Not everything sent to Fridman meets with disdain or mockery. He's shown on several occasions that he has a heart of gold underneath his sarcastic internet persona. This was one such occasion. The girl in the question suffers from vitiligo, which results in pale white patches appearing on the skin. As the condition is so visible, many people who have it feel embarrassed about their appearance. She thought it made her look ugly, and so she wanted to know if she'd look prettier if she were 'normal.'
Rather than do anything with the photo, Fridman told her exactly what she needed to hear. Having a skin condition doesn't make her unattractive, and if she carries herself with confidence, it needn't be an issue or a hindrance in her life. He could have taken the opportunity to airbrush her, but instead, he chose to be kind. Mr. Fridman, we salute you.