A system for applying laser radiation to skin of a patient, the system comprising: (i) a laser hand piece having a first cavity and including a laser radiation source for applying radiation into the first cavity, and a vacuum channel; characterised in that there is provided (ii) a removable insert having a base, and an outer wall extending from the base to peripheral flange, wherein: the base and/or outer wall at least partially conform to the first cavity whereby the insert is adapted for inserting into the first cavity; the base and outer wall defining a second cavity within the removable insert; the flange is configured to form a seal against a section of skin; wherein at leat the base of the removable insert is formed from a material transparent to a wavelength transmitted by the laser radiation source, and wherein the removable insert has at least one insert vacuum channel (14a,b) configured to provide vacuum communication between the second cavity and the vacuum channel of the hand piece to facilitate the establishment of a vacuum in the second cavity when the flange is sealingly applied to a section of skin tissue whereby the vacuum can cause the section of skin tissue to be drawn into the cavity. (i) a laser hand piece having a first cavity and including a laser radiation source for applying radiation into the first cavity, and a vacuum channel; characterised in that there is provided (ii) a removable insert having a base, and an outer wall extending from the base to peripheral flange, wherein: the base and/or outer wall at least partially conform to the first cavity whereby the insert is adapted for inserting into the first cavity; the base and outer wall defining a second cavity within the removable insert; the flange is configured to form a seal against a section of skin; wherein at leat the base of the removable insert is formed from a material transparent to a wavelength transmitted by the laser radiation source, and wherein the removable insert has at least one insert vacuum channel (14a,b) configured to provide vacuum communication between the second cavity and the vacuum channel of the hand piece to facilitate the establishment of a vacuum in the second cavity when the flange is sealingly applied to a section of skin tissue whereby the vacuum can cause the section of skin tissue to be drawn into the cavity. the base and/or outer wall at least partially conform to the first cavity whereby the insert is adapted for inserting into the first cavity; the base and outer wall defining a second cavity within the removable insert; the flange is configured to form a seal against a section of skin; wherein at leat the base of the removable insert is formed from a material transparent to a wavelength transmitted by the laser radiation source, and wherein the removable insert has at least one insert vacuum channel (14a,b) configured to provide vacuum communication between the second cavity and the vacuum channel of the hand piece to facilitate the establishment of a vacuum in the second cavity when the flange is sealingly applied to a section of skin tissue whereby the vacuum can cause the section of skin tissue to be drawn into the cavity.