Pigmented nevi are benign neoplasms composed of nevus cells. It is also known as nevus cell nevus. They can occur at any age, and especially increase during puberty. We often encounter many patients who come to our clinic to consult about the treatment of pigmented nevi. They are often eager to get correct and timely treatment because of aesthetic needs or fear of malignant transformation of pigmented nevi. The following are some of the most frequently encountered clinical problems and the most concerned patients. 1. “Doctor, I want to remove the mole, I think this mole doesn’t look good, can you remove it for me?” A: “Everyone has their own aesthetics, and they have their own views on various things and phenomena. We will give full respect to this. The patient’s needs are the direction of each doctor’s efforts. The doctor will fully communicate with the patient from a professional point of view regarding the diagnosis of the disease, the choice of treatment, the prognosis, and the risks to be taken, and try to meet the correct and reasonable requests of the patient, while patiently explaining and politely refusing certain unrealistic requests.” 2. “Doctor, I have heard that there are many kinds of moles, I want to know which kind my mole belongs to?” A: “According to the characteristics of nevus cells and the location of occurrence, there are three types: one type of freckle-like nevus (simple and senile); two types of blue nevus; and three types of nevus cell nevus (junctional nevus, compound nevus and intradermal nevus). In addition, they can be divided into congenital melanocytic nevus and nevus of nail mother according to the time and location of appearance.” 3. “Doctor, which moles are harmful to human body and must be treated actively?” A: “Pigmented nevi that are recommended for active treatment include: junctional nevi, pigmented nevi in palmoplantar and friction areas, and congenital pigmented nevi with larger areas. Foreign criteria are: whether A is symmetrical, B whether the boundary is clear, C whether the color is uniform, and D whether the diameter is less than 0.5 cm. some blue nevi are also subject to malignant transformation possibility.” 4. “Doctor, what is the manifestation of nevus malignant change? Which parts and types of moles are prone to malignant transformation?” A: “The vast majority of pigmented moles will not become malignant, but congenital melanocytic nevus, nevus cell nevus, nail mother nevus and blue nevus can become malignant. Especially in the friction-prone areas such as palm, plantar, waistline, armpit, groin and shoulder, if there are changes such as pain, itching, ulceration, bleeding, sudden increase of damage, deepening of color, satellite dots on the edge and enlargement of nearby lymph nodes, vigilance should be raised and if necessary, pathological examination should be conducted in time to exclude the possibility of malignant transformation.” 5. “Doctor, I heard that there are more treatments for moles, how should I choose?” A: “According to the different types of moles and different clinical manifestations, different treatment methods should be chosen. Becker’s nevus, blue nevus, nevus cell nevus (junctional nevus, compound nevus, intradermal nevus), congenital melanocytic nevus, halo nevus, nail nevus, if treatment is needed, surgery is preferred, which is not only good for reducing recurrence rate, but also good for wound healing. It is not only good for reducing recurrence rate, but also for wound healing, and pathological examination can be performed to determine whether there is malignant change, Mongolian spots can heal by themselves without treatment.” 6. “Doctor, will laser mole removal and surgical mole removal leave scars? What are their advantages and disadvantages?” A: “These are two different treatment methods, both of which may leave scars. The key is to choose the right indications in order to make use of their respective advantages. For example, if blue nevus and nevus cell nevus are treated with laser, it is easy to treat incompletely or leave depressed scars which will exist for life; while surgical excision will also leave scars, but the scars are in the shape of lines, and generally the scar lines will become less and less obvious after 3-6 months, except for patients with scar body, of course. If freckle-like nevus is removed by surgery, it will leave scars instead. Laser can not only remove the lesion but also leave no scars, so it should be a better choice.” 7. “Can I know in advance that I have scarring? Is there a way to treat scars if they appear?” A: “It cannot be predicted in advance. Some patients can have a genetic predisposition. Patients often determine whether they are scarred or not based on the characteristics of scars when trauma occurs and scars manifest. Patients with scarring should avoid any trauma, otherwise all traumatic areas will form scars that are painful, itchy and expanding, seriously affecting the aesthetics and even the function of movement. There is also a type of hypertrophic scar, which is a linear growth, but does not exceed the original trauma location. Hypertrophic scars can be treated with topical medications or local injections with better results. Conventional treatment for patients with scars is generally effective and must be combined with comprehensive treatment such as with radiotherapy.”