Frustrated with Picking / nothing working

I am around a decade younger than
you, and have suffered with this affliction for 15 years now. I am concerned that it might be with me my whole life...in various degrees of severity. Yet the overall goal for me is to lessen the extent of the picking. So I'm not thinking in terms of completely quitting it as it might be too much to expect, but a reduction in intensity and severity of picking is an ideal outcome. Even if it is a very gradual process. Have you personally experienced a change in your picking habits over the years? Are there lapses of time in between picking episodes or do you notice no drastic change throughout? It's key to pay attention to the pattern of your behavior.
Also, have you tried TCA chemical peels? Or any chemical peels for that matter? If you are comfortable with the idea of a chemical peel I suggest you look into it. I use Perfect Image TCA 15% chemical peel from Amazon. Costs only $30 but can give impressive results. You can check it out and read the reviews. It really can help the acne because the acid burns off all the bacteria at the top layers of the skin. It cleans out the pores. Even with a light application every 2-3 weeks you will see an improvement. For example, I was breaking out in the most irritating cysts under my jaw below the ear, and after regular TCA peels all of that went away for good. Same thing with annoying white heads that seemed to attack my chin. I used this peel on many different levels....from mild to very deep and it works great. If you have fair skin you are a better candidate as darker skin can have some residual hyperpigmentation afterwards. Just different ways various skin types heal. Another user on this forum tried the same peel and loves it. The whole peeling process is also strangely pleasant. You have to try it to understand. But I think for you it's worth a shot.

I will say that my picking has become less severe over the years. When I was in my teens and through my twenties I picked just about every night before going to bed, sometimes into the early hours of the morning. When I got into my thirties I stopped picking for several hours a night, and I also stopped hardcore digging out spots on my skin. Now I have gotten the sessions down to 15min to 40min at the longest, and it happens on average about once per week. Still, don't like that I'm picking though because I'm still doing damage to my skin that takes more time to heal. Even though I pick less, the older I get the longer it takes for my skin to heal.

I have not tried a chemical peel because I'm afraid of burning my skin. Did you experience a lot of redness? How long does it last?

I also think that basically everyone has some acne from time to time. Also, skin picking is very similar to body dysmorphia. We tend to amplify the imperfections that we see in the mirror. What is your goal for acne management? What sort of improvement do you expect to see? I think often time many different things can create acne, such as sunscreen, allergies, certain makeup blocking pores. It's a complex process and everyone breaks out at certain times.

This chemical peel that I mentioned is very gentle. You have to follow instructions at first and do a little patch test to see how your skin responds. Then you can start experimenting with one layer for one minute, next time five minutes, then two layers for ten minutes. You build up as you go. With the light peel it's nice, you get some tightening of the skin and maybe some dryness for two to three days. Probably light flaking. But if you do a bit deeper peel, there will be evident soon peeling which fades out to flaking. Not much redness unless you do a deep peel. If you do multiple layers and keep the acid on for a long time then you will experience some temporary redness until you peel.

I'll look into the chemical peel. My other issue with acne comes from the criticism and bullying remarks I have had to contend with. Often times I will find an acne management routine that works well for a while, then eventually it stops working. Then I just have to find another one. The acne problems I'm having now, have been ongoing for the last couple of years. I can't seem to find anything that works. I don't know what to do at this point other than wait it out.

Is it chronic cystic acne?

I also think that it's all about perception. For example, recently I picked at a tiny pimple on my chin and since my picking disturbed scar tissue which was on that spot, it is taking longer to heal. I have an orthodontist appointment tomorrow and I don't even care anymore. My perception of the wound is careless. I'm just going to apply new skin liquid bandaid on the spot and cover it up with makeup. I am so tired of my wounds limiting my life and limiting me from wanting to go out. And if people notice, oh well...I am sure they understand that people get acne and have skin problems. So I'm working on my perceptions not only of the pores and initial imperfections, but also the damage and the wounds from picking. If a wound doesn't bother me, I am less likely to be disgusted with my face, which will most likely halt the picking process. Because when you think of it... usually one picked spot can spur the urges to increase and the picking to intensify. Because we place so much attention on one particular wound, we can get carried away and pick at multiple spots out of frustration. By changing the perception, you can alter the urges and cause them to lessen in severity.

Yes, cystic acne and blackheads. It is exhausting to get so consumed in what are probably small blemishes to everyone else. I don't want my picking to interfere with my life any more than it already has. Also finding a way to find a little bit of humor around the picking, or changing my perspective on it, will probably go much further towards healing. Also, I think this problem is more common than we sometimes realize. It is reassuring to know that you have come to a place of not worrying about what other people think of a wound on your face.