What is Movember?
Movember is a global movement to raise awareness and funds to support men's health issues to improve health outcomes for men around the world. They provide education, advocacy, and collaborative opportunities to support gaps in men's health with a focus on mental health, prostate, and testicular cancer.
The Australian Society of Dermal Clinicians observes Movember by raising awareness of men's skin health issues.
Since 2003, Movember has funded more than 1,250 men’s health projects around the world, challenging the status quo, shaking up men’s health research, and transforming the way health services reach and support men. (https://au.movember.com/report-cards)
How are you marking Movember and raising awareness about men's skin health this November?
Men's skin - how different is it?
The skin is our largest organ and performs many functions to maintain our health and well-being. During Movember, we will highlight skin health concerns that may have a higher impact on male skin.
The underlying causes of sex-related differences in skin diseases are mostly unknown. Factors such as differences in hormones, behaviors, and environment may all contribute.
The differences presented may assist us with how we approach education in order to tailor our information and treatments to different preferences and needs. However, it is important to note that sex-related differences are not clinically significant and shouldn't drastically alter how we assess or manage the skin. Dermal health professionals always approach skin health in an inclusive and person-centered manner to achieve the best outcomes for each individual.
Anatomical differences
Male skin is thicker than female skin
Epidermal thickness doesn't appear to differ greatly between sexes however the dermis is thicker in male skin and with greater collagen density compared to female skin. While results in studies have been conflicting generally it's accepted that there isn't a significant difference in skin elasticity overall.
The subcutaneous (adipose or fat layer) is thinner in male skin with the structure of adipose tissue comprising smaller adipose lobules and a greater number of fibrous septa. This is thought to contribute to sex-related differences in cellulite
Male skin doesn't thin as much as female skin with ageing.
Skin Health Variables and Male Skin
There have been conflicting results in studies regarding parameters of skin health such as skin pH, transepidermal water loss (TEWL), surface hydration, and sebum between the sexes. This may be due to different areas of the body being studied as well as the impact of cosmetics. Overall there were no significant differences apart from sebum between the sexes.
According to a literature review by Rahrovan et al, (2018), sex-related differences are generally accepted to exert no or only minimal differences in skin pH.
Sebum output is higher in male skin with the appearance of larger pores. These differences are attributed to hormonal differences. It was also noted in a review of the literature that there was a correlation between higher sebum and impaired barrier as well as less use of cosmetics (moisturisers) due to the feel on the skin (Radhrovan et al, 2018).
(Radhrovan et al, 2018; Chen et al, 2010; Dao et al, 2007; Wong et al, 2016)
Sex-related differences in skin disease
Generally, males have a higher incidence of infectious skin diseases and skin cancers than females. However have a lower incidence of auto-immune, allergic, or pigmentary skin conditions.
The most common skin diseases with a higher prevalence among males that dermal health professionals may see due to their higher incidence include:
Acne Fulmicans
Rosacea Rhinophyma
Male Pattern Baldness
There are also several rare skin diseases that have a higher prevalence in males.
(Chen et al, 2010)
Skin Cancer and Men - How do they fare?
UV radiation exposure is the leading cause of skin cancer. According to the World Health Organisation, 1 in 3 deaths around the world resulting from skin cancer are attributed to working under the sun. Men are the hardest hit by these figures.
In Australia, the workplace is identified as a setting where you can be exposed to significant amounts of UVR. In Queensland, it has been estimated that working outdoors can expose you to twice as much UV radiation over a two-day period than those who work or go to school indoors. Outdoor sports have also been attributed to UVR exposure that may contribute to skin cancer development.
A 2014 study reported the outcomes of over 1000 phone interviews with men aged between 18-65 that were identified as working outdoors. This study found that 94% used at least one form of sun protection for more than half their time working outdoors. Protective clothing and hats were the most frequently used. However, only 8% were considered fully protected and used more than four methods of sun protection such as sunscreen, hats, clothing, and wrap-around glasses.
In a recent media release by the Cancer Council, they report that sun-safe behaviors such as seeking shade and using sunscreen are lower among men according to more recent surveys in Australia. Less than 49% of men seek shade to protect against sun exposure and only 29% use sunscreen regularly.
How dermal health professionals can improve sun awareness and early identification of skin cancer?
Educate on the importance of as well as encourage sun-safe behaviors, including using more than 3 protective measures when out in the sun.
