Black spots on the scalp at the age of 50 may be caused by seborrheic keratosis, nevus pigmentosus, melanoma and other diseases, and patients can take laser treatment, medication and surgical treatment. 1. Seborrheic keratosis: patients with seborrheic keratosis will have black patches, itching and other symptoms, mostly on the head and face. Patients can follow the doctor’s advice to take laser treatment, such as Q-switched laser, intense pulsed light, super pulsed CO2 laser and so on. Patients can also use hydrogen peroxide solution, liquid nitric acid-zinc composite solution as prescribed by doctors, and patients can also take surgical treatment, such as scraping, cutting, excision and so on. 2. Nevus pigmentosus: For nevus pigmentosus resulting in dark spots on the scalp, patients can follow the doctor’s instructions for surgical treatment, mainly by means of surgical excision. Patients can also take physical therapy, mainly laser therapy. 3. Melanoma: Melanoma patients will have irregular black pigment spots, itching, pain and other symptoms, patients can follow the doctor’s instructions to use injection of dacarbazine, paclitaxel injection and other chemotherapeutic drugs treatment. If necessary, surgical treatment can be taken, such as resection of the primary lesion, lymph node dissection and so on. When 50-year-old patients have black spots on the scalp, they should seek medical treatment in time and follow the doctor’s instructions.