A little background information: I've been struggling with acne, most of which was self-induced due to my problems with dermatillomania and stress management, for basically my entire high school career. I'm not completely out of it yet, but since I feel I've reached a good point, I wanted to provide a "guide" to what I've been doing and has been working for me so far.

Explanations will be in bolded text. Important stuff will be also be in bolded text. (That's because........ explanations are important *dodges shoe*) And if you don't care about my regimen, but want a direct and more concise way to tackle the actual Dermatillomania side of the problem (basically, if you want to stop picking), skip to that section below immediately. But be sure to read the purple stuff (just above that section) that it references.

The part of these tips that are geared towards girls (mostly purple section) can be replaced with the equivalent for guys, ie, shave, keep an up-kept image, shower often, smell nice ect. The lack of makeup makes hiding and dealing with skin picking a lot harder for guys, but at least not having the option to hide it might have lessened the severity of the problem from the start (ie "have to be socially acceptable to go out". That was me in eighth grade, when we weren't allowed makeup at school, I picked a lot less because I knew I would just be stared at the next day with my raw face.

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Before and after: As much as I would like to post before-and-after pictures, my avoidance of photography during my dermatillomania years doesn't give me anything that would do justice to how bad my skin was at times. I would have a range of on average 5 closed scabs in the process of healing, the same if not more open wounds, and a constantly either oily or overdried complexion given the harsh anti-acne chemicals I would apply to my face after picking sessions that would only make it burn more.

As of today, there is no acne on my face except for a hard bump under my eye socket bone which will eventually go away of its own, and, from previous experience, provides nothing to squeeze. The lack of acne does not mean the lack of acne marks (thankfully not scars) which unaccountably have taken their toll over how much harm I've induced to my face over 4+ years. However, I am currently implementing both chamomile and salicylic acid to lessen their visibility.

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Regimen:

nb. all prices listed from Target.com

Face cleanser, non-medicated: Cetaphil face cleanser - $8 The important part here is non-medicated. People tend to over medicate with salicylylic acid and benzoyl peroxide, for the purposes of my regimen, this is cut out of the cleanser and applied as night treatment, which is more efficient because I find my face tends to heal more at night anf you see immediate effects in the morning.

Medicated night treatment / Moisturizer: Clean and Clear Dual Action Moisturizer - $5.30

Spot treatment: Up & Up Maximum Strength Acne Medication - $3.75

Concealing Cream foundation / Moisturizer / Sunscreen: Elf tinted moisturizer - $3

Concealing Powder / Slight salicylic acid medication: Elf powder (wait, elf powder?!? as in real-life pixie dust??) - 1 smoking buck at Target, but buy like a ton of them 'cuz they run out really fast :/

Lightens the colour of acne marks: Chamomile tea bags

(Okay, so we aren't exactly dealing with the most ritzy $$$ ratio of rip-off to chemical product. xD) I guess you can substitute your own product that you are familiar with for any of the specific brand name above, as long as it performs the function bolded in blue, but what I've come up with is pretty good cost-effectively and covers all the necessary bases of skin's needs. Also, by choosing products that multi-task, the routine becomes a lot more less complicated and more time efficient. The greatest pro is that it isn't overly harsh on your skin.

Routine:

Morning:

- wash face with cetaphil

- apply tinted moisturizer

- apply face powder to whole face if needed, if not, only problem areas

- apply a spot concealer of your choice over lesions (kind doesn't really matter.... the Elf one works well if it isn't too orange for you, but if not the Rimmel London stick kind is what I use sometimes)

Get back from school:

- wash makeup off face with cetaphil, or take a shower, in which case no need to wash face

- apply spot treatment to any apparent lesions, rub in well

Night:

- wash face with cetaphil

- apply moisturizer/medication

- apply spot treatment

Other:

- apply spot treatment as needed throughout the day

- with a Q-Tip, apply chamomile tea to acne marks 3x per day

Quite simple. As you can see, most every washing of your face is followed by some moisturizing of some kind, so your face is never dry (uncomfortable = prone to picking). For the same reason of drying , wash your face with lukewarm water. A non acne-medication based face wash also means that after washing, your face won't be so red and with pimples so close to the surface after washing (prone to picking), because essentially what salicylic acid does is bring the pimples closer to the surface, because it exfoliates, and moving that to nighttime when you are in bed and can't see to pick it also solves a lot of problems.

