I am only at about CI3-3.5 currently so not a lot of skin tube yet. I am using a combination of My new DTR, manual tugging, rollback taping, and O-ring.

I really like my DTR, but I have to be very gentle. When I started I was way too aggressive using too much tension and wearing it at my desk(work from home) under clothing and all these things created discomfort and even pain after just short periods of time.
So I use less tension now, very mild, even without the rubber bands attached adding tension, just manually push in the rod to create tension that is there but not painful, and then tighten down the screws to hold the rod in place.

Two other things, if you can, get the solid retaining clear plastic cover, not the ones with holes like mine (see the picture). The holes create their own pain as little bubbles of skin are forced up through them and start to hurt after awhile. I thought I’d need the holes for grip to hold the foreskin in place. Not needed, the smooth one will grip just fine.

I also have discovered that sitting without pants, and having either my penis or penis and scrotum hanging freely out of my underwear while seated, also is much more comfortable and I can wear it much longer, with no pressure from clothing over the device and penis pressing on it or forcing it sideways etc to fit under the clothing.

Obviously you need to be some where you can sit with you junk exposed legally ;)

KOT!