Modern treatment of chronically photodamaged skin provides new, minimally invasive methods for laser intervention, using fractional, non-ablative thermal energy for an induction of dermal remodeling. The clinical efficacy coupled with a minimum "down time" for the patient has directed the development of fractional ablative laser systems. Recently introduced systems are based on CO(2) and heated Er:YAG laser systems. The clinical efficacy has been tested on one prototype each and verified their effects at a microscopic level. Initial reports suggest the results are comparable to those achieved with fractional ablative systems. We review the current possibilities incorporating our personal experience. Systematic investigations of clinical outcomes with various system settings are still needed. The possible combination of ablative and non-ablative fractional technology may also lead to increased efficacy and safety of the procedure.