A dermatological energy applicator and tissue interface module are provided which may include any number of features. The dermatological energy applicator can be configured to apply microwave energy to tissue to treat conditions of the skin, including hyperhidrosis or excessive sweating. The energy applicator can further include a cooling element and vacuum ports. The tissue interface module can include an applicator chamber adapted to receive the energy applicator, and can further include a tissue acquisition chamber adapted to engage tissue, a bio-barrier configured to prevent passage of gas and liquid, and a filter disposed between the applicator chamber and the tissue acquisition chamber configured to prevent passage of gas but prevent passage of liquid.