What does not typically worsen acne lesions?

Hormonal changes do not typically worsen acne lesions in the sense that they primarily act as catalysts or triggers rather than direct exacerbators of existing lesions. Acne is often influenced by hormonal fluctuations, particularly during puberty, menstrual cycles, and hormonal disorders like polycystic ovary syndrome (PCOS). While these hormonal changes can lead to the formation of new acne lesions due to increased oil production and changes in skin cell turnover, they do not necessarily worsen existing lesions.

In contrast, mechanical factors such as friction from clothing or headgear, wearing a helmet, or constant touching of the face can irritate the skin and lead to worsening of acne lesions. Similarly, makeup can contribute to clogged pores, especially if it's not non-comedogenic, and overzealous cleaning may irritate the skin further and disturb the delicate skin barrier, potentially leading to more inflammation and exacerbation of acne lesions.