Past Lives Fade at This San Francisco Tattoo Removal Clinic

The fluorescent lighting inside a hospital can be unforgiving.

Freddie Gutierrez settles into a waiting room at Zuckerberg San Francisco General Hospital, wearing sleek, designer shades like the kind celebrities wear to avoid the public eye. Soon, he’ll swap his sunglasses for protective, medical-grade eyewear — still cool, but with more of a sci-fi edge.

Guiterrez, 33, has kind, dark eyes. They could inspire pop songs. Etched between his ear and right eye is a small tattoo of an upside-down pitchfork. Above his left eye, he has a second tattoo of a crown, about an inch long. The designs refer to his past gang life.

“How’s school?” asked nurse Judy Wong as she prepared him for the exam room.

“It’s been a while since I’ve done a timed math test,” said Guiterrez, who is studying computer science at City College of San Francisco. “Sometimes, it’s eating up my life. When I’m done getting my bachelor’s, I’m gonna have gray hairs.”

Guiterrez braces for a painful procedure. Since September, he’s been undergoing laser treatment to remove his tattoos. The face is an especially sensitive area. He described the pain as similar to a rubber band snapping against the skin repeatedly, but he thinks the sessions, which last a few minutes, are worth the discomfort — a decision he made to start fresh.

April is Second Chance Month, which highlights the experiences of millions of Americans who are formerly incarcerated and the stigma they face for having a criminal record. As spring kicks off, patients like Gutierrez are grateful for SF General’s tattoo removal clinic.

Opened in 2009, the clinic, a partnership with UCSF and the San Francisco Department of Public Health, serves low-income people who have tattoos linked to incarceration, trafficking or gang affiliations.

“Not only the physical removal of tattoos is rewarding, but also just seeing people as they are in their journey of recovery — being a part of that and being a consistent face in that is really special,” said Dr. Matthew Pantell, who runs the clinic and is a researcher at UCSF on the social factors of health care.

Pantell took over the clinic from its founder, Dr. Pierre Joseph Marie-Rose. In 1998, he launched a similar effort, called Second Chance, for gang-affiliated youth in San Francisco (it’s still located at the Central American Resource Center on Mission and Cesar Chavez streets). While working at SF General Hospital, he applied for a grant to start a tattoo removal program at the hospital.

“This is a thermal injury. I was humbled that [patients] would come back and ask me to do it again,” Marie-Rose said. “I’ve never taken that for granted.”

When patients enter the laser room, lo-fi hip-hop music plays. Wearing a baseball cap, jeans and fresh kicks, Pantell arms a long glass cylinder, which resembles a thin highball cocktail glass, at the tattoos. Over the music, it’s hard to hear anything noticeable as patients brace for the pain. The procedure can last anywhere from a few minutes to a half-hour, depending on the tattoo size, complexity and location on the body, according to Pantell.

Other factors, such as ink color — red and green can be stubborn — and quality, can play a role, Pantell said.

“You don’t want to do two lasers in the same day, so we’ll do the black ink first and then come back every six weeks till it’s gone,” he added.

Since patients are required to return every six to eight weeks for treatment, the hospital setting helps connect patients with other health care services, according to Pantell. He pointed out that patients are linked to their primary care physician and other social needs, like housing.

For patients like Guiterrez, the tattoo removal visits are often the most consistent contact with the medical system that they have had. He said he has been “in and out of the [criminal justice] system” since he was a kid growing up in Santa Barbara. Last July, he was released from state prison after serving a nearly 13-year sentence for charges related to carjacking.

“I thought about what I want to do for myself and being a two striker, meaning that if I catch another strike that will give me a 25-to-life sentence. So that makes me really think about every decision I make,” said Gutierrez, who said he sought self-help groups in prison and got support from Criminals & Gang Members Anonymous.

He said a contact affiliated with Jails to Jobs, a Bay Area-based nonprofit that supports re-entry to the workforce for formerly incarcerated people, referred him to the clinic. Jails to Jobs estimates there are around 300 similar tattoo removal clinics in the U.S. Just under half of them are located in California which, in recent years, has seen an increase in access to these services — inside prisons through the California Department of Corrections and Rehabilitation, at university health systems like UC San Diego and in cities, like Santa Rosa, which launched a similar effort this year.

People typically seek tattoo removal to improve job prospects, but there’s also the societal stigma that can be as difficult to shed, said Mark Drevno, founder and executive director of Jails to Jobs.

“Simple things like traveling on the bus. I’ve had people tell me how they hide their hands on the bus because they don’t want anybody to see their hands,” he said. “Besides the practical stuff, there is inner work going on. They’re touching their soul when they’re removing these tattoos.”

Despite the wider acceptance of tattoos in modern American society, their associations with prison life, gangs and violence persist. Recently, U.S. Immigration and Customs Enforcement reportedly cited a tattoo of a Spanish soccer team as evidence for one of the 238 Venezuelan migrants deported from the U.S. to El Salvador over their alleged allegiance to the Tren de Aragua gang, which has become a target of the Trump administration.

Researchers with UC San Diego, where a free removal clinic was established in 2016, have studied motivations for tattoo removal among “justice-involved adults.” Their 2023 study, published in the International Journal of Offender Therapy and Comparative Criminology, found that over half of the participants cited reasons associated with “public or interpersonal stigma,” which included better perceptions among friends and family. The study also found that more than 80% of participants said they felt they had been discriminated against because of their tattoos.

Part of the appeal of clinics like the one at SF General is that there’s no cost to patients. The UC San Diego research cites cost as a significant barrier. Treatments at private establishments can cost thousands of dollars.

Pantell estimates around a dozen patients visit the weekly clinic at SF General. Ana Navarro has a rose design on her right ankle. It’s hard to see it as the treatment appears to be working. She said she has had it since she was a teenager and has been trying to get it removed for almost a year.

“I was young, not in the right relationships,” Navarro, 32, said. “So, being able to remove them, it feels like I’ve been an opportunity to clear the past.”

For a while, Shannon Whiley, 53, has been trying to get two tattooed dots removed — marks that were placed as part of her breast cancer treatment. The dots, about the size of a freckle, help doctors accurately position patients during radiation therapy.

Nikki, a sexual violence survivor, has an arm sleeve filled with interwoven hearts and flowers. She described it as a “bad cover-up” in an effort to hide associations to her past life trafficked as a minor.

“All of it was from some backyard tattoo artist who had no business really doing tattoos on a minor,” recalled Nikki, whose request to go by a nickname because of the stigma of sexual violence was granted under KQED’s anonymous sources policy.

She’s been coming to the clinic since September and has started to notice her tattoos begin to fade. She has a long way to go until they’re erased, but she’s used to hard work paying off. She said she’s in nursing school, following in her mom’s footsteps.

“Every time I leave the clinic, I’m like, ‘God bless this doctor,’” she said.