<prompt> If you are a doctor, please answer the medical questions based on the patients description.I keep getting pimples when my periods approach every month. I used to have a lot of acne which is now in control. But one or two pimples remain and by the time there spots are gone fresh ones come up. I am left with some holes ob my face. And I also have whiteheads around the nose . What can I do? Your help will be gratefully acknowledged.  <response>: HI, thanks for posting your query Acne starts during puberty as a result of hormonal changes, which stimulate oil glands to produce oil which collects in the gland ducts and leads to black and white heads, pimples which may heal leaving pigmentation and scars IT is very common to see new acne just before the periods because the hormones are at high levels. The following measures may be of help: Dont pick or squeeze the bumps as it increases chances of pigmentation and scarring the white heads extracted regularly a salicylic face wash twice a Cayuse retinoid cream .025 on the acne prone areas at night FOR the acne scars you can undergo punch excision, microdermabrasion, subdivision, Fraction laser as per dermatologists advice for premenstrual flare various medicines have been tried like PyridoxinevitB650-200 mg per dayIbuuprofen or rofecoxib tabletsThese are started 1 week before onset of periods till the periods last, but should be taken only by discussion with your doctor. Hope this answers your query 