Yikes! That's evidence of malnutrition for sure (haven't seen the pic, just going by description). What I think you should do is go militant on inflammation. I have an acne problem, always have, hopefully it goes away some time into my adulthood but it's frustrating. What should be first priority is reducing excessive inflammation so as to not get scaring. I used to get scaring, now if I get a little pimple it goes away in 2 weeks tops.
Eat salmon/sardines/other fatty fish (or brains. Always gotta mention them guyd) every single day to the tune of 5g or so of omega 3 fats, reduce omega 6 fats to less than 5g. Do that for a month
To stop the pimples. Get sufficient in nutrients, particularly magnesium and zinc but really everything, more or less. Heal the guy with a non gut irritating diet + gelatin and coconut, lots of those. Possibly colostrum too. Do paleo minus nuts, seeds, dairy, nightshades, eggs and anything else that causes gut irritation. Do that for a while. Think happy thoughts. Work out smart. Sleeeeeep.
Is there any more? Fill in the blanks, primals.
Stabbing conventional wisdom in its face.
Anyone who wants to talk nutrition should PM me!