If you like leaving your mark on your significant other, this news is a little alarming: A 17-year-old from Mexico City died this week after a hickey on his neck led to a blood clot and eventual stroke. Before you get all worked up, death by hickey is super rare, says Jamé Heskett, M.D., medical director at the Well Path.

We only know of two other cases where hickeys led to strokes, and both of those women survived. It happens when suction on the neck creates a vacuum that shrinks the diameter of the carotid artery, causing it to clog. If you are concerned, Heskett has some simple advice: “Do the hickey below the neck and you’re not going to have a problem.”