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Lifestyle (not product-related but POTENTIALLY THE MOST IMPORTANT PART OF THE REGIMEN. Think of it as, "the regimen outside the regimen)

Cleanliness:

- Sleep on a clean surface each night. This can range from anything from having multiple pillowcases (the front and the back side makes it good for two days), as well as simply laying a clean old t-shirt over your regular pillowcase as needed (again, front-back=2 days coverage.)

- Quickly wash makeup brushes on Saturdays and let air dry.

- I recommend using a headband to keep your hair back to wash your face. If that floats your boat, buy 2 of them at the dollar store and put one in the wash while the other one is being used. (change out about once every 4 days)

-------->Care of yourself/keeping a good self-image:<----- SO IMPORTANT! AH! HELP ME STRESS THE IMPORTANCE OF THIS, BOLD FONT!

- Keep your fingernails short and clean. Apply a coat of clear nail polish, and on your feet give yourself a French Manicure or paint your nails a nice color.

- Buy nice stay-around-the-house clothes. These don't have to be expensive, I bought large comfy t-shirts and cute leggings from my local Ross.

- Shave the parts of your legs that show in these clothes, even during the winter. Shave your armpits, if it's hot and you're gonna be wearing short-sleeve shirts around the house.

- Wear make-up inside the house.

-Get your eyebrows done or do them yourself if you're too poor/self-conscious about people getting close to your skin. This makes your face look better and prettier, but most or all, neater. Just because you have acne doesn't mean the other features of your face can't be attractive or well defined with that acne under make-up. Also, tweezing might provide a good short-term alternative to picking, and, for the most part, it works for attractiveness and a clean self-image, not against these things.

- Keep your glasses on inside the house, even if they're ugly, or wear contacts if they don't bother you. Seeing properly makes everything feel less groggy and you will have a better outlook on life (literally )

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How to Stop Picking:

- Start on a week when you are busy. Much of the time we pick at our skin when we are bored. For me, my skin happened to clear up in the weeks counting down to finals week-- I had too much studying to do to have time to pick at my face.

- ->>>>>Maintain an up-kept image<<<<<<----, even inside the house. I cannot stress the importance of this enough. That is what the purple-coloured listings in the last section that probably had you scratching your head explain.

• "What?!? Wearing makeup too much makes my acne worse!! I should take it off when I'm in the house, right?" Actually, no. From personal experience, I am less likely to pick a makeup-covered face that looks half decent excoriation-wise than a make-up free face that shows all the flaws. It eliminates the visual trigger to pick.
• More on this in the conclusion.

- Swear by the 24-hour method. Do not set goals like:

• "I will not pick for one week and then we'll see about more"
• or, "Let's see how long I can go without picking, I'll set the chronometer on my iphone and see if I can last longer than my previous time sans-picking"
• or even the hideous, "I will not pick ever again from this day on, because the last relapse session was so bad, and I am doing a terrible thing to my face and I really need to stop, this is insane, why am I doing this to myself"

COME ON, PEOPLE. We've tried that, and we know it doesn't work. Cross out all those approaches right now, and do this:

• Look at a zit. Acknowledge it. Then say to yourself, 'Okay, I'm going to wait 24 hours, the same time of day now but tomorrow, and then I will decide what to do with this zit. I have every right to pick at it, but only after 24 hours from sighting. Ha! I know! Maybe tommorrow it will have grown, and it will be one big-ass mofo of a zit to attack!! Or maybe it will have faded away a little and I'll no longer want to pick it that much... kind of dried up... maybe more healed than anything, it won't give nearly as much satisfaction."

- Keep in mind that the toughest time is the first week.

