Cryogen spray cooling (CSC) is used to minimize the risk of epidermal damage during laser dermatologic surgery. During CSC, skin surface is cooled by a short spurt of refrigerant R134a with boiling point of 26.2C. Since R134a is volatile in open atmospheric conditions, the atomized liquid droplets undergo continuous evaporation as they fly in air, leading to a lost momentum and mass. Therefore, the cooling effect of CSC depends strongly on the spray distance between the nozzle and the skin surface (L). The objective of this study was, therefore, to investigate the effect of L on the dynamic heat transfer of CSC. A skin model system made of poly methyl-methacrylate resin (Plexiglass) is used to simulate CSC during laser dermatologic surgery. A fast-response temperature measurement sensor is built using thin (20 m) aluminum foil and placed on top of the plexiglass with a 50 m bead diameter thermocouple positioned in between. Variation of the surface temperature is then measured under various spray distances. The surface heat flux (q) as well as the heat transfer coefficient (h) between the surface and the cryogen is estimated by solving an inverse heat conduction problem with the measured temperature data as input. The effect of L on surface cooling in CSC is then investigated systematically. Both the estimated q and h show strong dynamic characteristics and are strong functions of the L. Two distinct spray-surface interaction mechanisms are identified within the spray distances studied. For short L (> 30 mm), the spurt droplets impinge on the substrate violently, resulting in a fairly thin cryogen film deposited on the surface. Strong dynamics and high q result in this case, corresponding to a high h as well. Interestingly, h becomes strongly fluctuating and even larger after spurt termination for these cases. For long L (< 30 mm), q is lower and it steadily decreases after spurt termination. The dynamic variation of h in this case is similar to that of q. These results should help in the selection of optimal CSC parameters, which are needed to produce high heat fluxes at the skin surface and thus obtain maximal epidermal protection during various dermatologic laser therapies.