or allergen, avoid further contact with the suspected substance. Maintaining overall health through adequate hydration and a balanced diet rich in vitamins, especially C and K, supports skin health and can help prevent bleeding under the skin. While not all causes of hickey-like rashes are preventable, general hygiene practices, such as frequent hand washing and avoiding sharing personal items, can reduce the risk of infections that might cause these rashes.