"Less is more, and the more natural she looks the more real she looks, spots and all."
Absolutely true, but this is why I made my earlier comment about the wishes of the model & her family.
As you may know, I photograph a lot of students every year, and the word has gotten out that I can do retouching. Many of the girls specifically ask if I would mind giving them the overly smoothed look they see on posters, in magazines. Many of them really want to look like this, especially after they have had it done once or twice before. I have to turn them down because of the effort it would take (photography is only a fun sideline to teaching ... but it gets my photos published regularly ;-) ), but if they were private, paying customers, I would be happy to do it for them -- if that's what they (and their parents) want.
Since this girl's skin was in such bad shape, I gave her almost "the full treatment" just to show what could be done. Someday, she won't have those zits, and seeing what they can look in a few years like can lift the spirits of kids with this problem.
Just my $0.02,
T