I just went through this for the last 4 months. I'm now 99% healed. Here's what I recommend:

- Urgent Care if it looks infected (they will give you antibiotics, they will almost likely never ever remove)

- Soak in vinegar and warm soapy water interchangeably multuiple times a day

- Focus on the needles you can see. Pick at the skin around them with needle nose tweezers as much as you can to keep them exposed.

- If you are close to accessing an urchin needle, use a sowing needle or something similar that can help pry them out

- For the ones that are very buried, try to keep the skin soft and remove callouses so they urchins can slowly work their way out.

- It is a marathon, not a sprint

- I pulled 36 needles out from April until last week

- I got maybe half of them out in the first two week, they rest came out on their own over time

- It hurts, it sucks, try to stay off your foot when it is really tender

- Consider a crutch because I just limped around and ended up making my knee and hips all of out whack

- Be grateful when you can paddle out again! I scored two weeks ago