Abstract: Objective To observe the effect of microscopic XL-radiofrequency ablation on head-facial papulosa nigra and lichenoid seborrheic keratosis (LSK). Methods Sixty-three patients with head-facial papulosa nigra and LSK (32 males, 31 females) at the age of 35-81 years who visited our outpatient department from April 2008 to October 2011 were included in this study. The course of their disease was 6 months-40 years. The number of lesions was 274 with a minimal size of 4 mm×3 mm and a maximal size of 30 mm×25 mm. The diameter of 42 lesions was> 10 mm. Five lesions were located in the vertex and temple while the rest were located on the face. The lesions were treated once with microscopic XL-radiofrequency ablation. The patients were followed up for 6 months -2 years. Results Of the 274 lesions in 63 patients, 268 were cured with an excellent effect for 6 lesions and mild depigmentation in 1 lesion. No scar formation was found. Conclusion Microscopic XL-radiofrequency ablation shows a high curative rate for papulosa nigra and LSK with no scar formation.