I started experiencing skin picking when I was in my early teens - and I wish someone had taken the time to show me how to use concealer to hide the marks. Of course, my Mom never really taught me about makeup at all. It's not a solution, by any means, but as you're working on learning not to pick, it does help to be able to not feel so embarrassed. My brother was 3 years younger than me and suffered with severe acne (he didn't pick at his skin, just had to deal with the acne) and by then, I'd figured out how to apply concealer. I taught my brother, and he appreciated it. He didn't use it often, but when his acne was really bad or he had a special event to go to, he would use it. I don't think there's anything wrong with a teenage boy using concealer if it helps them to feel less embarrassed.

On the subject of actually stopping the skin picking, what I found most helpful for me was a combination of getting my anxiety under control through medication and learning to be aware of the skin picking through DBT skills. I've learned what my triggers are, what I can do instead of picking, and even how to stop myself once I start. I've been dealing with this for over 20 years now and it's become both habit and compulsion. There are days where I simply can't stop myself from picking, but I've had quite a bit of relief from it in the past year.

I think the hardest thing is dealing with the shame and embarrassment. My parents always made a big deal of it when I was a kid - tried to tell me to "just stop it," and never understood that I couldn't just stop. It was especially hard at school, when kids would ask me what had happened to my skin. It's still hard to answer that question, as adults are just as likely to ask as kids were. So, talk to your son about it - about how it's not something to be ashamed of or embarrassed about and about how you understand how hard it is to stop. Talk to him about what he can say or do when people ask him about it...would he feel most comfortable walking away, brushing it off with an "oh nothing, just a scratch," making up a story, or trying to explain about dermatillomania. When I was a kid, I either made stuff up or tried to brush off inquiries. As I got older, I just shut down. Now, I try to gently explain that the person is being rather rude in asking and that it's a compulsive behavior that stems from anxiety.