Pigmented nevus is a common skin disease, pigmented nevus is a brown or black congenital benign neoplasm composed of nevus cells, which is a developmental malformation and originates from the neural crest of the ectoderm, i.e., the original precursor cells or nevoblast. Pathologically, there are features of multiple nevus components or other components mixed with one component, such as intradermal nevus, junctional nevus, compound nevus, blue nevus, nerve nevus, black hair nevus, etc. For nevus occurring in giant nevus on the head and face, eyelid, ear, nose, etc., or frequently receiving wear and tear, such as the back of the neck, hand, finger palm area, or certain special areas, such as penis head, red lips, finger (toe) nail area, because nevus not only affects the aesthetic appearance, but also is easy to increase in size or even malignant, we suggest treatment for nevus of black pigmented nevus in these special areas if the patient’s family has the need for treatment. The treatment methods usually used for congenital nevus and giant nevus are: surgical excision, laser, chemical peeling and so on. Clinically, different surgical and restorative methods can be chosen according to the different clinical manifestations of nevus and the economic status and requirements of patients. Surgery is a reliable method to treat nevus nigricans, and early and thorough treatment is advocated. The principles of trauma repair are: those who can be repaired by direct suture, not by tissue transplantation; those who can be repaired by local flap, not by distant flap; those who cannot be repaired by local flap, repaired by free skin slice transplantation. Children have good skin elasticity, high tension, and strong plasticity of skin, so the excised wound can be repaired by direct suture, and the staged excision and suture method and local flap method are suitable for small facial lesions. Large pigmented nevus on cheek is excised by staged surgery; nevus on eyebrow arch and eyelid is excised in one stage and directly sutured or localized small area flap transfer or free skin flap transplantation; pigmented nevus on auricle, nose, between eyebrows and giant nevus on head and face is excised by focal free skin flap transplantation. In the head and face, repairing the trauma with free flap method is not only time-consuming, but also local bloating after surgery, which affects the appearance and requires second-stage repair in some fashions, and free flap grafting is recommended for large skin defects. Laser treatment is only applicable to pigmented nevi less than 3mm in diameter, which can be removed by vaporization with carbon dioxide ultra-pulse laser; nevus tissues larger than 3mm will leave obvious scar with laser treatment, and surgical excision is generally recommended to be better. Longitudinal black nail is a group of diseases that are clinically manifested as brown or black stripes from the root to the distal end of the nail bed of the finger (toe). The nail and nail bed lesions can be surgically removed, and the incision can be directly sutured or the wound can be repaired with free skin grafts.