Hairy moles, medically known as congenital melanocytic nevi, are common skin lesions that present with both pigmentation and hair growth. These moles can appear anywhere on the body, including the face, and are typically present from birth, although some may develop later in life. They vary in size, shape, and colour but are characterised by the presence of terminal hair, which is the thick, coarse hair that is usually found on the scalp, eyebrows, and other areas of the body.

Hairy moles may be flat or raised, and their colour can range from light brown to almost black. The size of these moles can also vary significantly, from a few millimetres to several centimetres in diameter.

What Causes Hairy Moles on the Face?

Hairy moles are caused by an overgrowth of melanocytes, the cells responsible for producing the pigment melanin, which gives skin its colour. The exact cause of this overgrowth is not entirely understood, but it is generally believed to occur during foetal development.

These moles become “hairy” because they often develop over areas of the skin where hair follicles are present. The hair follicles within these moles are not only present but can be more active than in the surrounding skin, leading to the growth of thicker, darker hair. The reasons why some moles grow hair while others do not are not fully understood, but it is believed to be related to the concentration of hair follicles within the mole and the hormonal influences on those follicles.

Why Do Moles Grow Hair?

The growth of hair in moles is linked to the presence of hair follicles within the mole itself. Hair follicles are tiny structures within the skin that produce hair. In some moles, these follicles become more active, leading to the growth of thicker, darker hair. This can happen for several reasons:

1. Hormonal Influence: Hormones, especially androgens like testosterone, can stimulate hair growth. Moles with a high density of hair follicles are more likely to produce hair, especially during puberty or other periods of hormonal change.
2. Increased Blood Supply: Moles often have a richer blood supply than the surrounding skin, which can nourish hair follicles and promote hair growth.
3. Genetic Factors: Genetics play a significant role in the development of moles, including hairy moles. If there is a family history of hairy moles, you may be more likely to develop them.

How Do You Remove Hairy Moles?

The removal of hairy moles can be performed for several reasons, including cosmetic concerns, discomfort, or if there is suspicion that the mole might be cancerous (malignant). There are several methods available for removing hairy moles:

1. Surgical Excision: This is the most common and effective method for removing a mole. The procedure involves cutting out the mole along with a margin of healthy skin, and then the wound is closed with stitches. This method ensures complete removal of the mole, including the hair follicles, preventing future hair growth at the site. Surgical excision is often recommended for larger moles or those with suspicious features.
2. Shave Excision: In this method, the mole is shaved off at the level of the surrounding skin. It is a quicker procedure and may not require stitches, but it might not remove all the hair follicles, meaning hair could regrow. Shave excision is typically used for smaller, raised moles.
3. Laser Removal: Lasers can be used to remove moles, particularly those that are raised or flesh coloured. The laser works by emitting a concentrated beam of light that breaks down the mole. However, laser removal is generally less effective for hairy moles because it does not always target the deeper hair follicles, which may result in regrowth of hair. This may need a laser hair removal with a different type of laser.
4. Cryotherapy: This involves freezing the mole with liquid nitrogen, which destroys the mole tissue. While this method can be effective for removing moles, it may not be the best option for hairy moles as it may leave some hair follicles intact, leading to possible regrowth.
5. Electrosurgery: This technique uses electric current to burn away the mole. It is often used in conjunction with curettage, where the mole is scraped off after being treated with electricity. Like other methods, this may not fully eliminate hair follicles, leading to the potential for hair regrowth.

Is Laser an Option for Hairy Mole Removal?

Laser removal can be an option for hairy moles, particularly if the mole is raised and the patient is primarily concerned with the aesthetic appearance. However, it is important to note that laser removal may not completely eliminate hair follicles, which are located deeper in the skin than the pigment that the laser targets.

Therefore, while laser treatment may remove the mole’s pigmentation and reduce its size, it might not prevent hair from regrowing if the hair follicles are not fully destroyed. This makes laser mole removal less ideal for hairy moles compared to other methods like surgical excision, which physically removes the entire mole and its associated structures, including hair follicles.

Does Laser Hair Removal Stop Hair Growing in Hairy Moles?

Laser hair removal targets the melanin in hair follicles, heating and damaging the follicle to reduce hair growth. This method is effective for reducing hair growth in many areas of the body but is generally not recommended for use directly on moles. This is because the laser used for hair removal can also affect the pigmentation of the mole itself, potentially causing burns or other skin damage. This can be done if the mole has been treated first with laser mole removal, shave or excision.

Moreover, since moles, including hairy moles, can sometimes be at risk for malignant transformation, it is important not to alter their appearance with treatments like laser hair removal. Altering a mole’s appearance can make it more difficult to monitor for changes that might indicate malignancy.

If hair growth in a mole is a concern, it is generally recommended to remove the entire mole rather than just targeting the hair. This can be done via surgical methods, which provide a permanent solution by eliminating both the mole and its hair follicles.

Conclusion

Hairy moles are common and generally benign skin lesions characterised by the presence of both pigmentation and hair growth. They occur due to an overgrowth of melanocytes and the presence of active hair follicles within the mole. While the exact reasons for hair growth in moles are not fully understood, it is believed to be related to hormonal influences, increased blood supply, and genetic factors.

There are several options for removing hairy moles, including surgical excision, shave excision, laser removal, cryotherapy, and electrosurgery. Surgical excision is the most effective method, particularly for ensuring complete removal of the mole and preventing hair regrowth. Laser removal is an option but may not fully address the issue of hair growth due to its inability to target deeper hair follicles.

The best approach for managing a hairy mole, particularly on the face, is to book a consultation with our doctors and plastic surgeons at CLNQ to determine the most appropriate treatment option based on the mole’s characteristics and the patient’s concerns.