I am a skin picker for 14 years now.

I have been picking since I was 12 years old. i am now 26. I see the smallest pimple, and i pick with a needle or my nails, to create a scab. Because in my mind, that can look like a mole or beauty mark vs a pimple. I know that seems completely crazy. It's this endless cycle of pimple, pick, scab, hide in the house until it heals, and then I'm okay until I find something else that no one else can see but me. The scabs always looks worse than If i just left it alone. But I can't just leave it alone. It's like I'm in this zone when I pick, and then I feel so guilty and ridiculous once I make the mark even worse. It's interfering with my life because I avoid things. I know it gets worse when I have stress or increased hormonal levels around my menstrual cycle. I've been to therapists, and have been on anti-depressants to try and treat it as OCD issues. I am also a perfectionist, which I know is part of the problem. Nothing seems to work for me. I haven't been to therapy for it in years, but I feel like I know what they are going to say already, and it won't help. I know that is wrong, and I should really go. I wonder if something in my past or my childhood triggered this behavior.