• Dermatillomania, like any addiction, is an addiction at a chemical level too. When you pick, chemicals are released into the brain that provide happiness and relaxation just as in eating chocolate, eating food when really really hungry, or sex do. Weaning off what your brain has been used to for an extended period of time and by now expects is VERY FRIKIN HARD. That release of happy chemical in your brain is now a gap, and you bet you will feel it. So fill it. Eat some chocolate, have caffeine, get really really tired working out and then crash on the couch and sleep (not before having some chocolate of course). Release some other chemicals in your body because it's hard to go cold turkey.
• Actually, don't go cold turkey. Use the 24-hour method. Be a 24-hour turkey, and then you can pick at anything you have spotted the day before. Not new ones though. Those get to wait another 24 hours.
• Side-note: Avoid what I like to call the "picking vortex". That is, when you start picking one zit that is totally worthy of picking, and then the hit of chemicals in your brain happens, and then you start feeling mellow and relaxed and before you know if some sort of trance starts and before you know it you are picking at stuff you shouldn't have picked by the 24-hour rule. Do this: jerk your head back, no, actually, jerk your head back, like you're trying to snap out of a bad dream, and look maybe to the floor next to the mirror, trust me, and break out of the trance.
• Your skin will also look it's worst during the first week. Those things you didn't pick, well yeah, they're going to turn into big pimples. Sorry to break it to you, but your skin is going to look like hell for a bit, things aren't going to look better after you miraculously don't pick for the first three days, but remember that's not our goal, our goal is to wait 24 hours for permission to pick. It is our goal so much that hopefully you wouldn't even notice when the first week is past. (In all honesty, I don't remember the actual day when I stopped picking either, or how much time has elapsed, about half a month, maybe, less? Lose track of time. It's to your favour. Except the 24 hours, which is easy because it's at minimum the same time of day, tomorrow, since you first saw the zit.)

- Once you made it through the "rough" period (week? ish?), it is downhill from there. There will be zits. Abide by the 24 hour rule. You can pick, you can pick! Nobody's denying you anything! Just after 24 hours, and see if that sucker will still give you satisfaction or not.

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A word of conclusion (important and comforting, but not to the extent of actually DOING everything, I mean every bullet point I took time to type out for you, anonymous internet user that I most likely will never see)

Compulsive Skin Picking isn't just limited to the field of it's effects, ie. dermatology and it's physical effects on your poor face. It goes deeper than that. My personal experience with derma have resulted in these conclusions: it has factors of 1)internal anxiety, 2)self-neglect, and a behavior you've essentially trained your brain to do through repeated relelease of chemicals, ie at the level of of 3)physical addiction. The only one you can do crap about at the time is self-neglect. Do this by:

- Adressing physically: Following the outrageous guidelines in purple above, every single bullet-point, even if they seem ridiculous.

- Adressing through mindest: You already do this a lot by following the guidelines in purple and taking care of yourself. Wait, why am I doing these things? Because some random person on the Internet ordered strongly recommended me to? No, because I wanna take care of myself. *cautious voice* I deserve it? Don't treat yourself like trash, because you are not trash.

- Also, tell a family member! I told my mom about 2 months ago after keeping it in the closet for about 4 years. And don't say:

• "OH CRAP, I have dermatillomania it's an addicting mental disorder which on the chemical basis is similar to crack addiction, and yeah, I willingly(?) cause wounds to my face on a daily and uncontrollable basis,
• say, "Hey, you know, sometimes I pick at my skin when I'm stressed, but I'm trying to stop because It makes my skin look like crap you know? Sometimes I just and just keep going... hah, it's a kooky form of stress relief like popping bubble wrap, but hey, it's really ruining my face... so if I'm in the bathroom for extended amounts of time, could you knock on the door to check on me and make sure I'm not picking?"
• This will not only make you pick less (Ah! How embarrassing to have to say yes to my mum like that from the bathroom... bring on the helpful paranoia that anytime I am picking she could knock and check me red-handed.) but also it's good to share problems and make sure somebody in real life and not the internet knows about it. It puts it onto a more factual basis and negated the idea that this is "all in your head and your are self-creating it".

- Also to be acknowledged are possible certain underlying emotional issues/ life crises (see 1)internal anxiety). But fixing picking at your face, is a lot easier than fixing these deeper-rooted problems. When I picked at my skin, I wasn't okay. Now that I don't pick at my skin, I'm still not okay... but that's okay, in a way(?! Dafuq?) I'm okay with not being okay. I don't exactly know why, but something was and still is off with my life, but it's something I can't fix, and at least not having dermatillomania makes one less problem to have/worry about.

Rats, my hands are tired (from typing, not picking!) Good luck to all. After the first week, it goes downhill once your brain weans out of the addiction to the chemical hit, and your skin clears up, giving you less stuff to pick at all, but --------->don't think about that, think about the 24 hour rule and from day to day mindset, not overall. ie. "Damn, I just have to wait another 24 hours to authorize myself to pick at this. (If I still want to by then, of course)"<---------

........Heck, even I'm scared. I don't know if and when I'm going to relapse. Dude, my mum laughed when I used the word relapse in talking to her. "Sweetie, it's not like you're an alcohol addict or anything!" Bahahah *laughs and cries* I don't know... just remember 24 hour method.