Bruises that look like hickeys are often ecchymoses: blood trapped under the skin. They can happen from suction, pressure, minor injury, or sometimes without a clear cause.

Get medical advice soon if they are new and unexplained, frequent, large, or accompanied by tiny red-purple dots, nose/gum bleeding, unusually heavy periods, fatigue, fever, or weight loss. Medicines such as aspirin and blood thinners can also cause easier bruising.

Seek urgent care now for rapidly spreading purple spots, heavy/uncontrolled bleeding, black stools, blood in urine, severe headache after a head injury, or if the person feels very unwell. Do not stop prescribed blood thinners without medical advice.