The tattoo can have several meanings. In the United States, it can signify that the wearer has killed someone. Alternatively in Mexico, the number of teardrops may indicate the number of times the wearer was raped while in prison. It may also indicate the wearer has been imprisoned or indicate the loss of a loved one or fellow gang member.
According to The Devil's Front Porch, a book written by Lester Douglas Johnson about serving 1927 to 1957 in Kansas State Penitentiary, the tattoo denoted a member of "The Old Fraternity", referring to the Biblical Cain who slew his brother.
It is sometimes worn by the female companions of prisoners in solidarity with their loved ones.
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