This review demonstrates the progress, current status and problems of photodynamic therapy and laser photothermolysis for various skin diseases and rejuvenation. These new minimally invasive technologies are detailed from the points of view of their advantages and disadvantages. Particular attention is paid to complications, associated with prolonged dermal phototoxicity after intravenous photosensibilisation and insufficient intradermal penetration of photosensibilisers after local application to skin. Finding a compromise between phototoxicity and insufficiency of local photosensibilisation we've developed a technical approach employed to overcome limitations associated with targeted delivery of photosensibilisers into deep dermal layers. Intradermal delivery of photosensibilisers through so-called microthermal zones or dermal micropores, formed by focused pulse-periodic radiation of fiber laser, previously never used for photodynamic therapy of dermal disorders.