Yes, a laptop cooler can help. Running hot can lead to performance problems and shorter equipment life. I don't have first hand experience with heat problems in an actual laptop (yet). An older laptop I have does tend to run very hot (too hot to touch on the underside) if I don't use a cooler, but with the cooler it stays reasonably cool.
The most recent example of equipment problems due to excessive heat I've seen was in a wireless router I have. A few months ago some stuff was put next to it, blocking its ventilation. It started having problems - frequent drop outs, for example. When I checked it out, I found it was extremely hot to the touch. I moved it to a place where it cannot be surrounded with stuff and it has operated without problem since.
A side benefit is that the laptop cooler I have sits under my laptop and allows me to change the angle of the system. This makes for better ergonomics. (Already having eye problems and CTS, I appreciate that.)
1I have a Dell m1530 and without a cooler it runs at 89C consistently. With a laptop cooler I'm running more at 50-60C. – James Mertz – 2011-04-29T03:47:06.460