Lying back on a reclining bed, eyes fixed on the ceiling, Dave Fitzpatrick, 42, wiggles his bare toes out of the bottom of his trousers and braces himself for pain. He’s been in this position before, twice; but this time, he’s heard, it will be worse. Thirteen years after first getting tattoos on his feet, he’s about to have them removed. Fitzpatrick is a tall, broad former skater with a neat, grey-flecked beard – he looks as if he can take it, but it’s hard not to want to comfort him.

Standing over his toes, laser in hand, is tanned, floppy-haired Dr Garrett Vangelisti, 44. The room is not a conventional clinic: exposed brick and beams, bits of moss in glass apothecary jars, a copy of Easy Edible Gardening magazine for clients to read. There is a framed certificate on the wall bearing the words American Board of Plastic Surgery MD. A large machine hums, beeps and makes a pop as the laser beam hits Fitzpatrick’s skin. In between winces, and with his arm covering his face, he gets out the sentence: “Getting them tattooed really sucked.” Getting them removed doesn’t look like much fun, either.

Tattoo removal has never been so effective, or so popular. Improvements in technology are delivering better clearance faster, making it more attractive to people who regret their 90s tribal symbol, 00s sleeve or maybe the ultimate jinx, a lover’s name.

In the US, the American Society for Aesthetic Plastic Surgery (Asaps) reported a 39% increase in laser tattoo treatments, from 2014 to 2015. Set this against a booming US tattoo industry, predicted to hit $1bn in the next five years, and it’s hard to see how removal won’t keep increasing in popularity.

Dave Fitzpatrick: ‘It was spur of the moment.’ Photograph: Annabel Clark for the Guardian

The UK market is also healthy, although the deregulation of non-medical laser clinics in 2010 makes official figures harder to collate. Nationwide, dermatologists carried out around 12,000 treatments in 2016 alone. The Cheshire-based manufacturer of lasers for tattoo removal, Lynton, saw a 38% increase in sales last year. “Traditionally, it’s been high-end clinics buying the machines,” managing director Jon Exley says, “but now even tattoo artists are asking about using them for modifications. It’s a new sector that’s emerging.”

This is Fitzpatrick’s first session at the Untattoo Parlor in Portland, Oregon. Historically, tattoo removal has been an embarrassing procedure carried out at non-hip suburban clinics, but the Untattoo Parlor is rebranding it as a desirable lifestyle choice. Even its downtown location –above a coffee house, along the corridor from a yoga studio and next to a boutique ad agency – are more akin to the studio of an Instagram-famous tattoo artist. Its conceptual posters promising erasure adorn billboards across this much-inked city. There’s a leaf blower attacking a floral shoulder design, and a sparkly unicorn being jet-washed off a foot to reveal the original, clean skin beneath. Tattoo removal allows us to reverse what we once might have called self-expression but now call a mistake.

Fitzpatrick, a writer, gave removal much more thought than getting a tattoo in the first place, nearly 20 years ago. “It was spur of the moment,” he says. One day in his late 20s, he was in a mobile tattoo parlour in the car park of a skate park, drinking with a skateboarding crew he was hanging out with at the time. “We shared a disdain for mainstream skate culture and called ourselves Sleestak.” He joked with his friends that it would be cool to get the name written across his toes. “A couple of guys each threw in $10 and 20 minutes later I’m getting my feet tattooed.”

There was no morning-after regret. Like many tattoos, it brought Fitzpatrick a connection to other people. “Initially, I’d have a feeling of camaraderie. I was part of this thing, and it felt rebellious.” But the group became associated with unsociable behaviour. “For a while it was funny,” he says, “but I grew out of it in a hurry. The tattoo became an embarrassing memory.”

It took me about five minutes to get it and it is taking over two years to have it removed

Seven years ago, he had the original letters covered with alternating three- and four-leaf clovers, in a nod to his Irish surname (he already had a Scottish lion on his forearm and an Oregon state tree on the other). Cover-up tattoos, as seen in the handiwork of Channel 4’s Tattoo Fixers, are the quicker, cheaper alternative to removal. “I was happy with the clovers,” Fitzpatrick says. “I felt I’d moved past the immature, drunken skateboarding part of my life.”

