A dilated pore of Winer is a single, enlarged pore that looks like an oversized blackhead, typically appearing on the face or neck of adults over 40. It is a benign skin growth rooted in a hair follicle, and despite its sometimes alarming size, it poses no health threat on its own. The lesion was first described by dermatologist Louis H. Winer in 1954, and removing it is straightforward, though the method matters if you want to keep it from coming back.
What It Actually Is
A dilated pore of Winer (often shortened to DPW) is classified as a benign follicular tumor, which sounds more dramatic than it is. In practical terms, it is a single hair follicle whose opening has slowly stretched over time and filled with compacted dead skin cells. The result is a firm, dark plug sitting inside a visibly widened pore, typically ranging from a few millimeters to over a centimeter across. Unlike a blackhead, which forms when sebum and dead cells clog a normal-sized pore, a DPW involves a structural change to the follicle itself. The follicle wall expands and develops distinct tissue patterns that set it apart from ordinary clogged pores.
These growths tend to show up on the head, face, and neck, though they can appear on the trunk as well. They are more common in older adults, and sun-damaged skin seems to be a frequent backdrop. Most people who develop one are over 40, and men and women are affected. A DPW is almost always solitary: you get one, not a cluster. It grows slowly over months or years, and many people live with one for a long time before seeking treatment, either because it does not bother them or because they assume it is just a stubborn blackhead.
How It Differs from a Blackhead or Cyst
The most common confusion is between a DPW and an ordinary open comedo (blackhead). Both present as a dark spot on the skin’s surface, and both contain keratin and debris. The differences are structural. A regular blackhead sits in a pore that is still essentially normal in size and shape. Clear out the plug and the pore returns more or less to baseline. A DPW, by contrast, involves a follicle that has permanently widened and developed thickened walls deep in the skin. Squeezing out the contents does not undo the structural change, which is why simple extraction tends to be temporary.
Sebaceous cysts (technically epidermal inclusion cysts) are another common lookalike. These are closed sacs beneath the skin that fill with soft, cheese-like material and can become inflamed or infected. A DPW, on the other hand, is an open structure: the pore’s mouth stays visible at the surface, and the contents are usually dry and compacted rather than soft. The distinction matters for treatment. A cyst that ruptures under the skin can trigger inflammation, while a DPW is far less prone to that kind of trouble.
Pilar cysts, trichofolliculomas, and other follicular tumors can also mimic a DPW on casual inspection. This is one reason dermatologists sometimes take a closer look with a dermatoscope or send a removed specimen for pathology: confirming the diagnosis helps rule out anything more concerning.
What Is Happening Beneath the Surface
Under a microscope, a DPW has a distinctive architecture. The follicular infundibulum, the funnel-shaped upper portion of the hair follicle, is dramatically dilated and extends deep into the dermis. The cavity inside is packed with layers of compacted keratin, the same protein that makes up your outer skin and nails. The lining of this expanded cavity is not uniform: near the surface opening, the tissue tends to be thin and flattened, while deeper down it thickens and shows more active cell growth.1Indian Journal of Postgraduate Dermatology. Dilated Pore of Winer; What’s That! This layered keratin filling is what gives the plug its firm, waxy texture and what makes it satisfying to extract in those widely-watched dermatology videos.
The underlying cause is not fully settled. Chronic sun exposure is frequently cited as a contributing factor, and the typical patient profile (older adult, sun-exposed skin) supports that idea. Some researchers have suggested that the follicle wall weakens or loses elasticity over time, allowing the infundibulum to balloon outward. Once it starts expanding, the keratin that naturally sheds inside the follicle has no easy way to escape, and the pore widens further as more material accumulates. It is a slow, self-reinforcing process rather than a sudden event.
How Doctors Identify One
Most of the time, a dermatologist can diagnose a DPW just by looking at it. The presentation is characteristic: a single, large, dark-plugged pore on the face or neck of a middle-aged or older adult. When the diagnosis is less obvious, or when the lesion looks atypical, dermoscopy provides more detail without cutting anything. Under polarized-light dermoscopy, a DPW shows a crater-like pattern with a central dark, structureless area (the keratin plug viewed from above) surrounded by a grayish-white halo, sometimes with a faint rim of darker pigment at the edges.2Clinical Dermatology Review. Dermoscopic Characterization of Dilated Pore of Winer That pattern is distinctive enough to help separate a DPW from other pigmented lesions that might otherwise prompt a biopsy.