Screen their skin regularly if they are coming to see you, as you can see areas they may not be able to.
Educate significant others to assist with monitoring skin health in hard-to-see areas.
Encourage regular medical skin checks.
Resources
Summary
This Movember we raise awareness of some of the skin health concerns and issues that impact on male skin. Anatomical, hormonal, environmental, and behavioral variation noted between the sexes can result in differences in skin care choice and use, as well as minor differences in the skin with age, healing as well as skin problems and diseases.
Dermal health professionals can make a positive impact in the area of male skin health through education, particularly in basic skin awareness and care to reduce the risk of skin infections, ensure optimal skin health, and prevent skin cancer. Monitoring the skin and assisting with referrals to see the right person, at the right time to get the right care can also have a positive impact on skin health outcomes.
Disclaimer
The information in this document is of a general nature only and is not, and is not intended to be advice. Before making any decision or taking any action, you should consult with appropriate accounting, tax, legal or other advisors. No warranty is given as to the correctness of the information contained in this publication, or of its suitability for use by you. To the fullest extent permitted by law, the Australian Society of Dermal Clinicians Inc. (ASDC) is not liable for any statement or opinion, or for any error or omission contained in this publication and disclaims all warranties with regard to the information contained in it, including, without limitation, all implied warranties of merchantability and fitness for a particular purpose. ASDC is not liable for any direct, indirect, special, or consequential losses or damages of any kind, or loss of profit, loss or corruption of data, business interruption, or indirect costs, arising out of or in connection with the use of this publication or the information contained in it, whether such loss or damage arises in contract, negligence, tort, under statute, or otherwise
References
Movember https://au.movember.com/?home
Skin cancer incidence and mortality, Skin Cancer Statistics and Issues Prevention Policy. Skin Cancer Council (2023), https://www.cancer.org.au/about-us/policy-and-advocacy/prevention-policy/national-cancer-prevention-policy/skin-cancer-statistics-and-issues/skin-cancer-incidence-and-mortality#gender
Carey RN, Glass DC, Peters S, Reid A, Benke G, Driscoll TR, Fritschi L. Occupational exposure to solar radiation in Australia: who is exposed and what protection do they use? Aust N Z J Public Health. 2014 Feb;38(1):54-9. doi: 10.1111/1753-6405.12174. PMID: 24494947.
Watts CG, Drummond M, Goumas C, Schmid H, Armstrong BK, Aitken JF, Jenkins MA, Giles GG, Hopper JL, Mann GJ, Cust AE. Sunscreen Use and Melanoma Risk Among Young Australian Adults. JAMA Dermatol. 2018 Sep 1;154(9):1001-1009. doi: 10.1001/jamadermatol.2018.1774. PMID: 30027280; PMCID: PMC6143037.
Australian Institute of Health and Welfare. (2022). Cancer Data in Australia.
Social Research Centre. (2022). 2022 Summer Sun Protection Survey (Life in Australia ™) - Analytical Report. Melbourne, Victoria.
S. Rahrovan, F. Fanian, P. Mehryan, P. Humbert, A. Firooz, Male versus female skin: What dermatologists and cosmeticians should know, International Journal of Women's Dermatology, Volume 4, Issue 3, 2018, Pages 122-130, https://doi.org/10.1016/j.ijwd.2018.03.002
Harry Dao, Rebecca A. Kazin, Gender differences in skin: A review of the literature, Gender Medicine, Volume 4, Issue 4, 2007, Pages 308-328 https://doi.org/10.1016/S1550-8579(07)80061-1
Wong, R., Geyer, S., Weninger, W., Guimberteau, J.-C. and Wong, J.K. (2016), The dynamic anatomy and patterning of skin. Exp Dermatol, 25: 92-98. https://doi.org/10.1111/exd.12832
Chen W, Mempel M, Traidl-Hofmann C, Al Khusaei S, Ring J. Gender aspects in skin diseases. J Eur Acad Dermatol Venereol. 2010 Dec;24(12):1378-85. doi: 10.1111/j.1468-3083.2010.03668.x. PMID: 20384686.
Roberts CA, Goldstein EK, Goldstein BG, Jarman KL, Paci K, Goldstein AO. Men's Attitudes and Behaviors About Skincare and Sunscreen Use Behaviors. J Drugs Dermatol. 2021 Jan 1;20(1):88-93. doi: 10.36849/JDD.5470. PMID: 33400407.
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