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Recognizing that visible tattoos serve as barriers to successful integration within school and the workplace, programs providing tattoo removal began appearing in the 1990s. Studies examining the efficacy of gang-affiliated tattoo removal suggest that such processes can help former gang members complete their integration into mainstream society. The present study examines case files of youth participating in the Clean Slate Tattoo Removal Program. We examine the reasons youth have for acquiring and ultimately deciding to remove their visible tattoos, their perceptions regarding how others perceive their visible tattoos, as well as their perceptions about themselves. Preliminary analyses indicated that participants were aware of the negative stigma associated with visible tattoos and believed that other people attributed internal negative characteristics to them. This assessment contrasted drastically with participants’ self-perceptions. Instead of internalizing the perceived negative labels, participants appeared to maintain positive self-images and desire to integrate into the mainstream society.