Dermoscopy is especially useful when a DPW sits near or on top of another skin lesion. Collision tumors, where two distinct growths share the same patch of skin, are rare but documented with DPWs. In those cases, the dermatoscope can reveal features of the second lesion that would not be visible to the naked eye, prompting earlier intervention if needed.
How It Is Removed
Removal options fall into two broad categories: extraction of the contents and surgical removal of the entire structure.
Content extraction is the simpler approach. A clinician uses a comedone extractor or a similar tool to press out the keratin plug. This can be done in a standard office visit with minimal discomfort. The pore empties, the skin flattens, and the cosmetic concern is temporarily resolved. In one reported case involving a DPW on a scar, a comedone extractor was used because the surrounding scar tissue made formal excision less practical, and topical silicone gel was applied afterward to manage the scar.3CosmoDerma. Dilated pore of winer on scar: An unusual presentation The limitation of extraction alone is that the dilated follicle wall remains intact beneath the skin. Because the structural change has not been addressed, keratin can slowly refill the cavity over time, and the pore may return to its previous appearance within months.
Surgical excision removes the entire dilated follicle, including its widened walls. This is typically done under local anesthesia with a small elliptical incision or punch biopsy technique. The wound is closed with a few sutures and heals with a small scar. Because the abnormal follicle is completely removed, recurrence after excision is uncommon. Surgical excision is generally considered curative.3CosmoDerma. Dilated pore of winer on scar: An unusual presentation
The tradeoff is straightforward: extraction is quick and leaves no scar but the pore may refill, while excision is slightly more involved and leaves a small scar but is definitive. For a DPW on the face, the choice often comes down to how bothered you are by the lesion versus how bothered you would be by a fine surgical scar. Many people start with extraction and move to excision if the pore recurs.
Why the Extracted Contents Look the Way They Do
If you have ever watched a DPW extraction video online, you have seen the plug emerge as a dense, pale, waxy cylinder or coiled mass. That material is almost entirely compacted keratin, the same structural protein that forms the outermost layer of your skin and your fingernails. Inside the dilated follicle, keratin sheds from the lining in thin sheets that stack up over months or years, pressed together by the narrow confines of the pore opening. The dark color at the surface is not dirt; it is oxidized keratin and melanin exposed to air, exactly the same process that darkens an ordinary blackhead. The deeper material, shielded from air, stays pale.
The size of the plug can be surprising. Because a DPW extends deep into the dermis, the total volume of compacted keratin is often much larger than the visible surface opening would suggest. Extractions that produce a centimeter-long plug from what looked like a modest pore are not unusual. This is also why squeezing at home with your fingers rarely works well: the plug is anchored deep and the pore opening is relatively narrow compared to the reservoir beneath it.
Can a DPW Turn Into Something Dangerous
On its own, a DPW is entirely benign. It does not become cancerous and does not spread. However, in rare cases, a skin cancer can develop in the same location as a DPW, either within the walls of the dilated follicle or immediately adjacent to it. In one documented case, routine surgical removal of a DPW on the nose revealed a trichoid basal cell carcinoma within the specimen, a finding that had not been reported before in the literature.4PubMed. Trichoid basal cell carcinoma found in a dilated pore on the nose The cancer was found incidentally during pathological examination of what had appeared to be a straightforward benign lesion.
A handful of other collision cases have since been described, including DPWs found alongside squamous cell carcinoma, trichoblastoma, and in one case, a melanoma in situ.5PubMed. Skin collision tumour and dermoscopic diagnosis of melanoma in situ and dilated pore of Winer These collision tumors are rare enough that each new case tends to get published as a standalone report. The practical takeaway is not that a DPW should cause anxiety, but that submitting the tissue for pathology after excision is a reasonable precaution. If your dermatologist removes a DPW surgically, they will likely send the specimen to a lab as a matter of routine. That step catches the occasional unexpected finding.
If a DPW changes in appearance, starts bleeding without trauma, develops irregular borders, or grows rapidly, those are reasons to have it evaluated promptly. Those changes do not mean the DPW itself has transformed; they may signal a separate process happening in the same area of skin.
