Café au lait macules (CALMs) are well circumscribed, homogenous light brown macules that occur as isolated lesions in the general population. Their prevalence varies amongst ethnicities but ranges from 0.2% to 18%.35 Café au lait macules may also be found as multiple lesions in association with a syndrome (e.g., neurofibromatosis, Noonan syndrome). Histologically, there is an increase in melanocytes along the basal layer, hypermelanosis of melanocytes and keratinocytes,and giant melanin granules. Treatment of CALMs with lasers is minimally successful and often unpredictable.Temporary lightening or clearing can be achieved after multiple treatments (Fig. 10).