A system for the application of microwave energy to skin, comprising: a signal generator adapted to generate a microwave signal having predetermined characteristics; an applicator connected to the signal generator, adapted to apply microwave energy to skin and to be positioned adjacent an outer surface of the skin, the applicator comprising one or more microwave antennas and a tissue interface; a vacuum source connected to the tissue interface, the tissue interface having a tissue chamber coupled to the vacuum source to engage the skin therein; a cooling source connected to said tissue interface; a controller adapted to control the signal generator, the vacuum source, and the coolant source; wherein the one or more microwave antenna is configured to radiate the microwave energy into the skin with an electric field component substantially parallel to the outer surface of the skin and having a frequency and electric field orientation which generates a standing wave pattern having a constructive interference peak in a target tissue, thereby creating a peak temperature at the target tissue, creating a lesion core by heating the target tissue using the radiated microwave energy, the target tissue being either in the lower portion of a dermal skin layer and the standing wave pattern is created by the reflection of at least a portion of the microwave energy off an interface between the dermal skin layer and a sub-dermal skin layer or in a glandular layer and the standing wave pattern is created by the reflection of at least a portion of the microwave energy off an interface between the glandular layer and a sub-dermal skin layer. a signal generator adapted to generate a microwave signal having predetermined characteristics; an applicator connected to the signal generator, adapted to apply microwave energy to skin and to be positioned adjacent an outer surface of the skin, the applicator comprising one or more microwave antennas and a tissue interface; a vacuum source connected to the tissue interface, the tissue interface having a tissue chamber coupled to the vacuum source to engage the skin therein; a cooling source connected to said tissue interface; a controller adapted to control the signal generator, the vacuum source, and the coolant source; wherein the one or more microwave antenna is configured to radiate the microwave energy into the skin with an electric field component substantially parallel to the outer surface of the skin and having a frequency and electric field orientation which generates a standing wave pattern having a constructive interference peak in a target tissue, thereby creating a peak temperature at the target tissue, creating a lesion core by heating the target tissue using the radiated microwave energy, the target tissue being either in the lower portion of a dermal skin layer and the standing wave pattern is created by the reflection of at least a portion of the microwave energy off an interface between the dermal skin layer and a sub-dermal skin layer or in a glandular layer and the standing wave pattern is created by the reflection of at least a portion of the microwave energy off an interface between the glandular layer and a sub-dermal skin layer.