The Dilated Pore of Winer (DPOW) is a distinct type of benign skin lesion. It is essentially a solitary, massive open comedo that often appears alarming due to its striking size and dark coloration. While its appearance frequently prompts concern, it is not a cancerous growth. Understanding the lesion’s unique structure and professional treatment options helps patients manage this common cosmetic concern.
Structure and Appearance of the Dilated Pore
The DPOW presents as a single, enlarged pore opening on the skin’s surface, typically surrounded by normal-appearing skin. Within this prominent opening sits a large, dark-toned plug composed primarily of accumulated keratin and dried sebum. The darkness is caused by the contents oxidizing upon exposure to the air, similar to a regular blackhead, not dirt. These lesions range in size from a few millimeters to over a centimeter, making them significantly larger than typical blemishes. DPOWs most commonly occur on the face and neck, but they are also observed on the trunk, particularly the back or chest.
Understanding How These Pores Develop
The formation of a Dilated Pore of Winer begins when a single hair follicle becomes obstructed. Dead skin cells and keratin collect within the follicle, creating a blockage similar to a standard comedo. Over time, the continuous accumulation of this material causes the follicular canal to gradually expand and widen, resulting in the characteristic dilated pore opening.
While the exact cause remains unclear, the condition is strongly associated with certain risk factors. DPOWs are typically seen in middle-aged and older adults, often appearing after the age of 40. There is a correlation between the development of these pores and a history of severe or cystic acne. Chronic sun exposure may also contribute to the skin texture changes that predispose an individual to this type of follicular dilation.
Professional Removal and Treatment Options
Treatment for DPOW is generally elected for cosmetic reasons rather than medical necessity. Simple manual removal of the dark plug, even by a professional, is often temporary because the deeply embedded follicular lining remains intact. Once the contents are expressed, the pore will gradually refill with new keratin material over several weeks. Therefore, permanent resolution requires the entire affected follicular structure to be removed.
The most effective and curative procedures involve surgical methods performed by a dermatologist. These options include punch excision, which removes a small core of skin containing the pore, or elliptical excision, which removes a larger section. These techniques ensure the complete removal of the pore’s wall, preventing keratin from accumulating again. Patients should avoid attempting to extract or manipulate the lesion at home, as this increases the risk of infection, inflammation, and scarring.
How DPOW Differs from Blackheads and Cysts
The Dilated Pore of Winer is distinct from more common skin lesions like blackheads and cysts. A typical blackhead, or open comedo, is much smaller and more superficial, often appearing in multiples across a small area. In contrast, a DPOW is characterized by its large size and presentation as a solitary, isolated lesion, representing a chronic, massive dilation of a single hair follicle unit.
Epidermoid cysts differ because they are closed sacs located deeper beneath the skin’s surface. While a cyst may have a central opening, the main structure is a defined sac containing a softer, cheesy mixture of keratin and cellular debris. The DPOW, conversely, is an open pore that continuously fills with a dense, hard plug of keratin.