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.