Yes, we all grow old, but that doesn’t mean resigning ourselves to a future of wrinkled, spotty visages. All you have to do is look at your behind — assuming you don’t sunbathe in the nude — to get an idea of what your skin might look like if you had spent a lifetime shielding it from the elements.

Patsy Colvin, a dermatology physician assistant at the Kenner Dermatology Center, said medical literature is full of examples of sun-savvy individuals and cloistered nuns "who have skin like baby bottoms, even at age 90."

According to Colvin, late summer is when dermatology offices see more patients coming in, hoping to erase the effects of increased time under the sun.

"During the summer months we get distracted. People are out relaxing, women aren’t wearing as much makeup, sometimes they forget to put on sunscreen. There’s a lot of damage that comes up with being outdoors and enjoying life."

Colvin is sympathetic, saying she got complacent while at Kailua Beach under an umbrella on a rainy day. "I got a beet-red sunburn on the top of my legs. I had sunscreen on my arms and face but got lax and didn’t consider the rays coming through the clouds. It was a really good lesson for me because I’m a professional. We’re not supposed to get burned."

Chief complaints from patients are sunspots, white spots, crepey skin and uneven tone. The culprit: ultraviolet radiation.

There are two kinds of ultraviolet radiation. UVB causes sunburn and is associated with causing skin cancer and malignant melanoma. Although UVA does not cause sunburn, these rays penetrate deeper into the skin and can lead to DNA damage, eye damage and skin cancer. On the UV index, Hawaii measures at 7 (very high) at about 10 a.m., with levels rising as high as 12.9 (extreme) by noon. Broad-spectrum SPF products can protect against both types of radiation when properly used.

Although deep-tissue damage might not surface for years, the immediate effect of exposure means "skin is much rougher. It’s dehydrated, it doesn’t glow and is not the fresh skin you might wish you had," Colvin said.

The good news is that the most common problems can be remedied with a dual strategy of repair and protection against future damage.

Without even setting foot in a dermatologist’s office, the best way to get started is to wear an SPF30 formula every day.

"The time to apply it is after your moisturizer goes on and before your makeup, and don’t forget your neckline to bra line and the back of your hands. That’s where the most damage shows because those are exposed areas that most people don’t think about," Colvin said, adding that sunscreen should be reapplied every two hours. Those at work can use mineral powder SPF for easy brush-on application that won’t mess up one’s makeup.

She also suggests wearing a broad-brimmed hat and UV-filtered sunglasses, and assures, "It’s never too late to get started. You can undo damage, even if you’re over 60."

Be aware of medicines and other products you are using that might increase photosensitivity. These include lactic, glycolic, salicylic and kojic acids, licorice extract, benzoyl peroxide, hydroquinone, Retinol, antibiotics and antihistamines.

Undoing damage might start with topically applied antioxidants available through dermatology offices.

"Ultraviolet light destroys molecules in the skin, and these products contain ingredients like vitamins A and C that help to repair damage."

Some of Colvin’s favorite medical-grade products, offered at her center, include the Environ C-Quence line of vitamin-filled products, and the NIA24 line of niacin-based skin care.

Exfoliation helps the skin absorb products better, and for those already familiar with the Clarisonic brush, she suggests upgrading to a medical-grade Clarisonic, which is more powerful than its commercial versions in removing dead skin, excess oil and makeup.

For more serious damage, consultations with a dermatologist will determine a proper course of treatment, whether chemical peels, microdermabrasion or IPL (Intense Pulse Light) photo facials.

"Not everyone is a good candidate for the various treatments, so you need someone trained in dermatology to sort it out," Colvin said. "Asian skin is prone to brown spots and medical melasma. The wrong lasers can make that worse.

"For people with melasma or IPLs, fractional lasers are generally not advised. This is because the response of the pigment is unpredictable in these types of skin. In response to those lasers, pigment can become darker or lost, producing white spots, scars or other disfiguring results. Those types of nuances may not be pres­ent in fairer skin, so the exact same treatments may be used with excellent results.

"Also, some body parts are much more prone to scarring and pigmentation problems than others. It’s important to know when to turn the laser down and when not to use it at all.

"Unfortunately, most dermatologists have a few patients who come to them for help after getting bad results from inexperienced practitioners."

With the proper care and treatment, she said, individuals should see changes in a month. "You can’t undo a lifetime of damage in a day. It requires consistency and forming a habit. Just like brushing your teeth every day, adding sun care needs to be an extra step that you do every day."

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The Kenner Dermatology Center is on the grounds of Castle Medical Center, 642 Ula­ka­hiki St., Suite 104. Call 263-3233.