The scenario was familiar. Henry looked peeved. Mary looked anxious. Henry spoke first.
"This spot on my nose has been there for months," he said. "I’m concerned because we’ll be in the sun in Aruba next week."
I examined Henry. "It’s not skin cancer," I said. "Just leave it alone, and it’ll be fine.
"Of course," I went on, "you’ll want to take sensible sun precautions while you’re on vacation, a hat, sunscreen, and so forth." That’s when Mary spoke up.
"You know, Doctor," she said, "Henry does not take sensible sun precautions."
"Yes I do!" Henry objected. "At 10 every morning I leave the beach ..." Mary interrupted him. "He abuses the sun, even though I remind him every day." You could tell by Henry’s hangdog expression that "every day" was no exaggeration.
In its many forms, the eternal battle of the sexes has been examined in countless books, plays, movies, and sitcoms. Gender stereotypes don’t tell the whole story, but without some truth they wouldn’t become stereotypes. There is no getting around the fact that men and women often have their own ways of looking at the world. One part of the world they see differently is health in general and skin health in particular.
I don’t know what life is like on other planets, but if it’s true that men are from Mars and women are from Venus, then it follows that:
• People on Venus follow instructions, eat right, and take care of things so they don’t get out of control. People on Mars can’t be bothered with stuff like that.
• People on Venus wash regularly and use good products. On Mars they don’t much care.
• Venusians moisturize and use sunscreen. Not Martians.
Mini-dramas like that of Henry and Mary play themselves out in our offices all the time. Women take health maintenance more seriously than men do (or than men like to pretend they do.) Proper face washing (in adolescents), regular mole checks (in adults), and careful sun care (especially among the older set) are common flashpoints of gender disagreement. By and large, women feel responsible to make sure men do the right thing, while men just want to be left alone. "I’m only here because..." says the man, but I cut him off. I know why he’s here. It’s just a question of which woman got him there. Real men, you see, don’t ask directions or visit doctors.
One of the right things that women feel obliged to encourage is moisturizing. Men are functional: We shop when we need something and we moisturize when we feel dry. Women think you should moisturize every day, regardless, to make skin healthier and ward off aging.
Maybe so, maybe not, but we men as a group really dislike the feel of lotions on our skin and resist applying them. We find the sensation unpleasant, and anyhow don’t get why we should bother in the first place. Women in turn can’t figure why men should be so cussedly defiant about doing what seems to them not just worthwhile but delightful.
Men, accompanied by women or sent in by them against their better judgment, often make a great show of being put upon. They shrug, roll their eyes, and look irritated, much as they did when they were 8 years old and their mother said, "Tell him, Doctor. Tell him to eat his vegetables. Tell him to wash his face." Now that he’s grown up, her plea is more likely to be, "Tell him, Doctor. Tell him he has to get his spots checked and put sunscreen on every day. Maybe he’ll listen to you. I tell him all the time but he never listens to me." When that happens, I try to split the difference when I can and let both parties save face. After all, they have to live with each other, not with me.
Besides, men’s little secret is that we expect the women in our lives to take care of us and make sure we do the right things that we can’t be bothered to do for ourselves. For many couples, that’s the unspoken deal. We men know it, but we keep it quiet, even from ourselves. Shh, don’t tell anybody ...
Besides, we don’t even have to ask directions anymore. We’ve got GPS!
Dr. Rockoff practices dermatology in Brookline, Mass. He is on the clinical faculty at Tufts University School of Medicine, Boston, and has taught senior medical students and other trainees for 30 years. Dr. Rockoff has contributed to the Under My Skin column in Skin & Allergy News since January 2002. Skin & Allergy News is a publication of Frontline Medical Communications.