In her tiny Hanoi apartment, tattoo artist Ngoc inks middle-aged women whose lives have been upended by divorce or illness, each of them searching for healing through an art form that is still largely taboo in Vietnam.

Although attitudes are changing, tattoos remain associated with gangsters, prostitution and the criminal underground in the country.

"I met many women who told me they loved tattoos but they were born at a time when no-one supported them," Ngoc, who goes by the name "Ngoc Like", told AFP.

But some are choosing to push back against those old ideas, seeing body art as emancipation from some of the rigid societal norms they have lived by.

Getting inked is often a landmark moment in these women's lives, Ngoc, 28, says.

"They have overcome that fear of social prejudice and have a personal wish to renew themselves... to open a new chapter in life."

Educated and business-savvy, Ngoc was ridiculed when she started out as a tattoo artist less than a decade ago -- with many assuming she did not go into the industry out of choice.

But she has since built up a solid, mostly female clientele.

"Being a tattoo artist, I have had to accept the fact that people dismiss my skill, my studies, my personality... They say: 'You do this because you did not get good grades'."

'Strength and confidence'

Just four percent of Vietnamese have tattoos, according to a small survey in 2015 by Vietnam market research firm Q&Me, the most recent data available.

It also suggested that 25 percent of people "feel scared" when seeing body art.

But for Tran Ha Nguyen, a high school teacher, getting a tattoo was an act of celebration following a divorce from her "conservative and rigid" husband.

"My ex strongly opposed any tattoo on my body," she recalled. "I on the other hand had been afraid I would lose my job if I had something visible."

After the separation, the 41-year-old told AFP she wanted a clean break from her old self and to do things she would never have dared do in her previous life.

She chose a daisy design for her thigh, high enough that no-one can see it unless she is in a bikini.

"It's just one small tattoo but I feel I have found my true self," Nguyen said.

Also recovering from trauma, 46-year-old Nguyen Hong Thai chose a rose tattoo over a scar on her stomach, and the words "forever in my heart" on her arm, months after her husband died of lung cancer.

He had always wanted her to get inked.

"Now he's gone, I think he would have wanted me to be strong, to be the person I had always been with him."

"The tattoos have given me strength and confidence (to do that)", said Thai, with a huge smile.

'I live for myself'

Ngoc has decided to focus her tattooing work on women with scars, both physical and mental.

Demand is growing -- her schedule is completely full, she says.

Her clients in Hanoi, where average monthly income per capita is less than $500, are often willing to spend double that amount on their body art.

One of them, 33-year-old office worker Huong -- not her real name -- has felt ashamed of her body since appendicitis surgery 14 years ago left her with an "ugly" vertical scar.

"I considered going to a clinic to see if they could get rid of the scar.

"But then I thought: why can't I have a tattoo to hide it?"

Her eyes shut tight in anxiety, Huong lies on the chair, waiting for the needle to begin its march across her midriff.

This "is not just about beautification... The beauty here is giving a woman the chance to be herself," says Ngoc.

Hours later, looking in the mirror at a string of pink flowers across her stomach, a grin breaks out over Huong's face.

"I was afraid if (my family) saw this big tattoo, they would think I was a party woman.

"But the most important thing is I live for myself. If I can lose the shame around my scar, life gets more interesting."

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