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.
