Responses
It's body dysmorphia, it makes the view of yourself seem distorted. Minor flaws would seem exaggerated by a lot and it would completely overshadow anything else. He can't even see his features the same way anyone else would. It takes a lot of psychological and psychiatric help to get better from this disorder.
The one thing I'm confused about is, if he thinks of himself (physical features and overall appearance) as ugly, why doesn't he see other people with the same/similar feature to him as ugly? I'm genuinely asking because that scope of mental illness is an uncharted territory for me.