Self-Harm Scars on Your Teen: What Parents Can Do

Noticing possible self-harm scars on your teen can bring up fear, sadness, and uncertainty. You do not need to have every answer before reaching out. Start with a calm, private conversation, take safety seriously, and help your teen connect with medical and mental health support.

What Can Self-Harm Scars Tell You?

Scars may suggest that a teen has injured themselves in the past, but their appearance alone cannot tell you what happened, when it happened, or whether your teen is currently safe. Some marks have other causes. Avoid making a diagnosis based only on what you see.

Self-harm can be a way of coping with overwhelming feelings, distress, or emotional numbness. It deserves a compassionate response and a professional assessment.

Self-harm does not always involve an intention to die. Clinicians may use the term nonsuicidal self-injury when someone intentionally injures themselves without suicidal intent. However, self-harm and suicidal thoughts can occur together. Do not assume that your teen is safe simply because they say an injury was not a suicide attempt.

1. Talk With Your Teen Privately and Without Judgment

Choose a quiet setting where you can speak privately and have time to listen. Begin with what you noticed and your concern for their well-being. Avoid accusations, threats, or demands for an explanation.

You might say:

“I noticed some marks on your arm, and I’m concerned about you. I’m not here to punish you. Can you help me understand what happened?”

If your teen tells you they have been hurting themselves, thank them for telling you. A response such as “I’m glad you told me. We will work on getting you support” can help keep the conversation open.

Try to understand what they have been experiencing rather than focusing only on the marks. Ask how they have been feeling, whether they have hurt themselves recently, and whether they feel an urge to do so now.

Avoid calling the behavior “attention-seeking,” asking them to hide their scars, or making them responsible for reassuring you. Even when a teen struggles to explain their behavior, their need for support matters.

2. Ask Directly About Suicide

Asking about suicide does not put the idea in your teen’s head. The National Institute of Mental Health recommends asking directly when you are concerned.

Use clear language:

• “Have you been wishing you were dead or thinking about suicide?”
• “Have you thought about how you would do it, or made a plan?”
• “Do you think you might act on those thoughts?”

Listen calmly and take their answers seriously. If your teen reports suicidal thoughts, seek prompt guidance from a qualified mental health professional or 988. If they may act on those thoughts, have a serious injury, or you cannot keep them safe, seek emergency help.

A denial of suicidal thoughts does not replace a professional assessment when other concerns remain.

3. Address Safety at Home

Take steps to reduce access to items your teen has used or might use to injure themselves. This can include securing sharp objects, lighters, and other identified items. Secure prescription and over-the-counter medications, and make firearms inaccessible to your teen.

Explain these changes as an effort to protect them, rather than a punishment:

“While we get more support, we’re going to make our home safer. You’re not in trouble. We want to help you get through difficult moments.”

Whenever possible, involve your teen in the conversation and work with a clinician on an individualized safety plan. That plan can identify warning signs, coping strategies, supportive people, and steps for getting urgent help.

Removing access to harmful items is one part of safety. It does not replace treatment, supportive contact, or emergency care when needed. A promise to stop self-harming is also not a substitute for assessment and a safety plan.

Respect your teen’s privacy while being clear that safety concerns may need to be shared with healthcare professionals or another trusted caregiver. Avoid promising to keep self-harm or suicidal thoughts secret.

4. Arrange a Medical Evaluation, Even if the Scars Look Old

If you notice possible self-harm scars or injuries at different stages of healing, contact your teen’s primary care provider. A medical appointment can help assess injuries, identify any treatment needs, and connect your family with additional care.

Old scars do not necessarily mean that self-harm is continuing. They also do not confirm that the underlying distress has resolved. Ask about your teen’s current experience rather than relying on how the scars look.

Fresh wounds, burns, or signs of infection may need prompt medical attention. Contact a healthcare professional about concerning redness, swelling, drainage, fever, or worsening pain. Serious injuries, uncontrolled bleeding, or a possible overdose require emergency care.

If the injuries are healed and there is no immediate safety concern, arrange a timely appointment with your teen’s primary care provider and a mental health professional. You do not need to wait for another injury before seeking help.

5. Connect Your Teen With Counseling

Counseling can help your teen understand what leads to self-harm and develop safer ways to respond to distress. An assessment can also explore concerns such as depression, anxiety, trauma, relationship difficulties, and suicidal thoughts.

Treatment should address your teen’s needs and include caregiver involvement when appropriate. Ask the clinician how your family can support safety, communicate more effectively, and respond when urges return.

How DBT May Help

Dialectical Behavior Therapy, or DBT, teaches skills for managing emotions, tolerating distress, practicing mindfulness, and navigating relationships. Research supports DBT as a treatment option for some adolescents experiencing repeated self-harm and significant suicide risk. A clinician can help determine whether it is appropriate for your teen.

Learn about DBT for teens at Kalamazoo Child and Family Counseling.

When More Support May Be Needed

Some teens need more support than weekly appointments provide. Depending on the assessment, a clinician may recommend an intensive outpatient program or another level of care.

KCFC’s Adolescent Intensive Outpatient Program in Kalamazoo provides a structured treatment option for teens who need additional support. An intensive outpatient program does not replace emergency care.

Keep Checking In After the First Conversation

Support should continue after the initial discussion or first appointment. Check in regularly without making every conversation about self-harm.

You might ask, “How have things been feeling today?” or “What would help you feel more supported?” Make time for ordinary connection, too, such as sharing a meal, taking a walk, or doing something your teen enjoys.

If your teen is reluctant to talk with you, help them identify another trusted adult or healthcare professional. Your goal is to keep them connected to support, even when you are not the person they find easiest to talk with.

If you are also noticing persistent sadness, withdrawal, irritability, or changes in daily functioning, read Teen Angst or Teen Depression? These concerns deserve attention whether or not self-harm is present.

Frequently Asked Questions About Self-Harm Scars on Teens

Find Support for Your Teen in Kalamazoo

If you are concerned about possible self-harm, you do not have to navigate the next steps alone. Begin with a supportive conversation, address immediate safety, and arrange professional care.

To ask about teen counseling services at Kalamazoo Child and Family Counseling, call 269-615-7637. Our team can discuss available services and next steps. For an immediate safety concern, use emergency or crisis services rather than waiting for an office response.

Sources and Additional Resources

• National Institute of Mental Health: 5 Action Steps to Help Someone Having Thoughts of Suicide
• Mayo Clinic: Self-Injury—Symptoms and Causes
• NHS: Getting Help for Self-Harm
• National Institute of Mental Health: Therapy Reduces Risk in Suicidal Youth
• QPR Institute: About Question, Persuade, Refer
• 988 Suicide & Crisis Lifeline

Clinically reviewed by Jeff LaPonsie, LMSW-C, Kalamazoo Child and Family Counseling.