Abstract: A laser treatment device and process with controlled cooling. The device contains a rod with high heat conduction properties, which is transparent to the laser beam. A surface of the rod is held in contact with the tissue being treated and other surfaces of the rod are cooled by the evaporation of a cryogenic fluid. The cooling is coordinated with the application of the laser beam so as to control the temperatures of all affected layers of tissues. In a preferred embodiment useful for removal of wrinkles and spider veins, the rod is a sapphire rod. A cryogenic spray cools the walls. A first surface is in contact with the skin surface being treated and an opposite surface is contained in an anticondensation oil chamber that is optically connected to a laser beam delivering fiber optic cable.