I have scratched up my face. It was one of the most extreme things that I have done, and it didn't go unnoticed, and I spent weeks afterwards feeling very self-conscious and wearing pancake makeup trying to make it less noticeable. The scars aren't noticeable now (it was a couple of years ago).

I would say that your brother needs therapy. If he isn't willing to go, it's hard to do anything though. Even if he is forced to attend, if he isn't ready to change, he won't. You say that you don't need therapy. Maybe you have finished your own work - I don't know, but if your brother's problems are causing significant stress for you, then you might benefit from therapy whether or not he goes, or even whether or not you have before, to help you to deal with your brother and your reactions to him.