You’re looking in the mirror and you see it. A dark, gaping, circular void that looks like someone poked a needle into your back or shoulder and just left it there. It isn't a normal pimple. It doesn't pop like a whitehead, and it definitely isn't a "stray hair." People on the internet have started calling it a black hole in the skin, but in the medical world, it’s known as a Dilated Pore of Winer (DPOW).
It's weirdly fascinating. Honestly, if you’ve ever fallen down a YouTube rabbit hole watching Dr. Pimple Popper (Dr. Sandra Lee), you know exactly what I’m talking about. These things look like literal portals. But despite the dramatic name, they aren't cosmic anomalies. They are just giant, overgrown comedones.
What Actually Is This So-Called Black Hole?
Basically, a Dilated Pore of Winer is a solitary, benign (non-cancerous) lesion. It’s a hair follicle that has decided to expand way beyond its original zip code. Think of a standard blackhead. Now, imagine that blackhead gets stuck, hangs out for a few decades, and slowly stretches the opening of the pore until it stays open forever.
The "black" part isn't dirt. That’s a huge misconception. It’s actually keratin—the same protein in your hair and nails—that has oxidized. When keratin is exposed to the air, it turns dark brown or black. It’s the same chemical reaction that makes a sliced apple turn brown on your kitchen counter. Beneath that dark "plug" is a mass of soggy, white skin cells that have been trapped in a dead-end street for a long time.
Most people don't even realize they have one until it gets big enough to catch on clothing. They are most common in middle-aged or older adults, particularly men, and they usually show up on the face, neck, or back. Why there? Because those areas have the highest density of oil-producing sebaceous glands.
Why Do These Gaping Pores Form?
We don't have a single, smoking-gun reason why one person gets a black hole in the skin and another doesn't. However, dermatologists like Dr. Louis Winer—who first described the condition back in 1954—noted that it’s essentially an architectural failure of the skin.
Sun damage is a massive factor. Years of UV exposure break down the elastin and collagen that keep your pores tight and "snappy." When that support system fails, the pore loses its ability to shrink back down. If a plug of keratin starts to form in that weakened pore, the pressure of the growing mass just pushes the walls further out. It’s like wearing a pair of shoes that are two sizes too small; eventually, the leather is going to stretch and stay stretched.
Smoking is another silent culprit. It wreaks havoc on your skin’s structural integrity. You’ll often see these dilated pores on the temples or cheeks of long-term smokers, a condition sometimes associated with Favre-Racouchot syndrome, where the skin becomes thick, yellowed, and riddled with giant blackheads.
Can You Just Squeeze It Out?
You can try. It’s tempting. But it probably won't work out the way you want.
Because the pore has been stretched into a flask-like shape—narrower at the top and wider at the base—the material inside is hard to evacuate completely. If you do manage to squeeze the "plug" out, you’re left with a literal hole. It looks like a crater. And because the walls of that pore have been permanently deformed, the hole will almost certainly fill right back up with keratin within a few weeks.
It's a cycle. You squeeze, it empties, it fills, it returns.
If you get aggressive with it, you risk infection or scarring. Since many of these "black holes" are located on the back or behind the ears, people often use dirty fingernails or unsterilized tools to reach them. That's a recipe for a staph infection. Don't do that.
Professional Treatment: The Only Way to Close the Void
If you actually want a black hole in the skin gone for good, you need a professional. A dermatologist isn't just going to squeeze it; they’re going to perform a minor surgical procedure.
The most common method is a punch excision. The doctor uses a small, circular blade—kind of like a tiny cookie cutter—to remove the entire affected hair follicle. Once the "sac" and the stretched skin are gone, they put in a couple of stitches. This replaces the gaping hole with a tiny, flat scar that eventually fades.
Other options include:
- Curettage: Scraping out the contents and the lining of the pore.
- Laser therapy: Sometimes used to resurface the area, though less effective for very deep DPOWs.
- Electrosurgery: Using heat to destroy the lining so it can't produce more keratin.
Honestly, the punch excision is the gold standard. If you don't remove the "lining" of that hole, it's coming back. Every time.
Misdiagnoses: When It's Not a DPOW
Not every dark spot is a Dilated Pore of Winer. This is where you have to be careful. While a DPOW is harmless, other things that look similar are not.
- Basal Cell Carcinoma (BCC): Sometimes a pigmented BCC can look like a dark, depressed area of skin. If the "pore" starts bleeding, crusting, or growing rapidly, it needs a biopsy immediately.
- Cutaneous Horns: Occasionally, the keratin in a pore can become so hard and compact that it starts to grow outward like a tiny horn.
- Epidermoid Cysts: These are deeper and usually feel like a firm lump under the skin, whereas a DPOW is mostly a surface-level opening.
- Melanoma: Rarely, a dark spot might be a serious form of skin cancer. If the borders are irregular or the color is "shready" and inconsistent, get it checked.
Practical Steps for Skin Management
If you have a large pore that is starting to look like a black hole in the skin, you can’t "shrink" it with over-the-counter creams. No toner in the world is that strong. But you can manage the contents.
Use a topical retinoid like Adapalene (Differin). Retinoids speed up cell turnover, which helps prevent the keratin from clumping together and stretching the pore further. It’s more of a preventative measure than a cure, but it keeps the "plug" from becoming a "boulder."
Salicylic acid washes are also helpful. Salicylic acid is oil-soluble, meaning it can actually get down into the pore and dissolve the "glue" holding the dead skin cells together. It won't close the hole, but it will keep it from looking so dark and prominent.
Lastly, wear sunscreen. It sounds boring, but protecting the collagen you have left is the only way to prevent more pores from giving up and turning into craters. Once the structural proteins in your skin are gone, they are incredibly hard to replace.
Realities of the "Black Hole"
These skin features are incredibly common, but they carry a weird social stigma because they look "unclean." They aren't. A Dilated Pore of Winer is just a sign of aged or sun-damaged skin doing its best to cope with a clogged follicle.
If it bothers you, see a dermatologist. Don't spend hours with a magnifying mirror and a comedone extractor. You’ll likely just end up with an inflamed mess and the same hole you started with. A 10-minute office procedure can fix what years of scrubbing couldn't.
Actionable Insights for Moving Forward
- Audit your skin: Check your back and shoulders using a hand mirror. Look for single, large, dark openings that don't go away with normal washing.
- Stop the squeeze: If you find a DPOW, resist the urge to self-extract. You cannot "empty" a dilated pore permanently without removing the follicle wall.
- Consult a Pro: Schedule a skin check. Ask specifically about "punch excision" if the appearance of the pore affects your confidence.
- Update your routine: Incorporate a 2% Salicylic Acid liquid exfoliant twice a week to keep keratin from hardening in existing large pores.
- Sun Protection: Use a broad-spectrum SPF 30+ daily to prevent the degradation of pore-supporting collagen.