A device for effecting change in tissue at a treatment site includes a housing having an aperture for receiving a user's finger, a cold plate supported by said housing for cooling the tissue at the treatment site, and at least one thermoelectric cooling semiconductor thermally coupled to said cold plate and electrically coupled to a power source. In another embodiment, the cold plate may include a surface for contacting the treatment site, and at least a portion of said cold plate including said surface may extend from said housing.
