No time to be macho: men are more likely than women to get skin cancer. Why? They spend more time in the sun and think skin lotions are prissy. Not smart.

OK, men, listen to me very carefully. Keep your shirt on. While you're at it, find yourself a wide-brim hat and learn to love sunscreen. Skin cancer rates are rising in the United States, and we male types are far more likely than women to develop the disease and die from it.

According to the American Cancer Society, the number of nonmelanoma skin cancers detected in the U.S. is increasing by around 5 percent a year. Men are twice as likely as women to develop this condition. While rarely fatal, these cancers can spread to other organs if neglected, and that unfortunate situation accounts for about 2,200 deaths of men and women each year in this country.

So, why men more than women? "Men may simply be getting more of the kind of ultraviolet exposure that's relevant," reports dermatologist Allan C. Halpern of Memorial Sloan-Kettering Cancer Center in New York.

Melanoma on the Rise

The incidence of melanoma, the deadliest form of skin cancer, has also been increasing at a rate of slightly less than 3 percent per year. Since 1969 melanoma death rates are up 50 percent. Men over 65 account for most of the increase, where deaths from melanoma rose 157 percent--three times faster than in women in the same age bracket.

Scientists have linked melanoma to skin damage caused by severe sunburns that occur at a young age. So, perhaps the high rates among men today reflect their recreational habits of the past when they, as children, were more likely to play outdoors under the unrelenting sun.

Nonmelanoma cancers appear to be caused by chronic exposure to the sun's ultraviolet rays. Men are more likely than women to work at outdoor jobs such as farming or construction.

Halpern goes on to say that one reason more men succumb to skin cancer is that the disease is more aggressive in males. Adding fuel to the fire is the fact that men do a poor job of monitoring and protecting their skin Doctors know that skin cancer in men, which is easily treated if detected early, is often discovered in its advanced, more dangerous stage. Women were nearly twice as likely to attend free skin cancer screenings sponsored during a 15-year period by the American Academy of Dermatology.

Then there's the matter of sunscreen. Women use it properly. Most men don't.

Cultural Aversions

Part of the male aversion to skin care in general may be cultural. Young women are encouraged at an early age to use various skin lotions and moisturizers as a way to enhance their physical beauty. Most maturing boys usually don't get beyond ache creams. "Men never get in the habit of applying things to their skin," says Boston University dermatologist Barbara Gilchrest.

And it's not just skin. Gilchrest and her colleagues have discovered that men are less diligent than women in all matters of health. Even those who get their cholesterol checked and prostates prodded annually tend to neglect their body's largest organ--their skin.

But attitudes may be changing. Trend-spotters say younger American males are gradually adopting personal care habits that were once considered "feminine," including concern about the appearance of their skin. If a guy can learn to apply skin toner and moisturizer, maybe he'll be more inclined to use sun-screen and perform a head-to-foot monthly skin-cancer exam (looking for unusual or altered spots).

Heeding the Warnings

There are signs that many people are heeding the warnings about skin cancer. Over the past 30 years, melanoma death rates have actually dropped among American males between ages 20 and 44. Young men seem to be getting the message. But it needs to Ire louder. Studies reveal that sunscreen use is very low among teenage boys.

So, men, if you think that a deep, dark tan makes you look macho, talk to someone who has battled melanoma. Patients who get skin cancer, says Gilchrest, quickly change their outlook.

Skin cancer rates are increasing in the United States, and men are far more likely than women to develop the disease and die from it. Here are the numbers compiled by the American Cancer Society for 2002.

New Cases

Male            30,100
Female          23,500
Total           53,600

Deaths
Male             4,700
Female           2,700
Total            7,400

Timothy Gower has written for such publications as Men's Health, Men's Fitness, the New York Times, Fortune, Better Homes and Gardens, and Reader's Digest. He lives in Harwich, Massachusetts.