A hand held device for treatment of a skin treatment area, constituted of: a housing exhibiting an opening therein; a temperature adjusting element secured to an end of the housing, one end of the temperature adjusting element arranged to contact the skin treatment area, the temperature adjusting element exhibiting at least one aperture; a light source secured to the housing; and a light path arranged to pass light energy from the light source to at least a portion of the skin treatment area via the at least one aperture. A pulsed light energy is provided to the portion of the skin treatment area from the light source proceeding through the aperture and the temperature adjusting element is powered so as to adjust the temperature of the skin treatment area.