A small team of doctors and nurses gathered on the fourth floor of Kaiser Permanente’s San Leandro Medical Center on a recent Saturday morning to turn back time. Led by Akhil Wadhera, a Kaiser dermatologist, the team prepared the time machine they’d be operating—a MedLite C6 laser. Down the hall, people sat quietly, waiting their turn to erase vestiges of their past.

It was the San Leandro opening of Project New Start Tattoo Removal, a program that provides free tattoo removal to youth between the ages of 13 and 25. Project New Start has two programs in the East Bay. Their Oakland-based program is funded and operated under the County Public Health Department serving North County residents. Their other program, which serves South County residents, is funded by Kaiser Permanente’s Community Benefit Program in the Greater Southern Alameda Area.

The majority of Project New Start participants live in Oakland. Although the program does not offer services exclusively to former gang members, “the high prevalence of gangs and growing ethnically-based gang violence in Alameda County, especially in Oakland and Hayward, has kept the need for tattoo removal constant,” according to a 2011 Alameda County Health Department report on the New Start program.

The New Start program, a collaborative partnership between Eden Youth and Family Center in Hayward and Kaiser Permanente, was founded in 1994 to help young people remove the stigmatized markings of their past. The youth must engage in a mentorship program, complete 50 hours of community service, and enroll themselves in activities like employment, education and vocational training.

Two out of three youth in the Alameda County Juvenile Justice System showed an interest in removing their tattoos and “expressed great frustration and paralysis regarding the stigmatization they were experiencing when applying for jobs or inquiring about educational programs,” said a report by the Alameda County Health Department in 2011. Despite attempts by these young people to move forward with their lives, gang or drug related tattoos “acted as a deterrent for prospective employers and warning signs, past and present,” the report said.

Now in its 20th year, Project New Start runs 18 tattoo removal sessions each year in donated spaces at Kaiser hospitals in Hayward, Fremont, and San Leandro—six clinics at each of the three locations. The clinics, held on Saturday mornings, operate on a first-come, first-served basis and typically draw between 20 and 30 participants.

As Dr. Wadhera prepped the procedure room, Briana Greer played on her phone and waited for a numbing cream to take effect. Greer was 15 when she got the first of several tattoos. Now, at 22, she was ready to remove the ink from her teenage years. “I’m just over them. I’m sick of looking at them every day,” Greer said. “It’s time to get rid of them and move on.” In exchange for the tattoo removal, she fulfilled the required 50 hours of community service working with a program that runs support groups for victims of domestic violence.

Nearby, 23-year-old Marlene Tovar sat waiting with her 1-year-old son bouncing on her lap. “I got this when I was 18,” she said, pulling back her hair to reveal a large tattoo of a zodiac sign surrounded by stars on the left side of her neck. “I didn’t really realize how big it was going to be. Now, career-wise, it’s really hard out there to get a job with this thing on my neck. It’s the first thing people see.”

Electing to have a tattoo removed is not a casual decision. Removal is a lengthy and often painful procedure that requires months of commitment. Laser treatments target the tattoo pigment, causing it to break up into fragments. Then gradually, over the course several weeks, the body’s white blood cells migrate to the site of the tattoo and remove the pigment fragments, causing the image to lighten over time. Patients undergo four to fifteen laser treatments over several months or years, depending on the size, quality and color of the tattoo. Green and yellow inks often require more treatments, while black and blue are easier to remove. Removing a tattoo also can be incredibly uncomfortable. Participants describe it as a burning sensation, or like a rubber band being snapped again and again against their skin.

“I’d say the removal is 10 times more painful than getting the tattoo; it’s the worst,” Tovar said after attending several removal sessions. But the New Start staff help take the edge off, she said. “Even though it’s a pain, I’m so thankful for this program. I’d never be able to afford the treatment otherwise. And these are really good people working here. They make you feel comfortable.”

All medical staff who work at the clinics are Kaiser employees who volunteer their time. For these volunteers, the lengthy removal process provides an opportunity to get to know the participants.

“As you perform the laser removal you’re causing the participants pain, and it causes you to enter into an intimate, therapeutic relationship,” said Jed Weissberg, a physician who volunteered at New Start’s Fremont clinics for 11 years before retiring from Kaiser. Weissberg said he found it gratifying to watch the participants transform over the course of their many treatments.

“I would get to see them mature a little more each time they came in,” he said. “Some people found religion, some people found work, some people found more stable living situations—it was wonderful to see that transformation.”

