Abstract: An apparatus for treating dermatological conditions with radiation includes a Peltier device for cooling the treatment area of the patient's skin. The Peltier cooling device has a cold surface in thermal communication with the treatment area and a hot surface, with an aperture extending between the cold and hot surfaces through which radiation is directed to the treatment area. In one embodiment, a lens disposed within the aperture of the cooling device distributes the cooling effect to provide substantially uniform cooling across the treatment area. A temperature sensor senses the temperature of the treatment area and is used to control the Peltier cooling device and/or the radiation source to ensure that the treatment area does not exceed a predetermined temperature. Various radiation sources are suitable for use with the Peltier cooled apparatus, including lasers and gas-discharge lamps, such as arc lamps and flash lamps.