When she was a kid in the 1970s and ’80s, fair-skinned Cherie Altsman spent as much time as she could in the sun. Whether on vacation in Florida or the Caribbean, or during lazy summer days in her home state of Ohio, the 53-year-old real estate agent lived for the chance to turn her skin a darker tone. More often than not, however, those hard-earned hours of sunbathing led to sunburns and, today, she lives to regret that unprotected time in the sun.

Whether too much sun worshiping, binge drinking in college, or youthful trysts with partners barely familiar, this is the age when your past can come back to haunt. In spite of warnings back in the day from well-meaning adults, the inability to believe that current behaviors can have future harm is, well, often behind the harm. Youth is wasted on the young.

“Earlier on, you could somewhat get away with neglecting your doctor’s visits and tests, but at this stage, there can be long-term repercussions from earlier behavior.”
–Dr. Meggie Smith

The good news, however, is that, in most cases, you can mitigate or still prevent some of the damage from your younger days, says Dr. Meggie Smith, a reproductive fellow at University of Southern California. “As you move into your 40s and 50s, you reach the time of life where you have to do some preventative maintenance in the form of screenings,” she says. “Earlier on, you could somewhat get away with neglecting your doctor’s visits and tests, but at this stage, there can be long-term repercussions from earlier behavior.”

While much of your riskier behaviors might have fallen into one category — say the sunbathing Altsman now regrets — it’s important to set routine screenings in motion across the board.

The annual check-ups you need

It was a screening that allowed Carol Weis to dodge a bullet. The middle-aged Massachusetts-based children’s author says that a Pap smear caught irregular cells just in the nick of time. “I contracted HPV from one or more of the many one-night stands I had in my 20s,” she says, “when I drank too much and behaved recklessly.”

The result of her Pap showed “class four” cells, one stage before cancer. Weis had a follow-up biopsy to remove any of the errant cells, which her physician considered successful. According to USC’s Smith, most people are exposed to HPV at some point in life, making screenings like Pap essential. “It’s sort of like the common cold,” Smith says, “but as we age, the body doesn’t clear it as easily and that can lead to cervical cancer.”

A Pap smear for women, along with annual OBGYN visits, should be your norm, Smith says. “If you’ve got one-night stands or incidents of unprotected sex in your history, the possibility of having contracted a sexually transmitted disease is there,” she says. “Some of which can lead to longer-term consequences.”

Then there’s the overexposure to sun from earlier years, making regular visits to the dermatologist a must. Altsman began seeing one annually in her 30s due to her history, skin tone, and a high number of moles. “In that time I’ve had about four moles removed,” she says. “In the past few years, I’ve also had several pre-cancerous spots on my face, which the dermatologist has treated.”

Smith says that, with skin, it’s important to know your family history and to be familiar with your body’s markings. “If you see something new or a change, it’s easily treatable when discovered early,” she says. “But if you aren’t diligent or getting screenings, and it turns out to be melanoma, it can be deadly.”

Even if you abused the sun in your younger days, you can still help minimize further damage by avoiding harmful rays in mid-day when they’re at their strongest, and wearing hats and sunscreen when outside. Altsman says she’s far more diligent today than in the past, and that some of the reason for this is also cosmetic. “I know I have more wrinkles than I would have if it weren’t for all the time I spent in the sun,” she admits. “Your face is what people see first; I worry I look aged beyond my years.”

Smoking and drinking

Smith says understanding potential fallout from heavy drinking in youth is also important. “For women, there’s evidence that binge drinking can be linked to breast cancer down the road, so, again, regular screening is important,” she says. “There’s also the risk of liver damage.”

Past cigarette smoking is another big one to keep in mind. “Once you quit, you lower your risks, but you could have lung damage and/or lowered sperm counts if you’re male,” Smith says. “And smoking and vaping lead to faster skin damage too.”

With the right set of screenings in the mix, you’ll hopefully be able to outrun your former indiscretions. One thing you might not escape, however, is regret. Says Altsman: “I definitely wish I had listened and been more careful.”

Amanda Loudin is an award-winning journalist whose work appears regularly in the Washington Post, NBC, Outside, and many other outlets. You can find her on her website and Twitter.

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