Abstract: A hand held applicator for delivery of microwave energy to skin surfaces is provided that is compact, easily manipulated, precisely positionable and secure against malfunction. Microwave energy of a chosen frequency is supplied for a given duration at a predetermined energy level, via one or more waveguides having a distal end section that is dielectrically loaded and matched to skin impedance. Positioning indicia may be disposed on a single use end cap adjacent the emitter end of the applicator to permit easy visualization by the surgeon or technician. Coolant, such as a pressurized gas refrigerant, is supplied in a burst to the skin surface via an interior solenoid controlled valve. The microwave energy pulse is initiated by control circuits after the effective delivery of coolant is sensed. The initiation of the cycle can be effected by actuation of a switch, movement of the applicator against the skin, or by tracking the movement of the applicator from one position to another.