Men are more likely to get melanoma than women, and almost twice as many will die from this form of skin cancer. But why the stark difference between genders? We spoke with Natalia Palacio, M.D., an internist and physician on the medical staff at Texas Health Dallas and Texas Health Adult Care, a Texas Health Physicians Group practice, to understand why and to get her tips for how men can lower their risks.

Understanding the Link

Skin cancer isn’t a gender-exclusive disease, yet men tend to get it more often, and have more adverse outcomes, compared to women. While the exact reason that men are more likely to contract melanoma isn’t certain, Palacio believes there may be multiple factors that contribute to the disparity.

“I suspect this is multifactorial, with a lack of education in regard to the skin-sun relationship definitely being one reason,” she says. “Also, historically, men tend to do more outdoor activities than women, and oftentimes without appropriate sun protection. They also tend to seek care later than women as well.”

Since the mid-1970s, skin-cancer rates in both men and women have increased, but the pace is especially astonishing for men, whose rates of developing melanoma have increased 150 percent since 1975.

As Palacio noted, dermatologists believe the disparity can be explained by both behavioral and biological factors, such as the ones listed below.

Behavioral

On average, men typically spend 10 hours more in the sun than women do every week. But all that extra sun time doesn’t usually come with extra protection. According to a study from the Journal of the American Academy of Dermatology, women are more likely than men to wear sunscreen. There may be a few explanations for this; women may be more used to applying lotions and caring for their skin because it’s something that they’re socialized to pay attention to at a young age and predominantly for the rest of their lives.

So applying sunscreen or even remembering to do it may be less ingrained within men. Palacio adds that there are also more opportunities for women to get an SPF boost in products they already use on a daily basis, since many products such as makeup, moisturizer and creams come with sun protection built-in, albeit not enough to forego actual sunscreen.

Another explanation may lie within a lack of knowledge about sun damage and protection. In a 2012 survey by The Skin Cancer Foundation, researchers found that nearly half of the men surveyed said they hadn’t used sunscreen at all in the past year. And as it turns out, even when men do use sunscreen, many don’t use enough; nearly 80 percent of men didn’t know how much sunscreen to use.

Additionally, 70 percent of men didn’t know the warning signs of skin cancer. Most do not know how to perform a skin check either, or how often you should be checking. To make matters worse, most skin cancers don’t have symptoms until later stages. No symptoms can mean no prompt to get something checked out until it’s possibly too late.  

Biological

Beyond behaviors, there are some biological differences between men’s skin and women’s.

“Men have thicker skin with less fat beneath and more fibers that give the skin its firmness (collagen and elastin),” Palacio explains. “It seems that this composition makes men’s skin more susceptible to UV damage which can result in melanoma.”

Small studies also suggest that women’s skin seems to heal sun-damaged skin better than men.

Women also get the advantage of having more estrogen than men, which has been discovered as a potential contributor to an increased immune response against melanomas. People with higher estrogen levels tend to respond better to treatment and have a higher chance of survival. However, scientists discovered this connection exists in both women and obese men, both of whom are more likely to have high levels of estrogen.

How to Prevent Skin Cancer

Thankfully, if caught early, melanoma and most skin cancers have a high cure rate. But you have to take care of your skin, know what to look for, and attend an annual skin check to catch the less obvious signs.

If you don’t like the greasy feel of sunscreen or the “white cast” that can often form on the skin, Palacio says there are quite a few options on the market, particularly for men.

“There are many options out there and one of them will likely feel better on your skin than the others, so you just have to try until you find one you like,” she explains. “For starters, there is sunscreen formulated especially for men’s skin and its particular needs. Whichever sunscreen you choose, however, I would recommend at least SPF 30, broad-spectrum and water-resistant. I personally like Elta MD sunscreen or Neutrogena Ultra Sheer.”

Palacio also recommends regularly checking your skin once a month for anything that may look new or suspicious. She also suggests getting someone to help you with the particularly hard-to-see spots, such as your back and scalp, which also tend to be hotspots for skin cancer in men.

Remember the ABCDE rule:

• A is for asymmetry – Meaning two sides of the spot don’t match
• B is for borders – Look for smooth, even borders around the spot
• C is for color- Look for an even, uniform color throughout the spot
• D is diameter – Anything bigger than 6mm (size of a pencil eraser) should get checked
• E is evolution – Look for any change in size, shape or color from last month

It is also recommended that you see your doctor annually for a skin checkup, similar to your annual exam, but your doctor is only looking at your skin for any suspicious spots and examining those spots with special tools. They can also take samples to be sent off for testing if anything concerns them. Fortunately, just like your annual, it’s covered by most insurance plans.

“A skin check is recommended yearly so you can see a dermatologist and get in the habit to go yearly as you would do with a regular physical exam,” Palacio says. “But don’t be afraid to talk to your primary care physician about your skin health and concerns too.”

If you’re uninsured, the American Academy of Dermatology also offers free skin checks in the spring through the SPOT me® Skin Cancer Screening Program.

Get to know your skin and if you see something that doesn’t look/feel right, seek attention through your dermatologist or primary care provider. Don’t wait or hesitate. And remember to wear sunscreen every day, even when it’s cloudy, and avoid peak hours in the strongest sun.