Men’s Attitudes and Behaviors About Skincare and Sunscreen Use Behaviors

January 2021 | Volume 20 | Issue 1 | Original Article | 88 | Copyright © January 2021


Published online December 8, 2020

Courtney A Roberts MSPHa,b, Elianna K Goldstein c, Beth G Goldstein MDd, Kristen L Jarman MSPHe, Karina Paci MD MBAa, Adam O Goldstein MD MPHe,f

aUniversity of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
bUniversity of North Carolina at Chapel Hill, Eshelman School of Pharmacy, Chapel Hill, NC
cVenture for America Fellowship, St. Louis, MO
dUniversity of North Carolina at Chapel Hill, School of Medicine, Department of Dermatology, Chapel Hill, NC
eUniversity of North Carolina at Chapel Hill, School of Medicine, Department of Family Medicine, Chapel Hill, NC
fUniversity of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, NC

Abstract
Importance: Skin cancer is the most common cancer in the United States, and men experience higher rates of skin cancer than women. Despite publicized preventative measures, men are less likely than women to use sunscreen.
Objective: To assess men’s motivations, behaviors, and preferred product characteristics towards daily sunscreen use.
Design and Setting: Cross-sectional online survey of 705 men, administered July– August 2019, using Survey Monkey and distributed through Amazon Mechanical Turk.
Participants: Men ages 20–70, having completed at least High School/GED, and living in the United States were eligible. Sampling strategy ensured diversity in terms of race, ethnicity, and sexual orientation.
Main Outcome(s) and Measures: Men’s sunscreen use, behaviors, and preferred skincare product characteristics.
Results: Final participants included 705 men. The most frequent skincare products used regularly were liquid soap/body wash (65%), bar soap (47%), and moisturizers (32%). Most men (n=612; 83%) reported not using sunscreen daily, and 38% reported using sunscreen weekly. Income was related to daily and weekly sunscreen use, as males who earned between $40–$50,000 annually used sunscreen less often compared to people who earned $100,000 annually (OR 0.54%, 95% CI −0.34% to .88%; P = .01). Age, sexual orientation, race, ethnicity, and region were not related to daily or weekly sunscreen use. Main motivators for daily sunscreen use included reducing skin cancer risk (n=575; 82%) and looking younger (n=299; 42%).
Conclusions and Relevance: This survey shows lapses in evidenced-based sunscreen behaviors to reduce skin cancer among men. Campaigns to reduce skin cancer should focus on increasing men’s interest in daily sunscreen use and adherence to wearing sun-protective products.

J Drugs Dermatol. 2021;20(1):88-93. doi:10.36849/JDD.2021.5470

INTRODUCTION

Skin cancer is the most commonly diagnosed cancer in the United States. More than five million Americans are diagnosed annually, and 20% will develop skin cancer by the age of 70.1,2 While non-melanoma skin cancers (NMSC) such as basal and squamous cell are more common, men, regardless of race and ethnicity, are disproportionately affected compared to women, developing both melanoma and NMSC at higher rates. Research shows that men are more prone to UV-induced immune suppression, and their skin does not respond as well as women to environmental stressors like UVR.3,4 The American Cancer Society predicts that men will fall victim to 60% of new skin cancer cases (excluding NMSC) and will comprise near 70% of death from these cancers in 2019.1 In 2020, >100,000 new cases and 6,800 deaths will likely occur from melanoma in the U.S..5

Most melanoma cases are preventable through reduced sun exposure, including avoiding indoor tanning and applying broad-spectrum sunscreen with a sun protection factor (SPF) of 30 or greater, wearing protective clothing, seeking shade, and avoiding midday exposure.1 In 2014, the Surgeon General called for increased public awareness and preventative skin cancer measures. Despite these efforts, men are less likely than women to use sunscreen.6

Although prior literature exists examining general consumer preferences regarding7,8 and motivations for use,9 limited research focuses specifically on men’s behaviors (ie, daily or weekly sunscreen use) surrounding skin cancer prevention. Our objective in this study involved assessing men’s use of and motivations for regularly applying sunscreen, as well as