Koi issue, raised red spots

[XxVooDooxX]

Ok my buddy has this koi and has had it for 2 years and it has started to develop these red raised spots on it's side and is acting lethargic. This is the best photo I could get. You can see the red spots behind his gills If you have any thoughts that would be great. Thanks!!

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[XxVooDooxX]

Another shot

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[Crepe]

My koi got that before. It's hemoraghing from poor water quality. What are his parameters? A topical rince with hydrogen peroxide (avoid the gills) or other antimicrobial disinfectant (for fish) will stop the infection.

Treatment of the whole water with a regular anti-infection agent intended for koi will also work using both methods in tandem along with massive water changes will clear it up. Any scales the fish may lose will be permanently lost.

Ask him what are the readings (in ppm, don't give me "good") of ammonia, nitrites and nitrates. Additionally what he's keeping the fish in and with.
Koi Bacterial Disorders