In El Salvador, a country besieged by violent gangs, some one-time members are taking advantage of a state program to rid their bodies of tattoos that make it difficult to reintegrate into society. But disassociating one's self from the clans is not that simple.

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SAN SALVADOR, El Salvador —

When Santos Guzman sought government help for one-time gang members, there was no mistaking his gang affiliation.

His forehead bore the large, tattooed inscription “MS-13 Sur,” a unit of the feared Mara Salvatrucha, or MS-13, gang that has tentacles across Central America and the United States. Two tattooed teardrops trickled down his cheek below his left eye. Huge tattoos on his chest and back gave him an inky sort of body armor. His fingers and legs also sported gang tattoos.

On his sixth visit to a state Tattoo Removal Clinic, Guzman lay face down on an exam table. A physician aimed chilled air at a giant tattoo on Guzman’s back, drawing a slight wince. With a laser, she traced the outline of the tattoo, gently coaxing ink from below the skin.

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Guzman wants the 20 or so tattoos on his body to vanish. He gave up the life of a gangbanger long ago but learned only recently that evidence of his past could be erased. He said he tired of trying to hide his tattoos with long-sleeved shirts, and with pancake makeup on his face.

“The culture here is that whoever has tattoos is a criminal,” he said.

Potential employers shut the door on anyone who is tatted up, fearing street gangs that extort businesses. When tattooed riders board buses, passengers often change seats or exit. Gangs have firebombed buses as part of widespread campaigns for extortion and turf.

“People panic when they see these guys,” said Gladis Pacheco, a psychologist at the Tattoo Removal Clinic, run by the National Council of Public Security. “In this country, it is just a primordial requirement to get rid of one’s tattoos.”

Tattoos have a mystique in North America and Europe. A survey early last decade found that one of every seven U.S. adults has at least one tattoo. Skin art is in the mainstream.

Not so in El Salvador. Tattoos are the province of the two big street gangs, the MS-13 and the 18th Street, and tattoos on the faces of young gangsters serve as a warning to anyone who dares cross them.

That started to change eight years ago, with the first of a series of mano dura, or “hard hand,” crackdowns on criminal gangs. Gang leaders told members to restrict tattoos to less visible parts of their bodies.

Yet, gang members have become a greater menace in Central America — particularly in Guatemala, El Salvador and Honduras — with up to 70,000 total members.

Los Angeles roots

The MS-13 and 18th Street gangs began in Los Angeles, with the Mara Salvatrucha comprising Salvadorans who fled their nation’s 1980-92 civil war and the 18th Street starting with Mexicans but spreading to other Hispanics and to other races.

While thousands of Salvadoran gang members have been deported from the United States, they remain a scourge. The FBI says MS-13 is active in at least 42 states, with 6,000 to 10,000 members. The gang is particularly active in the West, Northeast and, increasingly, the Southeast.

But it’s in El Salvador where concern has soared over how gangs have morphed into incipient transnational mafias with links to Mexican drug cartels.

“If you’re talking about drug trafficking, the gangs are there. Extortion? They are there. Hired killings? They are there, too. … We estimate that 90 percent of the homicides in the country are carried out in some way by the gangs,” Defense Minister David Munguia Payes said.

Gang-led extortion has extracted a brutal toll, especially in the transport sector. Last year, 148 bus drivers, fare collectors and owners of the 7,000 buses that crisscross San Salvador each day were slain.

In one attack, a crowded bus was sprayed with gunfire and then torched, killing 17 people.

More former gang members have come to the Tattoo Removal Clinic since then. They’re usually in their late 20s or 30s.

“To get into this program, you have to prove that you are not in gangs anymore,” Dr. Maydee Ramirez said. The treatment is free. Length of treatment depends on the ink, the age of the tattoo and its size.

The clinic has treated 710 people, some with as many as 150 tattoos, Ramirez said.

Guzman, who entered gang life at 15 and is now 26, said he slipped out of MS-13 after a couple of years. But fellow gang members tracked him down and ordered him to commit new crimes, inflicting punishment when he failed.

Rival 18th Street gangsters also would attack him.

Guzman eventually learned a trade, auto painting and detailing, and ekes out a living despite his gangster skin art. He works in the street in the San Marcos district of the capital. At home are his 5-year-old daughter and his wife.

A difficult life to leave

Leaving gang life rarely is accomplished. Many are leaving the only life they’ve ever known.

“They are 35 or 40 years old, they have kids, and they want to leave this crazy life behind,” said Luis Lechiguero, a member of a European Union delegation that helps finance programs to reduce gang activity.

But social pressure can be huge. Entire low-income districts of El Salvador’s cities are controlled by gangs and live off proceeds of extortion and shakedowns in other areas.

“Mothers, wives and children participate in making the calls, picking up the money and researching targets,” said Jeannette Aguilar, of the Central American University.

Gangs literally control some prisons, and gang bosses use cellphones to organize crime campaigns, Aguilar said.

Efforts to outlaw membership in a gang have failed. President Mauricio Funes, the head of a leftist government, signed the law in September despite a three-day, gang-enforced transport strike aimed at halting its enactment.

The law has proved toothless. Judges require a wide array of evidence, Attorney General Romeo Barahona said, such as that the gang had at least three members, controlled territory, met regularly and intended to commit crimes.

For former gangbangers, removing tattoos is only one step.

“Getting rid of tattoos alone isn’t enough to get you back to normality,” Lechiguero said. “You need a job, family and community support, and individual willpower.”

Removing tattoos also carries risks. “If [gangs] find out you got rid of your tattoos,” he said, “they will come after you.”

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