My acne turns to swollen lumps sometimes, I actualy have to put on an anti-inflamitory cream. If it is from steriods he needs to start by going toa doctor and get some anti-biotics to to start working from the inside and some topical for the outside. Severe acne is cause by hormonal imbalances, so blood work will need to be done also in order to see what is realy causing the problem. From there you can work on correcting it. I would think he has to much estrogen.