Every morning I apply sunscreen, always to my face and usually to any other exposed skin too. Vanity drives my habit more than fear of skin cancer, but that vanity is going far to keeping my skin healthy — especially as a Florida resident.
But the same can’t be said for my husband.
Despite having a partner who writes about skin care and speaks enthusiastically about sunscreen, he doesn’t wear sunscreen daily. But he, along with other men, have good reason to start: Males are significantly more likely than females to die of melanoma, according to recent Centers for Disease Control and Prevention data. Among white people, who experience much higher rates of melanoma than people with other skin tones, males died of the cancer at more than twice the rate of females.
Lian Mack, a board-certified dermatologist and the medical director and owner of Gramercy Laser and Medical Dermatology, sees a disparity firsthand in her New York City and Scarsdale offices. “The number of women presenting to our offices for skin checks far exceeds the number of male patients,” she said, noting females in their mid-20s to late 50s make up the predominant demographic.
This same pattern is repeated elsewhere too. “Men seem to need a lot more coaxing to be seen in the office for skin checks,” said Luke Maxfield, a board-certified dermatologist. “Every year I have at least two or three men who are dragged into the office by their spouses only to have me confirm the diagnosis of melanoma. Literally, spouses often save men’s lives,” he said.
Delaying skin checks or forgoing them altogether means that problematic moles or spots may not be caught until later stages when melanoma’s survival rate begins to decrease, which can explain some of the increase in death rates. While skin cancer is more common in light skin, delaying skin checks is problematic for people of colour: Those with darker skin who are diagnosed with skin cancer often have a worse prognosis because it’s caught at a later stage.
Forgoing skin checks isn’t the only factor. Behaviour, lifestyle and even the locations of cancerous lesions make a difference.
“Women are more likely to wear sunscreen, more likely to stay out of the sun, and young women are more likely to have done a self-examination looking for skin cancers and also much more likely see a doctor for anything concerning,” Maxfield said. “These tendencies are extremely important given that more than half of melanomas may be first noticed by people examining their own skin at home.”
Without proper self-examination, those concerning spots can be hard to find and treat, especially in hard-to-see areas. “In males, most melanomas occur in areas that they are unable to monitor, like the shoulders or the back,” Mack explained, and without a partner to point it out, major delays in treatment can occur.
There may be biological factors, as well. Even when comparing melanomas of similar thickness and location between men and women, the men still fared worse. Levels of testosterone may play a role, but the science is still out on why exactly this is. “The story seems much more than just hormones, and there seems to be a biological role we have yet to discover,” he said.
Given the science, why aren’t more men wearing sunscreen? When used properly, sunscreen has been proven to reduce the risk of both melanomas and other types of skin cancer. But while many people may apply sunscreen when heading out to a day at the beach, making it a daily habit is essential since UV exposure is cumulative over time. “Most of my male patients need to be educated on the importance of sunscreen and the role that its use plays in the prevention of skin cancer and early aging. Most men simply do not believe that they need sunscreen if it is cold out or overcast,” Mack said.
It’s also not the easiest product to work with. Some sunscreens can leave behind an uncomfortable stickiness or a white cast on the skin. “My skin-of-colour patients often struggle with the cosmetic elegance of sunscreen,” Mack said, explaining that some can leave behind a greyish-blue tone.
Since the effects of UV radiation damage don’t show up right away, it can be hard to connect time in the sun to any serious effects. And unlike women who use sunscreen to prevent premature aging, men often don’t share the same motivation, Mack explained.
Making sunscreen a daily habit — even if it’s cloudy — comes down to just one thing: choosing a sunscreen and applying it. “The best sunscreen is the one you use,” Mack said, repeating a quote oft-given by dermatologists.
For face, a cream sunscreen of SPF 30 or higher is ideal, applied daily after cleansing and moisturising (skipping moisturiser is OK if it’s not needed). Applying enough is important to get full coverage — Mack recommends the two-finger method. Apply a streak of sunscreen to two fingers from base to tip, and apply generously. “I tell my patients to put some of that product on their ears and neck as well,” Mack said.
Don’t forget to apply sunscreen to the body, especially if you’ll be in the sun during the day. “If you are going to be at the beach and applying sunscreen to your body, you should apply at least 2 ounces or the size of a shot glass to the entire body 20 minutes before sun exposure and reapply every 80 minutes,” Mack said.
Think about your lifestyle when choosing a sunscreen. “Moisturisers with SPF do double-duty to hydrate and protect the skin while also providing sun protection. Tinted sunscreens can help them blend with darker skin tones as well as protect from visible light and protect skin from dark spots. And if you are an active person, make sure you are getting something water-resistant,” Maxfield said.
There is good news: Despite bleaker statistics for men, knowledge and prevention can go a long way. “Take control of what you can,” Maxfield said. “Know your risk factors. These include sun exposure, having multiple moles on your body, or a family history of melanoma,” he said. Outside of seeing a dermatologist, self skin checks can be lifesaving. “Check yourself for moles that have multiple colours or irregular borders, those larger than a pencil eraser, or any changing moles, and make sure you seek out a dermatologist if there is anything concerning,” Maxfield said.
And of course, wear sunscreen.