Most benign pigmented eye lesions including nevi, or complexion associated melanosis do not need treatment, except for observation for potential malignant change.
There are several pigmented lesions that require closer follow-up and even diagnostic biopsy for potential malignant changes, and these include primary acquired melanosis, or pigmented lesions with suspicious characteristics including significant asymmetry, thickened/elevated lesions, amelanotic or mixed pigmentary lesions.