No single sign on this list proves your teen is self-harming. But patterns matter. If you are seeing several of these together — especially physical signs combined with behavioral changes — it is worth paying closer attention and gently opening a conversation.

Physical Signs

Unexplained injuries

Cuts, scratches, burns, or bruises that your teen cannot adequately explain — or that they explain with stories that do not quite fit. Pay attention to injuries that are linear (suggesting cutting), clustered in one area, or in varying stages of healing. Common locations include the forearms, upper arms, inner thighs, stomach, and hips — areas that are easily covered by clothing.

Long sleeves and full coverage in warm weather

One of the most common and recognizable signs. If your teen has started wearing long sleeves, pants, or hoodies even when it is hot — especially if this is a change from their previous habits — they may be concealing injuries. Wristbands, bracelets stacked up the arm, fingerless gloves, or arm warmers worn consistently serve the same purpose.

Wound-care supplies in unexpected places

Bandages, gauze, antiseptic, butterfly strips, or medical tape in your teen's room, bag, or locker. Teens who self-harm often treat their own injuries to avoid medical attention.

Blood stains

Blood on clothing, towels, bedding, or tissues — especially if discovered in the trash or laundry. Your teen may attempt to wash stains before you see them, or attribute them to nosebleeds or other routine explanations.

Sharp objects where they should not be

Razor blades, pencil sharpener blades, box cutters, scissors, or other sharp objects found in your teen's room, backpack, or personal spaces. Missing pencil sharpener blades are a particularly common indicator, as they are small, sharp, and easy to conceal.

Behavioral and Emotional Changes

Increased secrecy

A noticeable shift toward privacy that goes beyond normal teen boundary-setting. Locking the bedroom or bathroom door. Becoming agitated when you enter their space unexpectedly. Refusing to change clothes in front of family members or in shared spaces like locker rooms.

Avoiding activities requiring skin exposure

Declining invitations to swim, refusing to wear shorts for sports, skipping events at beaches or pools, or dropping out of dance or gymnastics. If your teen previously enjoyed these activities and has suddenly stopped, the reason may be concealment rather than lost interest.

Withdrawal from friends and family

Pulling away from relationships — spending more time alone, declining social invitations, becoming less communicative at home. Self-harm thrives in isolation, and the secrecy required to maintain it can cause teens to withdraw from the people who might notice.

Mood shifts — especially the relief cycle

Watch for a pattern of visible distress followed by sudden, unexplained calm. Self-harm provides temporary emotional relief, which means a teen may seem agitated, anxious, or deeply upset and then abruptly appear calmer — without any external event that would explain the shift. This relief cycle is one of the more subtle indicators.

Harsh self-criticism and expressions of worthlessness

Statements like "I'm such a mess," "I don't deserve anything good," or "Everyone would be better off without me." Self-harm frequently co-occurs with low self-esteem and self-loathing. The language your teen uses about themselves may signal the internal state driving the behavior.

Declining grades and school disengagement

Academic decline is not specific to self-harm, but when it appears alongside other signs on this page, it adds to the pattern. The emotional distress driving self-harm often reduces concentration, motivation, and the capacity to engage with school.

How Teens Conceal Self-Harm

Teens who want to continue self-harming — or who are not ready to stop — develop elaborate strategies for hiding it. Understanding these methods helps you see past the surface:

• Cutting in locations normally hidden by clothing — upper inner thighs, torso, hips, between toes, under the hairline
• Using cover stories for visible injuries: pet scratches, kitchen accidents, roughhousing with friends, gym class
• Wearing wristbands, bracelets, rings, and jewelry over healing wounds on wrists and fingers
• Applying makeup, including concealer or foundation, over scars and fresh marks
• Using black ink pens to draw over scabbed-over cuts, disguising them as body art
• Storing sharp objects in discreet locations: inside deodorant sticks, taped behind furniture, inside book spines, in pencil case compartments
• Carrying tools to school to cut in private locations like bathroom stalls
• Flushing bloody tissues, cotton balls, or bandages down toilets
• Washing blood stains out of clothing before putting it in the laundry
• Claiming to have stopped after a conversation, then hiding the behavior more carefully
• Attributing scars to past injuries to shut down current questioning

This list is not meant to make you paranoid. It is meant to help you recognize that a teen's denial does not always mean the behavior has stopped. Looking past the explanations to the overall pattern is what matters.

What to Do If You See These Signs

If several signs on this page resonate with what you are observing, here is what we recommend:

Do not confront — connect. Your goal is not to catch your teen in a lie. It is to open a door. In a calm, private moment: "I've noticed some things that worry me. I'm not angry. I want to understand what's going on and help."

Do not demand to see injuries. This can feel invasive and shaming. Instead, ask how they are feeling and whether they would be willing to talk about what they are going through.

Do not make them promise to stop. Promises to stop rarely hold because self-harm is a compulsive coping mechanism, not a choice. A broken promise adds shame to an already painful cycle.

Do schedule professional support. A therapist experienced with adolescent self-harm can evaluate the behavior, determine what is driving it, and develop a treatment plan. You do not need to solve this alone.

Self-harm thrives in secrecy. Recognizing the signs is how you bring it into the light — and light is where healing begins.

Sources: NAMI; Child Mind Institute; American Academy of Child and Adolescent Psychiatry.