I had terrible issues with acne on my back and shoulders. They were terrible, painful, constantly being inflamed, bleeding all around. I couldn't imagine wearing a white shirt, going to the beach, pool, scars showing with short slieved shirts. People actually asked me what's wrong with me, some thinking I was self injuring myself with cigarettea. Doctors described it as one of the worst cases they seen, recommended all sorts of medicine (some doing more damage than good). Spent a fortune treating them and years.
At one point I embraced them. It's me, I stopped being caring. And they went... Psychotherapy probably helped, although I went because of completely different reasons.
I wouldn't write this, but replace acne with ulcerative coalitis, and you have my good friend's story...