A fractional treatment system can be configured with a laser wavelength that is selected such that absorption of the laser wavelength within the tissue increases as the tissue is heated by the laser (e.g., 1390-1425 nm). Desirably, the laser wavelength is primarily absorbed within a treated region of skin by water and has a thermally adjusted absorption coefficient within the range of about 8 cm−1 to about 30 cm−1. An adjustable mechanism can be used to adjust the beam shape, beam numerical aperture, beam focus depth, and/or beam size to affect the treatment depth and or the character of the resulting lesions. The system may be designed to be switchable between a treatment mode that is semi-ablative and a treatment mode that is not semi-ablative. Adjustment of these parameters can improve the efficiency and efficacy of treatment. Illustrative examples of adjustable mechanisms include a set of spacers of different lengths, a rotatable turret with lens elements of different focal distances, an optical zoom lens, and a mechanical adjustment apparatus for adjusting the spacing between two optical lens elements.