Several factors can worsen acne, including:

1. Hormonal Changes: Fluctuations in hormones can trigger acne breakouts. This is common during puberty, menstruation, pregnancy, and hormonal disorders.

2. Certain Medications: Some medications, like corticosteroids, lithium, and some birth control pills, can exacerbate acne.

3. Diet: Consuming high-glycemic foods, dairy products, and foods rich in saturated fats may worsen acne in some individuals.

4. Stress: Stress can contribute to hormonal changes that lead to increased acne breakouts.

5. Cosmetics: Using oil-based or comedogenic products can clog pores and worsen acne.

6. Over-washing or Harsh Scrubbing: Excessive washing or abrasive scrubbing can irritate the skin and make acne worse.

7. Not Moisturizing: Skipping moisturizer can lead to dry skin, which can trigger excess oil production and worsen acne.

8. Environmental Factors: Pollution, humidity, and certain climates can also impact acne.

It’s essential to understand your skin type, triggers, and potential aggravators to effectively manage and prevent acne flare-ups.