Does direct sunlight make acne worse or better?

Better, but marginal: Simply exposing oneself to light should make acne better, however, due to the long time necessary to see a result makes this a poor method, especially with the risks of increased sun exposure (skin cancers, premature aging etc.) topical medications, oral medications, as well as special light therapy done by a dermatologist are all proven to work for acne with much better safety profiles.