A method and apparatus are provided for treating dermatological conditions, in which a first beam of
radiation is used to ablate a hole in
skin tissue, and a second beam of
radiation is directed into the hole and onto a region of
skin tissue adjacent to and / or at the bottom of the hole. The first beam can be provided by an
ablative laser such as a CO2
laser or an ER:YAG
laser. The second beam can be provided by, e.g., an
ablative laser operating at a lower peak
power level than the first beam, a non-
ablative laser, a flashlamp, a
tungsten lamp, a
diode or a
diode array. A controlled amount of
thermal damage can thereby be provided at a desired depth within the
skin, using
radiation sources that would be absorbed closer to the surface of the skin if an ablated hole were not present. Cooling and / or freezing of the skin prior to
ablation can be provided to provide an
analgesic effect and / or stabilize the tissue surrounding the ablated hole. The region of skin to be treated can optionally be pulled towards the radiation source using a vacuum to stretch and / or stabilize the
skin tissue surrounding the volume to be ablated.