<s>[INST] My 14 year old son picks his skin around his fingers layer by layer, sometimes till they bleed He also touches his head, stroking his hair at least 3-4 stokes each time. He has recently told me he hums and talks to himself while at school and alone - he seems worried about it and says he is mad. He has not yet hit puberty either and is small for his age say around 12 year old size. [/INST] Hi and welcome to Healthcare Magic. Thanks for your question... With the limited information which you have given, I reckon that some symptoms (such as repeated skin picking, repeated touching, stroking of the hair) may indicative of "compulsive" behaviour. "Compulsions" are repetitive, unwanted acts or rituals or behaviour which the person is aware of doing but is unable to control, thus resulting in distress. Compulsions can exist alone or may often be associated with underlying "obsessions" (which are repetitive, unwanted thoughts, ideas or mental images) as part of a disorder called Obsessive Compulsive Disorder (OCD). You need to elaborate more on his other behaviour, for example, the humming and talking to himself. Such symptoms, in childhood, can be due to a variety of causes (they could even be some kind of obsessive / compulsive symptoms, especially because your son is well aware of them and is distressed by them). What I would strongly advice you to do is to get a consultation with a Child Psychiatrist, who would be able to assess your son in detail and advise the appropriate management plan. Please do not hesitate or delay as it would only be putting your son through more unnecessary suffering and distress. All the best. - Dr. Jonas Sundarakumar Consultant Psychiatrist </s>