But he began to notice the clovers would sometimes attract attention in public. While wearing flip-flops, he’d catch people looking at his toes for a second longer than he was comfortable with. He happened to pick up a book about prison life and realised that in the US prison system, the three-leaf clover is an Aryan Brotherhood gang symbol. At first he shrugged it off; he wasn’t likely to be in prison. “Then one day, I was sitting outside a cafe and this big guy walks by, covered in prison tattoos,” he says. “He saw my toes and stopped and turned to look at my feet, then directly at me. I thought, ‘This isn’t good.’” Fitzpatrick decided it all needed to go. “I’d mistakenly put white supremacist prison gang tattoos on my feet: how embarrassing.”

Removal does not come cheap: prices vary, depending on size, ink colours, age and quality of the tattoo. The type of laser you opt for and your skin pigment will affect the number of sessions required; darker skin tones require more work, as do newer tattoos. If Emma Stone decided to remove the birds’ feet on her wrist, with the most modern laser she’d be looking at five to six treatments of around £300 each.

Medical student Sierra Willett, 26, describes the laser as feeling like “hot oil popping on sunburn, while a cat scratches your skin”. Although she quickly adds, “But it’s super-fast. I wouldn’t discourage anyone because of the pain.” She is two treatments away from no longer having to wear a plaster to cover a tattoo on her upper arm.

Dr Garrett Vangelisti at the Untattoo Parlor, Portland. Photograph: Annabel Clark for the Guardian

She talks about how she was raped during her first year at university, aged 19. “The assault was the most traumatic experience of my life,” she says. “I didn’t party at high school, because I was close to my parents and didn’t want to do anything that would disappoint them. So I was excited when I got to college. Then, at the second party I’d ever been to, a friend of a friend drugged me and I was raped. Campus rape is a big issue in the US, and there’s a big self-blame component, where you think you must have done something to make this person think it was OK to do that to you.”

After a long process of counselling and recovery, Willett got a tattoo that read “Carpe Diem”, as a reminder of how far she had come since the attack. “I felt like my body was taken away from me, and the idea of having a tattoo was liberating,” she explains.

Survivor tattoos are common in the US, and are gaining popularity in the UK. After an Oscars performance last year, Lady Gaga and other sexual assault survivors got matching symbols in an act of solidarity. In London last year, the My Body Back Project saw a group of women get tattooed with their own empowering phrases to reclaim their bodies after being raped.

Willett’s tattoo was meant to remind her of her strength. “I wanted to look at it and feel good about all the things I did to get better,” she says, “how I tried to help other girls [who’d been] in my position. I assumed my emotional response would be positive.” But now it reminds her of the assault. “Even though I’m OK with what happened to me, I don’t want to have to think about it every day,” she says. “It feels like I branded myself with a message of what I’d been through. It’s a common thing to do after a traumatic experience.”

Willett is having the words faded at Outside In, a non-profit clinic in Portland, where she also volunteers. The no-frills service helps people in vulnerable situations remove their tattoos, often assisting re-entry to society or work. In the US, such clinics provide removal as a form of therapy. “A lot of people don’t understand why removal should be a social service,” Willett explains. “They think a tattoo is a choice. But for people who have one from gangs or prison, or drug abuse or sexual abuse, the reasons are systemic. We’ve all got a responsibility to help each other change if we want to.”

It feels like I branded myself with a message of what I’d been through

Dr Lesley Segal, a physician, gives her time to the service for free. “Tattoos can be a physical and emotional barrier,” she says. “If you are trying to get a job and it says F–U–C–K Y–O–U across your knuckles, it’s really hard to cover that up. Removal changes people’s lives.”

Willett has given a lot of thought to her own motivations. “When I got it, it was supposed to be because I was healed,” she says, “but it’s removal that’s giving me that sensation. It feels like I’m erasing my connection to that person, to the way they made me feel.”

Dazuqnick Castro was 15 when, to her surprise, her grandmother agreed she could have a tattoo. “I just went for it before she could change her mind,” she says with a laugh, at her home just outside Seattle. “She agreed I could do it on the condition that it was small, but when it came to it, I got overly excited and got this big old huge thing right on the top part of my chest.”

