Hi I have an ongoing struggle with my compulsive skinpicking as well.
Man, the only things that have helped me was realizing that this problem has a name and that other people are struggling with it, too. After realizing this....I sort of looked at it as a clinical problem that needed fixing. I sort of self-diagnosed myself with dermatillomania.
I also used to end up in trance-like states where I would just pick at EVERY piece of skin, blackhead, bump, zit, cyst, that I could get my hands on. I would sit in my sink and just look at each pore and pick and pick for HOURS. After a while, I started doing the tissue thing as well "to be more sanitary", but would end up putting it down and just obliterating my face again with my fingers. I tried cutting my fingernails, then I tried growing them out, but nothing made me want to stop picking my face. It was so defeating to me...I would get the worst satisfaction from "clearing my pores" and then an equal amount of guilt afterwards-- sitting there with a hot, red face covered in bumps. Sometimes I would do it before needing to go somewhere, and then I'd feel the discomfort the entire time I was out thinking "what will the blackhead that I picked over on my cheek turn into? Will it be a full-blown cyst by the end of the night?"...Most of the time (and still, when I get a relapse) I do it at night before bed. It pretty much consumed me and my life.
So, now I tell myself that I have a mental problem, an addiction-- one that I need to actively try to overcome or else it will take over my life. I'm 23 years old and live with my fiance. I told him that I need help getting over this and that it's a compulsive act that I do. This made it "real" for me. For a couple months now, I've really lessened the amount that I pick at my face. Here's what I do to stop myself:
-When I go into the bathroom at night, I tell myself that I'm a normal person who doesn't pick their face.
-I turn on only the dim lights in the bathroom.
-I tell myself that my skin is so delicate and that I shouldn't hurt it.
-I NEVER sit on the sink anymore (that is definitely one of my triggers).
-I try not to let my anxiety take over in the bathroom (also one of my triggers).
-If I DO pick now, I make it a big deal to pick just one spot. I swab it with alcohol, get tissue, pop it, swab it again with alcohol, put some witch hazel on it, throw some AHA on it, and then either put makeup back on or go to bed. I couldn't possibly put that much effort into 25 spots on my face, so I don't pick that many spots!
-I have clear nail polish on my nails that I'll pick at as soon as I feel like picking my face. It kind of looks like peely skin, so it gives me similar satisfaction ( I know I should kick this habit, too...as it only feeds my picking compulsion).
-Like Lilly, I see the results from not picking. I do not get as many spots as I used to, my red marks fade faster because I didn't dig at my skin. This is a HUGE contributor to my healing process.
-I went on tumblr and searched the #skinpicking and #dermatillomania tags and was able to see that there are other people who also pick at their skin in a trance-like state like I do. Reading their accounts, posts and struggles made me realize that I could get over it and that I could change the way I thought about my skin and my anxiety.
Anyway...haha, this sounds so dramatic, but I take it one day at a time. I picked a LITTLE last night, but I didn't destroy my face. This is a triumph for me...one day, I'll be able to say "Hm. I haven't picked in weeks!!" As for right now, though, I'm still healing my addiction to skin picking. It's nice doing something productive rather than destructive. Good luck and don't give up!
(Sorry for such a long post!)