All three Q-switched lasers are highly effective for treating all types of lentigines.Both 35% trichloroacetic acid peels and cryotherapy are inferior to Q-switched lasers in the treatment of lentigines.With one treatment using a Q-switched laser, at least 50% clearing of lentigines is expected, and additional treatments may be utilized to remove remaining pigment (Figs. 8 and 9). Although less selective, non Q-switched (millisecond domain) KTP, 595 nm pulsed-dye, ruby, alexandrite, and diode lasers may also be used to treat lentigines. A study of Asian patients with lentigines found a long-pulsed KTP (532 nm) laser (without skin cooling) to be as effective as a 532 nm Q-switched Nd:YAG laser, and with less risk of post-inflammatory hyperpigmentation. Additionally, a study using a 595 nm pulsed-dye laser on lentigines in Asian patients showed a mean of 82% improvement in lentigines by reflectance spectrometry.Several studies have also demonstrated the effectiveness of broad band light sources (Intense Pulsed Light) in clearing lentigines. Adjunctive use of 5-aminolevulinic acid (5-ALA) with IPL provides greater improvement of epidermal pigment than with IPL alone.