Like Mardi Gras, medicine is vivid with seasonal colors of Carnival – the golden glow of jaundice, the green discharge of gonorrhea and the purple hue of hemorrhagic skin lesions.Carnival’s colors have medical significance. Many Carnival revelers have memories of awakening with an easily recognized dermatologic badge of lovemaking that coalesces into all the colors of Mardi Gras over a few days. It peaks in the 15- to 20-year-old group, there is no evidence that its incidence is decreasing over time and many young lovers will fall victim this Mardi Gras season. It is a skin lesion often found on the neck – the hickey. Under circumstances when the chemistry clicks, hickeys are easy to give and receive. Teenagers pass out hickeys like dogs lift their legs. It is a mark of temporary possession, saying, “I was there.” A suction-induced kiss on the neck causes the breakup of thousands of microscopic surface capillaries responsible for transporting oxygen and tissue nutrients. This passion-induced burst of small capillaries traps red blood cells in the skin tissues. The oxygen-deprived hemoglobin contained in these red blood cells is bluish purple in color. The purple/blue of recent passion bruising morphs into shades of gold/yellow and green after a day or two. Hemoglobin in the trapped red blood cells is visible through superficial tissues as it breakdowns into component colors like any other hematoma or minor collection of blood under the skin. These adolescent love marks last from several days to a couple of weeks depending upon how many extravated red blood corpuscles must be reabsorbed.What do you do once you get one? Location is paramount. A hickey on the tummy is much easier to hide than one on the neck. Some say immediate application of an ice pack will decrease the color changes but most folks who get a hickey aren’t thinking about the immediate need for first aid measures. The chemistry of speeding up the natural resolution of a hickey is more high school and college lore than science. You can brush or comb the bruise in an attempt to spread out the displaced pigment into nearby tissue. Initially this makes for a larger discolored area but the idea is to reduce the color intensity. Any list on what to do with Mardi Gras doubloons should include a reference to hickey removal that is said to be more effective than combing or brushing. Use two fingers to stretch out the area of hickey-involved skin. Use the edge of the doubloon to scrape the skin just like you would spread a pad of butter across a piece of toast. Use light pressure as scrapping too hard will cause bleeding and even more local skin damage.All sorts of cosmetic makeup creams, concealers and even eye shadow pencils can help conceal a hickey. Be careful. A searching eye can detect these touch ups. Often the best solution is a turtleneck. For women and certain dapper men (you know the type I mean) a scarf is another way to hide a hickey.When all else fails and an indiscreet relative or friend gets on your case, you can always claim your temporary tattoo of passion is a neck injury from a thrown Zulu coconut – but don’t assume that you’re really fooling anyone. There is another more painful skin injury that peaks in incidence during alcohol-induced partying – the black eye. This bruising injury transforms over time with the same spectrum of Carnival-related colors. Fortunately most black eyes are minor and heal themselves over time. It is the visibility that often hurts the most.  Forget about a raw piece of steak to reduce eye swelling. Save meat for the grill, not the face. An ice pack is time-honored first aid for a black eye because it does help reduce the swelling. Some crushed ice in a cloth towel applied over the injured area for 10 to 15 minutes every couple of hours for the first day will help. The Mardi Gras founders in 1872 probably didn’t have the evolution of hickeys and black eyes in mind when they first linked purple, green and gold to the first Mardi Gras in 1872. Although recent research would link the origin of the colors to heraldry (see the books Marched the Day God published by the Rex organization or New Orleans Magazine Editor-in-Chief Errol Laborde’s book, Krewe), according to Carnival historian Henri Schindler, the Rex organization actually addressed the importance of color in a big way 20 years after the fact. The theme of Rex’s 1892 parade was “The Symbolism of Colors.” The meaning of those colors parallels in some ways the lapel ribbons worn for common causes today.

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