The tattoos detail their extensive crimes, which include weapon and drug dealing and murder.
But these intimidating men hold their fear over others by running the very prison in which El Salvador has incarcerated them.
The Mara Salvatrucha (MS-13) gang rule Penas Ciudad Barrios, a mini-nation of 2,500 behind the walls of a prison building.
They have a bakery, workshops, hospital and rehab, but the guards stay out of the way, keeping what they can of the peace from outside the gates.
The maximum security prisoners, housed in San Salvador, were captured by Adam Hinton, a photographer from London who was given freedom in 2013 to snap the prison and Las Victorias, the area of San Salvador which their families call home.
Adam explains: "The prison was built for 800 and now houses more than 2,500.
"As you enter the prison you soon realise there are no guards around. They only stay on the outside and let the gang run the joint, which they do very well given the conditions.
"For almost a year now, there has been a truce between the gangs in El Salvador, the MS and the 18 Street gang, or B18.
"As the leaders of MS are mainly incarcerated at the prison, it has become a focus of the negotiations."
Gang violence is a major concern in the country.
From January to August, El Salvador recorded 4,246 homicides, an average of 17.5 a day.
MS-13 by Adam Hinton is published by Paul Belford ltd, £25. More details on the publisher's website and see more of Adam's work here.
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