At-Home Extraction and Why Dermatologists Wince
The popularity of pore-extraction videos has led some people to try removing a DPW at home with pore strips, comedone extractors purchased online, or improvised tools. This rarely goes well. The pore opening of a DPW is small relative to the mass of compacted keratin beneath it, so you are essentially trying to push a large plug through a narrow opening without the benefit of proper lighting, sterile instruments, or anesthesia. The likely results include incomplete extraction, bruising of the surrounding skin, and introduction of bacteria that can cause infection.
Even when people manage to express some material, the plug often breaks off partway, leaving the deeper portion in place. The pore refills just as it would after a professional extraction, except now the surrounding skin may also be inflamed or scarred from the attempt. A dermatologist, by contrast, can widen the pore opening with a small nick, express the full plug cleanly, and decide on the spot whether the follicle should be excised entirely. That is a fundamentally different procedure from what you can accomplish in a bathroom mirror.
DPW on a Scar or in Unusual Locations
While the face and neck are the classic locations, DPWs can appear in less expected spots. Case reports have documented them on the trunk, shoulders, and even within scar tissue. The scar-associated presentation is particularly interesting because it raises questions about whether altered skin architecture (disrupted follicles, changed collagen patterns) might predispose to DPW formation. In at least one published case, a DPW developed directly on a preexisting scar, complicating the treatment approach since excision through scar tissue carries a higher risk of a conspicuous wound.3CosmoDerma. Dilated pore of winer on scar: An unusual presentation In that instance, the clinician opted for comedone extraction followed by topical scar management rather than cutting through the scar again.
Location matters for another reason too. A DPW on the nose or central face sits in skin that is thicker and more sebaceous, which can make the pore look larger and the plug more prominent. A DPW on the trunk, where skin is thinner and follicles are spaced differently, may look more like a small cyst and be diagnosed only after removal and microscopic examination. If you have a solitary, persistently plugged pore anywhere on your body that does not respond to normal skincare, it is worth mentioning to a dermatologist, even if it is not on your face.
Why They Show Up So Often in Extraction Videos
DPWs have become a staple of dermatology content online, and there is a reason beyond their satisfying extractions. They are common enough that busy dermatologists encounter them regularly, they produce visually dramatic results when the plug is removed, and the procedure itself is brief and low-risk, making it easy to film. The sheer volume of DPW content has had an unintended educational side effect: more people now recognize the lesion and seek evaluation, sometimes after years of assuming they just had a stubborn blackhead.
The downside of this visibility is that it can create unrealistic expectations about extraction. In videos, the plug slides out cleanly because the clinician has widened the opening, is using proper tools under good light, and has years of experience judging how much pressure to apply and where. The videos also rarely show the follow-up conversation about whether excision is warranted to prevent recurrence. The satisfying “pop” is the beginning of the clinical decision, not the end of it. If you find yourself watching these videos and recognizing something similar on your own skin, the right next step is a dermatology appointment, not an attempt to recreate what you saw.
What Happens After Removal
After a simple extraction, the skin typically looks flat and normal within a day or two. There is no significant wound to manage, though the area may be slightly tender. The key question is whether the pore stays flat. Without excision, many DPWs gradually refill over a period of months. If you had the contents extracted and the pore slowly returns to its previous appearance, that is normal behavior for a DPW and not a sign of anything worrying. It just means the dilated follicle structure is still there, doing what it does.
After surgical excision, you will have a small sutured wound that heals over one to two weeks, depending on the location and your skin’s healing tendencies. The resulting scar is usually a thin line, and on the face, where DPWs most often appear, dermatologists are typically careful about cosmetic closure. Recurrence after complete excision is rare because the entire abnormal follicle has been removed. If pathology reveals anything unexpected in the excised tissue, your dermatologist will contact you to discuss next steps, but in the vast majority of cases the report simply confirms a benign DPW.
There is no known way to prevent a DPW from developing in the first place. Sun protection is generally good for skin health and may reduce the cumulative damage that contributes to follicular changes over time, but no study has specifically shown that sunscreen prevents DPWs. If you have had one removed, there is no particular reason to expect another, though having sun-damaged skin means the conditions that favor DPW formation are still present.