Mental Health Problem, Low Self Esteem, Bmd

I am 44 year old male. Living at home with mum which arrangement fine as mum is active very out going person. I am gay have had past history of bad acne from early teens until late 20s. First trial patient with ro-accutane from early 1980s, when early/late teens almost suicidal over acne and big nose!!! Had private nose rhinoplasty aged 21 in hope skin would improve as thought all related to stress/appearence!! Nose job successful surgeon referred me on to nhs for this new drug for acne as nhs patient. Ro-accutane remained on for 10 years nhs/private patient done its trick but still left scarring!! Two times dermabrassion not deemed successful and left with still feeling paranoid over sin and how I look. This has blighted my life do not go out, can just about hold my job down have compulsion to always re-check appearence and over wash skin. I still feel skin is bad coarse, very orange peel uneven skin tone I get stuck in the mirror. Have tried reading all books on increasing self esteem and bmd disorders but can not feel better and still very low and exist through life rather than experiencing it. I will go to bed at night wondering what my skin will look like the next day?? Very distressed over this as I am now in love and fear that this self obsession will kill relationship. My boyfriend lives in another area of england(met on internet and have met/holidayed several times) I do so want to move and be with him but feel stuck and fear change?? I know I need help/counselling but find that I always feel chucking money at the next fix ie dermatologist has told me skin resurfacing would improve condition and make me feel better about my appearence?? In my heart of hearts I know that I need mental therapy to change my chain of thought but find it so difficult to brooch with gp and rather asshamed! Having said that I have snt a letter to my gp explaining how I feel and to what extent it screws up my life!!! I do not want to loose this love of my life and yet fear change and talk myself out of being able to start afresh which I dispise in myself as I know it is not healthy to stay living at home with mum!! I love my guy to bits and I want to move forward in life and yet feel like a rabbit trapped in the headlights of a car!! I write this as I am off sick at the moment and know that it is a god given opportunity to listen to reason and sort my life out for a future of hope and to live rather than dispair in the situation I feel I am within. I dispise my sentiment as sounding vanity rather than emotional but have always been very hard on myself over life and taking things too heart. My love has taught me compassion and sinserity I don't want to let him down and more so myself! I know we only have one life I want to live it rather than hide from it please any advice and type of counselling you may feel I may need would help. It has taken me a long time to look at this as a serious problem. My humour has had me put it on a back burner! But in the reality of illness I know that I am mentally ill and that is what needs addressing! What makes things worse is that I know that I am very much in love with this guy as have had long distance relationship with previous partner for 10 years but was not totally in love with him! Just was taken on the compliments and chase he made to me, and the fact that he bolstered my confidence when in his company. Knowing true love now I know that though it is hurtfull I am very wary that if I do not like/love myself how can I go forward with my true love. I want to change I need to change. For me and for my ben as I want him in my life forever he is my true soulmate and I want fun, happiness and joint self adventure from being with him. I don't want to suffocate any future relationship I need to live and feel good about myself and put others first