A device (100, 302, 400) for light treatment of skin, the device comprising: a handpiece comprising an interior compartment (102, 402) having a proximal end (102A, 402A) and a distal end (102B, 402B) and an optical aperture (104, 404) disposed at the distal end (102B, 402B) thereof; a laser or Broad Band Light source (106, 308, 406) that produces a laser or BBL beam (106A, 406A), the laser or BBL beam (106A, 406A) having a first optical path disposed within the interior compartment (102, 402) between the proximal end (102A, 402A) and the distal end (102B, 402B) and exiting the interior compartment (102, 402) through the optical aperture (104, 404); an imaging system (108, 306, 408) configured to receive a return signal from the optical aperture (104, 404), the return signal having a second optical path disposed within the interior compartment (102, 402); a selectively reflective optical element (110, 410) disposed in the first optical path and in the second optical path; and an applicator (114, 414) attached to the distal end (102B, 402B) of the interior compartment, wherein the selectively reflective optical element (110, 410) transmits at least 60% of the laser or BBL beam (106A, 406A) incident on the selectively reflective optical element (110, 410), wherein the selectively reflective optical element (110, 410) reflects to the imaging system (108, 306, 408) at least 1% of incident return signal received from the optical aperture (104, 404), and wherein the applicator (114, 414) is configured to couple the device (100, 302, 400) to a surface of skin of a patient and to prevent or track relative movement of the surface of skin of the patient in one or more lateral directions relative to the optical aperture (104, 404). a handpiece comprising an interior compartment (102, 402) having a proximal end (102A, 402A) and a distal end (102B, 402B) and an optical aperture (104, 404) disposed at the distal end (102B, 402B) thereof; a laser or Broad Band Light source (106, 308, 406) that produces a laser or BBL beam (106A, 406A), the laser or BBL beam (106A, 406A) having a first optical path disposed within the interior compartment (102, 402) between the proximal end (102A, 402A) and the distal end (102B, 402B) and exiting the interior compartment (102, 402) through the optical aperture (104, 404); an imaging system (108, 306, 408) configured to receive a return signal from the optical aperture (104, 404), the return signal having a second optical path disposed within the interior compartment (102, 402); a selectively reflective optical element (110, 410) disposed in the first optical path and in the second optical path; and an applicator (114, 414) attached to the distal end (102B, 402B) of the interior compartment, wherein the selectively reflective optical element (110, 410) transmits at least 60% of the laser or BBL beam (106A, 406A) incident on the selectively reflective optical element (110, 410), wherein the selectively reflective optical element (110, 410) reflects to the imaging system (108, 306, 408) at least 1% of incident return signal received from the optical aperture (104, 404), and wherein the applicator (114, 414) is configured to couple the device (100, 302, 400) to a surface of skin of a patient and to prevent or track relative movement of the surface of skin of the patient in one or more lateral directions relative to the optical aperture (104, 404).