Ephelides (freckles) are hyperpigmented small macules located on sun-exposed skin and become darker in the summer and lighter in the winter. There is no increase in the number of melanocytes on pathology, but there is an increase in melanin. Ephelides respond well to Q-switched laser treatment (Fig. 11). Another common lesion, seborrheic keratoses, may respond to laser treatment. In general, thinner seborrheic keratoses respond better to laser treatment than thick lesions.Cryotherapy or cryotherapy in combination with laser treatment is preferred to laser treatment alone for thick seborrheic keratoses. A nevus spilus (speckled lentiginous nevus) consists of a background CALM and scattered nests of nevi cells. Successful clearing of the darker nevocellular component has been reported with the QSRL, but the CALM component tends to recur.A Becker’s nevus is a hyperpigmented, hairbearing plaque that most commonly occurs on the upper trunk or shoulder of males. These lesions may also be associated with a dermal smooth muscle hamartoma. The hyperpigmented component of Becker’s nevi respond similarly to laser treatment as CALMs, having frequent recurrences (within 6–12 months) and post-inflammatory hyperpigmentation.