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Subscribe to the skin on the Steam Workshop page above. If the skin is accepted into the game by Facepunch, you will see it available in your Steam Inventory and on the in-game item where it applies (rifle, hatchet, sign, spray, clothing, and so on).

Workshop submissions are reviewed and selected by Facepunch on a rotating basis, so subscribing does not guarantee the skin ships to the live game. Check Facepunch's monthly skin updates for the latest accepted batch.