A Dilated Pore of Winer (DPOW) is a large, non-cancerous, solitary follicular lesion that often resembles an oversized blackhead. This benign growth originates from an enlarged hair follicle, clogged by dead skin cells, oil, and keratin. Although the lesion is asymptomatic and poses no threat to health, individuals seek professional removal for cosmetic or hygienic reasons. Complete closure requires professional intervention focused on removing the entire lining, not just the contents.
Identifying a Dilated Pore of Winer
A Dilated Pore of Winer typically presents as a single, prominent, raised pore significantly larger than a typical blackhead. The dark center is a plug of keratin and sebum that has oxidized upon exposure to air. These lesions are most frequently found on the head and neck, but they may also appear on the trunk, particularly the back.
The surrounding skin usually appears normal, but the lesion can become inflamed or tender if manipulated. Professional evaluation is necessary because a DPOW can mimic other skin conditions. A dermatologist will differentiate the lesion from similar growths, such as an epidermoid cyst or basal cell carcinoma. Confirmation of the diagnosis ensures the correct treatment path, as non-surgical methods are ineffective for permanent closure.
Professional Treatment Options
The core principle for permanent closure is the complete removal of the enlarged follicular lining. Simply extracting the plug inevitably leads to re-accumulation of the keratinous material. Therefore, surgical techniques are the most definitive methods employed by dermatologists. The most common and effective treatment is simple surgical excision, which cuts out the entire pore structure, including the epithelial wall.
This procedure is typically performed under local anesthesia and involves removing the lesion with a small, elliptical incision. The resulting wound is closed with sutures, ensuring permanent removal and leaving a linear scar. For smaller lesions, a punch biopsy removal may be used, which employs a circular instrument to excise the lesion and replace the pore with a small linear or circular closure.
Alternative methods, such as using a comedone extractor or a curette, only temporarily clear the dark plug. These approaches do not remove the underlying cyst-like wall, guaranteeing the pore will refill as the lining remains intact and continues to produce keratin. Techniques like electrocautery or laser surgery are also less effective than excision because they may not reach the deepest part of the hair follicle unit, risking recurrence. Patients should avoid self-extraction, as squeezing or using at-home tools can cause incomplete removal, push contents deeper, introduce bacteria, leading to infection, inflammation, and potential scarring.
Preventing Reoccurrence and Minimizing Scarring
Recurrence is uncommon when the entire abnormal follicular unit has been successfully removed during excision. Maintaining a consistent skincare routine promotes exfoliation and prevents pore blockage, supporting overall skin health. Products containing topical retinoids, such as adapalene or tretinoin, help regulate skin cell turnover and manage residual pore-clogging issues.
Post-operative care is crucial to manage scar tissue and minimize visibility. The incision must be kept clean and protected immediately following the procedure to prevent infection, which worsens scarring. Sun protection is important, as ultraviolet exposure can cause the newly formed scar tissue to hyperpigment, making it darker and more noticeable.
Once the sutures are removed and the wound has closed, silicone sheets or gels are often recommended for scar management. Silicone products hydrate the scar and regulate collagen production, leading to a softer, flatter, and less noticeable result. If a scar becomes excessively raised or firm (a hypertrophic scar), a dermatologist may administer intralesional corticosteroid injections to flatten the tissue.