In memory of her mother, who died in a car accident when Castro was a child, she had RIP Niskisha written over her heart. It was peer pressure, she says. “I went to school in a small town in California. When another kid got a tattoo, it seemed they were so much cooler than everyone else. Friends were getting things like Hello Kitty and all these cartoons. It was so fun and exciting.” Her grandmother didn’t agree. “She totally freaked out when I came home,” Castro says. “But I chose my mother’s name because I knew it was something I’d always love.”

Dazuqnick Castro, on her third session of removing a tattoo in memory of her mother, who died when she was a child. Photograph: Annabel Clark for the Guardian

But, like many people, her taste has changed now that she’s 21. A college student and nursing assistant, Castro says she feels “more conservative than when I was younger. Back then, I thought, ‘Oh, cool, I’m wearing a little tank top and I’ve got a big tattoo and I look good.’ Now I feel like it looks a bit tacky. It doesn’t work with my style. It might have been different if I’d had it done somewhere else.”

It was when Castro began preparing for her wedding two years ago that the regret really hit. “I’d been hiding it with clothes and my hair for a while, but the day I tried on my wedding dress and looked in the mirror, I was so upset. There was just this big tattoo on my chest and it didn’t look right.” Come her wedding day, a makeup artist covered it, a trick she said she performed for many brides. “While it worked for that night, I had to do something more permanent.”

Castro is now on her third session of removal and eager to show her progress: once solid, the inside of the letters are mottled, with the ink heaviest on the outlines. “I’m so glad this technology exists,” she says. “In the past, this would have been permanent. I’m proud of myself for going through with it and not just putting up with it.”

I tried on my wedding dress and looked in the mirror: I was so upset. There was this big tattoo on my chest

Her grandmother has been more sceptical. “She said, ‘What do you mean? A laser? You’re going to get burnt!’ But I’ve been sending her pictures of it fading, and she’s happy.” Does it make Castro feel sad that she’s taking away her mother’s name? “I still love the meaning of it, I’m not ashamed of that. But I was practically a child when I got it done. I was figuring out who I am.”

Chanel Jansen, 29, felt doubtful before the needle touched her skin. When she asked for her boyfriend’s name, Rich, in capital letters on her wrist (with the C as the Chanel symbol) the tattoo artist questioned her. “I had every intention of being with Rich for ever, but the woman doing it asked if I knew it was a bad omen to get someone else’s name on your body. She said she’d make it small in case it didn’t work out.”

It didn’t work out.

“When we broke up, it was painful to look at,” says Jansen, a blackjack dealer in Las Vegas. “I was madly in love with him, but he was insecure and I got the tattoo to stop him berating me about proving my love. The relationship broke down when we went to see Marilyn Manson on our first anniversary. He said he couldn’t be with me because I wasn’t the perfect girl for him – he called me a freak for liking weird music. He’s well known in the fitness industry and said I didn’t work out enough. I wish I’d realised earlier that it’s great to be with somebody who’s your opposite, but you should never compromise yourself to appease them – especially not your body.”

Because the ink was less than a year in her skin when she began the removal, it’s harder to shift. “It took me about five minutes to get it and it is taking over two years to have it removed,” she says. She was living in California when she began the treatment and keeps travelling back to the same clinic. “It was important for me to find somewhere I didn’t feel judged,” she says. Every other month, she drives an eight-hour round trip to Dr Tattoff in Los Angeles, part of a popular US chain of removal clinics.

Being a blackjack dealer, Jansen’s hands get looked at and she is asked what “RICH” means. “I try to be brief, because I don’t want people to think, ‘Oh, she was stupid.’ Because I wasn’t stupid, I was in love.” For her, the hardest part of still having the tattoo is dating. “Guys always ask about it. Some have said to me, ‘That’s so tacky.’ It made me laugh when one guy who had a child with a girl he didn’t care about talked down to me for having a tattoo of my ex.”

For Jansen, the tattoo is now “an emotional shackle”. After her first removal appointment, she cried. “Part of it was mourning a relationship I knew I could never salvage. The other part was relief that I was finally free.” One day she wants sleeve tattoos of her favourite films, Labyrinth, Jaws and Star Wars – but she won’t be doing that until she’s at least 40.

None of the people I interviewed said no to more tattoos, suggesting the rise in removal is less a death knell than a trend, more of a “meh” to their permanency. “I’ve forgiven Rich,” Jansen says. “You can’t hold hate in your heart.” If you can tolerate the price and the pain, you no longer have to hold ink in your skin, either.