Thank you for your response Pondlady! I have tried medication and it became a bit better, but as soon as I quit it returned full force or even worse.
At the moment I don't want to go down the medication route again but am trying to find other ways: therapy, exercise, meditation/mindfulness...
I think BDD/OCD and obsessive skin picking is similar to alcoholism, and by learning about how I can stay sober and fight urges to drink and deal with related stress and anxiety I might find ways to manage my BDD.
I think recovery for me, on all levels, is dealing with underlying issues, learning to identify triggers, accepting myself as I am, and finding practical ways of dealing with negative thoughts and emotions; breaking destructive habits.
Many years of therapy has made me understand what might have set all of this in motion, but insight isn't enough. On one hand I understand where it comes from, but I am still very judgemental towards myself and it is very hard to break certain pattern of thoughts and behaviour. Sometimes I feel as if I need to be reprogrammed in order to recover. To take all the pieces apart and put them together again.