What actually brings men in

Men are a minority of dermatology appointments and a majority of late melanoma diagnoses. Those two facts are related, and the second one is the reason this page exists.

Hair, first

Hair loss is the most common reason men come in and the one where the timing of the first appointment matters most. Treatment is considerably better at holding on to the hair that is still there than at bringing back the hair that has gone. A follicle that has miniaturised can often be rescued; one that has been gone for years generally cannot.

Which means the appointment that helps is the one made when you first noticed, not the one made after a few years of hoping it had stopped.

The moles nobody can see

The common sites for melanoma in men are the back, the shoulders and the scalp. They are also, not coincidentally, the three areas it is impossible to examine on yourself. A partner noticing something is the usual route, and that is a thin system to rely on.

A full-body check takes fifteen minutes and happens once a year. It is genuinely the highest-value quarter of an hour available in dermatology, and the reason men present later is almost entirely that nobody has told them the appointment exists.

Shaving

Pseudofolliculitis barbae — razor bumps — is coarse or curly hair re-entering the skin after it is cut, and the inflammation and pigment that follow. It is common, it is often mistaken for acne and treated as acne, and it frequently responds to a change in shaving technique before it needs anything prescribed.

It is also one of the conditions where treating the pigment left behind matters as much as treating the bumps, particularly in deeper skin tones.

Why men come in later

It is not usually stoicism, whatever the advertising suggests. In the surveys that have asked, men are less likely to have been told what a dermatologist does, less likely to have had a skin check recommended to them, and considerably less likely to be able to name a warning sign.

The practical consequence is that the first appointment tends to be prompted by something that has already become obvious — a lesion that has changed enough for somebody else to comment, a receding hairline that has been receding for five years, a rash that has stopped responding to whatever was in the cupboard.

Almost everything in this list does better the earlier it is seen. That is the whole of the argument for making the appointment before there is an obvious reason to.

And the cosmetic question

Men ask it late in the appointment, usually prefaced with an apology. The honest answer is that the objection most men have to cosmetic treatment — that it is visible — is a dosing problem rather than an argument against it.

A man’s brow sits lower and is stronger, the skin is thicker, and the muscle takes more to move. Treated with a woman’s dose and a woman’s injection points, the result is the frozen forehead everybody recognises. Treated for the face in front of you, the line softens and the face keeps its movement, which is the whole of what was being asked for.