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I feel for your friend because my mom had acne until (I assume) she hit menopause, and my acne starts back up if I ever take a break from continuous birth control. Doctors are also incredibly dismissive about these things because no one understands female hormones -yay for us!!
I can't diagnose your friend, but I can point you in some directions to bring up at the doctor:
What treatments? (you don't have to tell me, but have it ready for the doctor) Usually they'll hand you some benzoyl peroxide and salicylic acid along with the antibiotics as the initial treatment. Maybe tretinoin (retin-A). These are very harsh actives, so they can be very irritating if you use too much or don't combine them with a skincare routine. They also just don't work for everyone. She can go back to the dermatologist and try something else.
This sounds like it could be fungal acne (again not qualified to diagnose, go to a doctor). If it's itchy and also gets worse with heat/sweat, try some anti-dandruff shampoo with ketoconazole or zinc pyrithione and see if that helps.
She should speak to her doctor about PCOS and/or PMDD. They will likely recommend birth control for these conditions if she has them, but that is not the only option if she doesn't want to go on it.
"Looking young," "big eyes," and "small nose" could be indicators of various genetic or endocrine conditions, but I wouldn't bring this up to the doctor since it's super vague and doesn't point to anything in particular. She should just stick to symptoms that are bothering her. Presumably the doctor will be able to spot the connection if there is one.
I don't think this is a useful question. Acne is a common condition even in adults, but it is still a condition that most people want treated. The point is she wants treatment. If a doctor dismisses her with a "oh it's normal" or a "it's just a sign that you have young skin!" (my mom got this line into her 40s...), go to a different doctor.
+1 for the anti-dandruff shampoo trick. I keep a bottle in the cabinet for when I work outside in the summer. It’s the only thing that prevents massive breakouts (all over my chest and shoulders) after I sweat a lot. Use it like a face/body wash, and let it sit for an extra minute or two (however long the bottle says) before you rinse. For particularly bad/stubborn spots, I use it like an overnight spot treatment. Dab it on directly and let it dry before bed, then rinse off in the morning.
It will only make a difference if the acne is actually fungal. But if it is, your friend will likely see a world of difference.