Newer carbon-dioxide laser systems incorporating short pulse and scanning technology have been used effectively to resurface the skin. Although scarring is rare, as the number of resurfacing cases has increased, some hypertrophic scarring has been observed. Previous dermabrasion and continuous wave (cw) carbon-dioxide studies suggest that depth of injury and/or thermal damage are important predictors of scarring for a given anatomic region. To determine if overlapping laser pulses/scans significantly altered wound healing, we examined residual thermal damage, cell death, and histologic and clinical wound healing in a farm pig. The Ultrapulse and SilkTouch systems were used with various radiant exposures, degrees of overlap, and numbers of passes. Thermal damage was assessed by histology, and dermal cell viability was measured with nitrotetrazolium blue staining. Presence or absence of clinical scarring was determined by noting textural change and loss of skin markings. We observed that thermal damage and cell death depth did not increase significantly with pass number; however, by double-pulsing or double-scanning sites, residual thermal damage and cell death depth were increased as much as 100% over areas without immediate overlap of laser impacts. Also, scarring was increased focally in areas with overlap. We conclude that immediate overlapping of carbon- dioxide laser pulses/scans is a significant risk factor in increasing thermal damage, cell death, and scarring.