I've picked my skin for as long as I can remember, possibly around 25 years (I'm turning 30 next week). Last year I found out that it's really a mental hangup which also others have. It's not just me being a will-less person with a discusting habit. Anyway - I've had a huge improvement this last year and I though I should share.
Ok - my story:
I've had my share of troubles - bullied in school, teenager severe depression, eating disorder, aggressiveness and insomnia in addition to the skin picking.
I think I've tried most advices- from deciding not to pick, trying to reduce stress levels, inducing pain everytime the need to pick came to my attention in a desperate attemt to make myself have negative assosiations with the need. Nothing worked. I managed to limit the most intense picking to places which are normally covered with clothes.
My parents told me to stop the picking and I really tried but it didn't work. Even one of my doctors gasped in shock over the condition of my back. He wanted to prescribe me with antibiotics, but I said it was not contagious - I picked on the scabs - so antibiotics wouldn't correct it. I lost every hope of ever being able to quit.
I started my chemistry education and being on lab do not promote skinpicking although it can be stressful. You can't pick when you got a labcoat, latex gloves and possibly carcinogenic compounds on your hands. Besides I had to learn to be aware of my hands and what I did so I wouldn't spill chemicals by accident. I started my master of chemistry and started working with radioactive stuff - which I really do not want into my bloodstream! As long as I was on the lab I did not touch anything without being totally aware. You do not pick your face mindlessly when you know you could put plutonium in yourself by doing it...
Then I found out it was a real condition. It wasn't just me. And then I started looking for a cure once more. One advice: learn about the magnificence of skin. I knew perfectly about how the skin works and that did not turn me from picking when I was not at the lab. Try to inflict pain in order to get a negative association. Did not work. Try SSRI. I've done SSRI when I was depressed and it didn't do anything to releave my picking although I managed to beat depression. By the way - most of my other problems solved itself after I became an adult, with some exceptions - I am still easily stressed and have insomnia, but I've found methods to cope with those aspects as well.
The final piece of the pussle seems to be tattoos. I noticed I did not pick on my favorite tattoo and decided to get a tattoo on my shoulder, which was my hotspot at the time. In order to prepare my skin, I put sports tape on the scabs for a month and a half before getting the tattoo (of course fresh tape 1-2 times a day). I could not remove the tape without noticing and stopped myself. I started picking more at my other shoulder, but it was acceptable. The tattoo was a design of great importance for me and it was perfectly done. I love it and I do not want to ruin it. So I quit picking at my shoulder. And I practically quit picking my other shoulder. Sometimes my awareness slips or I get acne, but still - it's a huge improvement. And the last 6 months I've hardly picked any scabs at all compared to how I've mutilated myself before. I'm getting a new tattoo in a few weeks and going to fix the tattoo I don't really like, which also are at the hotspot of my picking. I've decided not to get tattoos on my arms below the elbows, below the knees and on the neck/head. Lately I've been somewhat stressed and I've started to pick at my neck, but if it continues, I'll get white tattoos which don't show (at least not more than scars) - but I'll know they are there and I get tattoos for my own sake - not for others to enjoy.
I wouldn't recommend to get tattoos and messing with chemicals in order to beat dermatillomania, but I think the cure might be somewhat unorthodox if nothing else fixes it. Awareness and acceptance of yourself including your blemsihes and scars may be the key. Good luck in finding your cure to dermatillomania.