Bowen's disease

Bowen's disease is a very early form of skin cancer that's easily treatable. The main sign is a red, scaly patch on the skin.

It affects the squamous cells, which are in the outer layer of skin, and is sometimes referred to as squamous cell carcinoma in situ.

The patch is usually very slow growing, but there's a small chance it could turn into a more serious type of skin cancer if left untreated.

The most effective method of reducing your risk of Bowen's disease, as well as other more serious types of skin cancer, is to limit your exposure to the sun.

Get more advice about sunscreen and sun safety

Is Bowen's disease serious?

Bowen's disease itself is not usually serious. It tends to grow very slowly over months or years, and there are several very effective treatments for it.

The concern is that Bowen's disease can eventually develop into a different type of skin cancer called squamous cell skin cancer if it's left undiagnosed or neglected.

It's estimated this happens in up to 1 in 20 to 1 in 30 people with untreated Bowen's disease.

Squamous cell skin cancer is often treatable, but it can spread deeper into the body and is sometimes very serious.

Symptoms of Bowen's disease

Bowen's disease usually appears as a patch on the skin that has clear edges and does not heal.

Some people have more than 1 patch.

A small red patch on the skin. The patch is flat with an irregular outline and looks dry and scaly. Shown on white skin.

The patch may be:

The patch can appear anywhere on the skin, but is especially common on exposed areas like the lower legs, neck and head.

Sometimes they can affect the groin area and, in men, the penis.

If the patch bleeds, starts to turn into an open sore (ulcer) or develops a lump, it could be a sign it's turned into squamous cell skin cancer.

When to get medical advice

See a GP if you have a persistent red or scaly patch of skin and do not know the cause.

It's important to get a proper diagnosis, as Bowen's disease can look like other conditions, such as psoriasis or eczema.

If necessary, your GP will refer you to a skin specialist (dermatologist) to determine what the problem is.

If they are not sure about the cause, they may need to remove a small sample of skin so it can be looked at more closely (a biopsy).

Causes of Bowen's disease

Bowen's disease usually affects people in their 60s and 70s.

The exact cause is unclear, but it's been closely linked with:

Bowen's disease does not run in families and it's not infectious.

Treatments for Bowen's disease

There are a number of treatment options for Bowen's disease. Talk to your dermatologist about which treatment is most suitable for you.

The main treatments are:

In some cases, your dermatologist may just advise monitoring your skin closely – for example, if it's very slow growing and they feel the side effects of treatment will outweigh the benefits.

Looking after your skin after treatment

After having treatment for Bowen's disease, you may need follow-up appointments with your dermatologist or GP to see if you need any further treatment.

If you had surgery, you may need to have any stitches removed at your GP surgery 5 to 14 days later or once your wound has healed. Sometimes dissolvable stitches are used that do not need to be removed.

If you had a dressing on your wound, you may need to go to your GP or the hospital to have it changed.

After treatment:

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Page last reviewed: 6 October 2022
Next review due: 6 October 2025