The unusual skin appearance shown in the image may be associated with large epidermoid cysts or severely enlarged, blocked pores. Epidermoid cysts develop when skin cells become trapped beneath the surface and produce keratin, a protein normally found in skin and hair. Over time, this material builds up inside a sac, creating a lump that may have a dark central opening. If the cyst becomes inflamed or ruptures, it can release thick, dark or cheese-like material.
Another possibility is a condition called a dilated pore of Winer, in which a hair follicle becomes unusually enlarged and filled with hardened keratin. Multiple deep lumps, draining openings and scars can also occur with chronic inflammatory conditions such as hidradenitis suppurativa, although this condition more commonly affects skin folds. A bacterial infection can also cause painful, swollen abscesses filled with pus.
How is it treated? The correct treatment depends on the diagnosis. A dermatologist may examine the skin, assess the openings and drainage, take a swab if infection is suspected, or recommend a biopsy when necessary. Cysts can often be permanently treated through surgical removal of the entire cyst wall. Abscesses may need professional drainage and sometimes antibiotics. Chronic inflammatory conditions may require prescription medication, specialized wound care or surgery. There is no single treatment that works for every cause.
Can it be cured? Many epidermoid cysts can be successfully removed, while chronic conditions such as hidradenitis suppurativa can be controlled but do not currently have a definitive cure. These lesions should never be squeezed, cut or drained at home, as this can cause infection and scarring. Anyone with growing, painful, warm or repeatedly draining lumps should seek medical assessment; fever or spreading redness requires urgent medical attention.
