Systems and methods that enable tissue cooling and delivery of energy for altering tissue are described herein. Aspects of the disclosure are directed to, for example, heating tissue at treatment zones to ablate, denature, reorganize, coagulate, or otherwise alter the tissue to affect the cosmetic appearance of the patient. The method can include, for example, removing heat from the target region of the human subject before, during, and/or after energy delivery to cool tissue to a temperature below normal body temperature to inhibit pain.
