Brauer, a clinical associate professor of dermatology at NYU Langone Health, said he was stunned.
“I said to him, ‘You’re exemplifying a huge part of the problem for men when it comes to skin cancer.’ There’s just a huge disconnect in men’s perception of the sun and sun damage and skin cancer,” said Brauer, who practices dermatology in Purchase, NY.
In 2023, according to the Skin Cancer Foundation, 97,610 cases of invasive melanoma were diagnosed in the United States; of those, 58,120 were males, 39,490 females. Of the 7,990 people who will die of melanoma, 5,420 are men.
A fast-growing cancer, melanoma can spread to blood vessels and lymph nodes and attack other organs, according to the Skin Cancer Foundation.
What makes men so vulnerable to melanoma, the deadliest form of skin cancer?
Some studies suggest that men’s skin antioxidants may not be preserved the way women’s skin looks, which can increase the risk of skin cancer. Others suggest that women higher estrogen levels may offer skin protection. But men like Brauer’s patient show behavioral effects.
Surveys show that men know less about skin cancer risks than women and because of this more likely to use sunscreen.
Dawn M. Holman, a behavioral scientist at the Centers for Disease Control and Prevention, has studied sunscreen use in the United States. “About half of women say they use sunscreen regularly when they spend time outside on a sunny day while only about a quarter of men say they do,” she said. “And more than 40 percent of men say they don’t use sunscreen when they’re out in the sun.”
“Some men may actually see using sunscreen as more of a feminine behavior,” Holman adds.
Men know nothing about sun damage
Men are more likely to work and play outside than women, says Ida Orengo, professor and chair of dermatology at Baylor College of Medicine in Waco, Tex. “Thus, they tend to get more cumulative sun exposure throughout their lives.”
Men also seem to know less about the dangers of the sun. Fewer males than females gave the correct answer to a Survey of the American Academy of Dermatology on sun exposure and the risk of cancer.
Men are more likely to believe that you can have a healthy tan (all tans indicate sun damage, says Orengo), a “base tan” can protect you from the sun (not it can be), and you won’t get skin cancer in out-of-the-way spots like skin between your toes (You can do it).
One of the best ways to prevent skin cancer is to avoid the sun, experts agree. But if you’re going to spend time outside, protect yourself. Lotion, cream, stick or spray sunscreen can be applied in many ways. Find something you like and use it, says Orengo.
Cover all exposed skin, says Holman, including your ears and the back of your neck. Reapply every two hours or when you get out of the water or sweat. And if you’re a hairy guy, be sure to carefully rub in the sunscreen, says Stacy P. Salob, clinical assistant professor at Weill Cornell Medical College. Don’t rely on hair to protect your skin.
Holman adds that sunscreen isn’t enough: Stay in the shade when you can, and wear a hat and sunglasses. You should also avoid the sun’s strongest rays: If your phone’s weather app there is UV index, consult it, says Holman. Avoid outdoor activities in the middle of the day when the index is above five. If it’s 11 or higher, stay indoors.
Finally, consider UV protective clothing. “I’m a fan of sunscreen,” says Salob. “It offers the equivalent of a 50 SPF and you don’t have to wear sunscreen for the whole big part of your body. And then you don’t need someone else to put it on your back.
Another challenge for men is that they often get melanoma on their backs and the top of their heads, places they can’t see. The result, men often miss changing moles that is the sign of melanoma. That might explain why some studies show that men with partners have earlier melanoma detection — and healthier outcomes — than single men.
Brauer says a lot of male patients come in with “pencil things all over their body. Their spouse or partner is paying a lot of attention to them, which is great.
Dermatologists would rather reassure you that you’re fine than discover a melanoma too late. “We’re good at treating melanoma when we catch it in the early stages when it’s just in the skin,” Salob said. “And it’s scary to lose when it spreads inside the body. So early detection is key.”
One of the biggest risk factors for melanoma is previous sunburn.
“If you’ve had even one of your sunburn blisters, that automatically puts you in the higher-risk category,” says Salob, as does having blonde or red hair, blue eyes, fair skin and more 50 moles on your body. It may be hard to believe, but a sunburn you suffered in your youth could be responsible for the skin cancer you develop in your 50s. Every time you burn, you increase your risk. And according to Holman studymore than one-third of Americans say they’ve had a sunburn in the past year.
In addition, while white men are more likely to be diagnosed with melanoma, Black men are more likely to die once diagnosed with it — perhaps because their diagnoses tend to be at a later stage.
“When you get sunburned, the ultraviolet light enters your skin and damages the DNA in the skin cells,” Orengo said. “Then your immune system gets in there and says, ‘Oh my gosh, we’ve got to repair this damage before the cancer starts,’ the immune system repairs the damage. That can happen over and over — until you reach your 40s, 50s and 60s is when your immune system naturally starts to become less effective. When DNA is damaged again, your immune system can’t repair it, and cancer grows.”
To ensure early detection, see a dermatologist for annual skin cancer screenings.
In between, says Brauer, check in with yourself. He recommends standing naked in front of a full-length mirror once a month. Scan your body, and grab a hand mirror to look at your back. Look for anything “new, changing or unusual,” says Brauer, and if you find it, consult your physician.
The ABCs of protecting yourself from melanoma
An ABCDE guide was developed by dermatologists to help patients identify melanoma on their bodies:
Asymmetry: A melanoma lesion is often oddly shaped
Border: It has an irregular border
Color: It comes in different colors
Diameter: This is usually 6 millimeters in diameter, about the size of a pencil eraser
Evolving: It changes rapidly in the skin.
