No medical treatment for mucosal or cutaneous lesions is known. A low risk of recurrence exists. In patients with mucosal lesions, treatment may be limited to the removal of the precipitating stimulus.  Lesions spontaneously resolve in approximately 40% of patients with oral lesions. 
Surgical excision is the treatment of choice for both mucosal and cutaneous lesions. Because rare cases of premalignant or malignant cutaneous lesions are reported, wider resection with clear margins is recommended. In benign cutaneous melanoacanthoma, local excision or ablation of the site is adequate. If mucosal lesions do not resolve, local excision or ablation is indicated.
Cryosurgery, electrosurgery, or laser treatment  may be used to remove lesions; however, these modalities may jeopardize the microscopic diagnosis.
No evidence of malignant transformation has been reported. No complications arise from incisional or excisional biopsy.