As the participants waited to be called into the procedure room, New Start team members Javier and Julian Jimenez sat at the entrance of the clinic, warmly greeting arriving them with handshakes and fist bumps. Javier, 36, and Julian, 39, operate New Start’s youth outreach team. As they watched people trickle in to the clinic, the Jimenez brothers could imagine how the arriving participants were feeling.

“That was us just a few years ago,” Javier said.

The Jimenez brothers grew up in Newark, in southern Alameda County, in a neighborhood riddled by violence and addiction. By the time they were teenagers, the boys were headed down a destructive path.

“When I was a kid, everything my brother did, I did too,” Javier said. “Selling weed, getting tattoos, doing drugs, guns, sex, gang stuff. It all started when we were super young,” Javier said. “Both of us ended up going to prison at a young age.” The brothers continued drug and alcohol abuse and gang activity well into their twenties. By the time he was 27, Javier had spent more than six years of his life in California prisons.

But their father’s death in 2003 served as a wake-up call. “Our dad died as a direct result of drinking and his lifestyle,” Javier said, “and after he passed that’s definitely when things started to change.” Soon after their father’s death, Julian enrolled in a recovery program and began to turn his life around. As his recovery progressed, he reached out to his younger brother, hoping to help him along a similar path.

“I was in prison at the time,” Javier said, “and my brother came to visit. He told me he was in recovery—he was clean and he had a job and was getting married. ‘I’m living the dream now, man. Let’s do this together,’ he told me.” But Javier was dubious. “I thought he was crazy for getting clean. I was so deep into the gang and drug stuff back then that I didn’t know there was any other way to live. No one in our world had ever been successful. But Julian told me I could do it. He said ‘We can do this together. I’m going to love you until you learn to love yourself.’”

That visit started Javier on the long road to recovery. After completing his prison sentence, Javier enrolled in a treatment program where he got clean. Soon after, he began to do outreach work throughout Alameda County to promote positive change in communities with high rates of gang and drug activity.

But as Javier threw himself into outreach and prevention work, he discovered that the gang-related tattoos on his face and neck were hindering his efforts. “I was trying to make a difference with these people I was working with, but I still had all these reminders of my past on my face—that’s the first thing anyone would see,” Javier said. In 2008 he turned to New Start, a program his brother had already begun. “By going through this program and removing the tattoos on my face, I was able to help more people.”

Today, Javier and Julian share their personal stories with incoming New Start participants. “We’re here to help show them the way. These guys might be like us and not have a model for success,” Julian said. “We can show them it’s possible to come from where we come from and make it out. We come here to spread the message of hope.”

Beyond offering support during the clinics, the Jimenez brothers offer support to participants between removal sessions, checking in regularly to see how they’re doing and reminding them to stick with the program.

“These guys really know how to network with our participants,” said program coordinator Cindy Santiago. “They text them, call them and stay in contact with them throughout the tattoo removal process. They really engage with the participants. They build strong relationships and the participants open up to them.”

Santiago is herself a New Start graduate. After completing the program in 1999, she was immediately offered a job. “I did my service hours with the former program coordinator,” Santiago said. “When I was done, the coordinator said, ‘I just put in my two-weeks notice, and I told my boss that you should take over for me—you’ve done great work.’ At the time I was a housewife trying to remove tattoos so I could make a lifestyle change. Then all of a sudden I ended up with a job. It was amazing.”

For Santiago, the Jimenez brothers, and the hundreds of other New Start graduates, removing the physical traces of their past was an essential step on the path toward a successful future. “We’re so blessed to be where we are now,” Javier said. “My brother has been clean for 11 years now. I’ve been clean for 9. We’ve finally broken the cycle. I’ve got a beautiful family. Julian has a beautiful family. My kids have never seen me high; they never will. My brother showed me the way. I’m living the dream now, too.”

As Project New Start moves in to its third decade, the program organizers are focused on meeting a new set of goals, including expanding case management and counseling to provide quality health services for their participants; ensuring successful transitions to schools and jobs; building their health and wellness programs to make them more than a tattoo removal program; and increasing accessibility and outreach in the community.

Back on the fourth floor of Kaiser’s San Leandro Medical Center, participants finished their treatments and filtered out into the sunny day, their tattoos carefully covered with sterile dressings. Santiago watched the young men and women leave.

“It’s so rewarding to see the transition these people go through,” Santiago said. “Their tattoos used to tell a story. Now the removal process tells a new story.”

This story was updated on October 29 to correct the spelling of Dr. Akhil Wadhera’s first name and the locations of Project New Start’s programs.