Check your ears, your neck and your left forearm first

Your left forearm has had a harder life than your right one.

If you drive for work, that's just geometry. Window down, elbow out, ten years of afternoons. There's a photograph published in the New England Journal of Medicine of a delivery truck driver who spent 28 years behind the wheel, and the left side of his face looks a couple of decades older than the right. Same man. Same genes. Same everything except which side faced the glass.

That photo is the whole argument. Sun damage isn't abstract and it isn't evenly distributed. It piles up on the parts of you that face out, and if you frame, roof, pour, farm, fish, survey, coach or haul, you've been collecting it since you were nineteen.

The good news is that the check costs nothing and takes five minutes.

The five-minute version, once a month

Do it after a shower, in a bathroom with decent light. Don't make a project of it. The whole point is that it's short enough that you'll actually do it twelve times a year instead of doing a thorough job once and never again.

Start at the top and work down.

• Scalp and part line. Run your fingers through and look. If you're thinning up top, that skin has been taking direct sun with no shade at all.
• Ears. The top rim and the little shelf behind them. Nobody puts sunscreen there. Ever.
• Face, with attention to the nose and the lower lip. A lip that's chronically dry, rough or pale in one patch isn't chapped. It's been sunburned for thirty years.
• Neck, front and back. The V where your collar opens. The back of the neck if you wear a ball cap, because a cap brim protects your nose and abandons everything behind your ears.
• Forearms and the backs of your hands. Including between the knuckles.
• Chest, stomach, shins. Shins get skipped constantly and they're a common spot.
• Feet. Tops, soles, between the toes, under the nails. Yes, really.

Then you need help with the back, and this is the part men skip. The back and shoulders are where a lot of melanoma turns up in men, and it's the one region you physically can't inspect. Ask your wife. Get her to look for two minutes and take a phone photo of your whole back while she's at it. Next month, compare. A photo is a better memory than you're.

What you're actually looking for

The standard teaching is ABCDE, and it holds up:

Asymmetry. Fold it in half in your mind. Do the halves match?

Border. Normal moles have a clean edge. Trouble has a ragged, notched or blurry one.

Color. More than one shade in a single spot. Brown and black together, or a fleck of red, white or blue.

Diameter. Bigger than a pencil eraser, roughly a quarter inch. Not a hard rule, but a flag.

Evolving. Changing size, shape, color, or starting to itch, crust or bleed.

Two more that matter as much as the letters.

The ugly duckling. Most of your moles look like siblings. If one of them looks like it wandered in from another family, that's the one to show someone.

And the sore that won't heal. A scabby patch on your ear or temple that crusts, comes off in the shower, and comes back three weeks later. Men write these off as a shaving nick or a scrape from a branch for a year and a half. Basal cell carcinoma is by far the most common skin cancer, it's extremely treatable when it's small, and it very often shows up exactly like that. A scab with a six-month tenure isn't a scab.

When to stop looking and make a call

If something's been changing for a month, or it bleeds without you catching it on anything, stop self-diagnosing and get a professional set of eyes on it. Start with your primary care doctor if that's easier to get into, and ask for a referral to a dermatologist. A full-body skin exam is one of the least invasive things in medicine. You stand there in your shorts, someone looks at you with a bright light and a magnifier, and in ten minutes you're back in your truck.

If they take a piece off, it's a shave or a punch biopsy under local anesthetic. You'll feel a pinch and then pressure. You'll get a small bandage and a scar the size of a freckle.

I'm not your doctor and this isn't a diagnosis. It's a prompt to go get one.

The prevention that survives an actual workday

You're not going to reapply lotion every two hours on a roof in July. Let's not pretend. So build the protection into things you're already wearing.

A shirt beats sunscreen every time. A long-sleeve lightweight work shirt with a UPF rating does the job all day, doesn't sweat off, and doesn't need remembering at 1 p.m. Sun shirts got genuinely good in the last decade. They breathe better than the cotton tee you're currently sweating through.

Replace the ball cap with a real brim. A cap does nothing for your ears or the back of your neck, and those are prime real estate for skin cancer. A wide-brim hat or a cap with a legionnaire flap covers what the cap ignores. You'll feel like a park ranger for about a week and then you'll stop noticing.

Keep a zinc stick in the truck. The solid kind, five or six bucks, no mess on your hands. Nose, ears, lip. It takes eleven seconds and it's the one you'll actually use.

Sunglasses. Eyelid skin is thin and gets missed by everything else.

Gloves. If you're already wearing them, your hands are handled. If you're not, they're getting the same dose as your face.

Here's the honest trade-off. Sunscreen on your hands and forearms wipes off on lumber, on a steering wheel, on a wrench, within about twenty minutes. That's not a reason to skip it, it's a reason not to rely on it as your only layer. Fabric doesn't wipe off.

And on vitamin D, which somebody always raises. If you work outside, you're getting sun on your skin whether you like it or not, and deliberate burning has never been a sensible way to manage a vitamin level. If you're worried about it, get the blood test and talk to your doctor. That's a lab question, not a tanning question.

Put it on a schedule you'll keep

The first of the month, after your shower. That's it. Same principle as everything else that works long-term: a sustainable habit you'll run for twenty years beats a perfect protocol you'll abandon by March.

Add one annual professional check if you've had bad burns, if you've got a lot of moles, if anyone in your family has had melanoma, or if you're fair and you've spent your working life outdoors. Book it the same week you get your truck inspected. You'll remember.

The guy who catches it at the size of a pencil eraser gets a stitch and a story. The guy who waits until it's the size of a dime because he didn't want to make a fuss gets a much longer year.

Be the first guy. Your wife would rather look at your back than sit in a waiting room.