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Solar lentigines are benign keratinocytic proliferations resulting from prolonged and cumulative sun exposure. The newer photoselective lasers have become the mainstay of treatment. However, cryosurgery and trichloroacetic acid (TCA) solution are cost-effective alternatives in the treatment of solar lentigines.Twenty-five patients with multiple solar lentigines over the dorsa of their hands were included. Each hand was treated randomly with either 30% TCA solution or liquid nitrogen spray. The efficacy of treatment was evaluated at 8 weeks.Cryosurgery was more likely to produce significant lightening of the lentigines than 30% TCA solution (P < 0.05) but was more painful and took longer to heal.Cryosurgery was found to be superior to TCA 30% solution in the treatment of solar lentigines. This study demonstrates that old-fashioned treatments for solar lentigines are still excellent and cost-effective therapeutic choices.