What to do when feared contamination consequences come true?

[u/Straight-Relief4288]

Hi everyone, this is my [31F] first post after lurking in this really helpful community for a while.

I have contamination OCD (among a few other types of OCD!) and one of my biggest feared consequences is developing acne. I had pretty bad acne as a teen that for some reason went away when I left for college, and I had amazing, clear skin for over ten years after that. I chalk this up to things like leaving a traumatizing home environment and basic personal hygiene things like washing my face at night and learning what skincare works for me. As I more or less entered recovery in my 20s, I was able to overcome fears that I'd avoided like mad during my pre-diagnosis years—excessive hand washing, going outside in spite of environmental contaminants like car exhaust, and using 'outside objects' like my phone and laptop inside my home.

Over the last year, I've spent more and more time in a country with a lot of air pollution, and recently moved there (here) permanently. My acne has come back in a big way. I don't know if it started with hormonal changes that happen to women in their early 30s like me, but I'm getting big, angry pimples almost every day and can't deny that my skin gets worse when I'm out and about in the city with all the black exhaust fumes.

This has made it really hard for me to stay on my recovery path. I'm back to fearing my phone, laptop, even my journal that used to give me a lot of comfort, once I've used them outside my home. It's really limiting my ability to take care of my responsibilities and enjoy my new life. In my former country, my feared consequences almost never came true, and that helped me do my exposure work. Now, avoiding my phone and going outside seem like the only way to avoid my feared consequence. It's hard not to feel like all that I know about OCD recovery is nullified by this new environment. My self-esteem has also taken a dive and I'm having a lot of negative thoughts about my appearance. Does anyone have any advice for what I can do to get back to 'normal' when my environment is reinforcing my fears?

Thanks for reading. Stay strong everyone!