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https://www.reddit.com/r/themoddingofisaac/comments/2n7pmk/psa_how_to_start_modding/
The parts you need to read to learn to mod textures are under the headings "How to use Rick's unpacker", "How to install your mods as modder", and "How to install your mods as player". It's actually really easy-- it's as simple as unpacking the files, editing them in any image editor, and saving them in the right place. Good luck!
Also completely incorrect, even before official support (AB+) you could edit textures.