Bowen’s disease

This is a rare skin condition which occasionally can develop into a full blown squamous cell carcinoma. As a result of this it requires regular monitoring by a dermatologist in case it progresses to this invasive form of skin cancer.

Bowen’s disease is considered to be pre-invasive in that it is confined to the top layer of skin or the epidermis. It is viewed as an early form of squamous cell skin cancer which if left untreated, can spread further into the skin and eventually the lymphatic system.

This disease then becomes an invasive skin cancer. But in both cases it requires early detection and treatment. It is not caused by an allergy and is non-infectious.

It is easy to feel worried or upset when you hear the words ‘skin cancer’ but this is a very treatable form of skin cancer with a high success rate.

Risk group for Bowen’s disease

This is similar to basal cell carcinoma in which the most at risk group is people with fair skin and/or freckles. This equally applies to Bowen’s disease. There is no genetic link but there are risk factors such as fair skin which often runs in families.

So if you have fair skin as do one of both parents then this does increase your risk of developing this disease. But that it by no means a certainty.

But what will increase your risk is prolonged exposure to the sun in the form of sunbathing or the use of sunbeds.

Causes of Bowen’s disease

This most common cause is the sun, as in excessive sunbathing, an outdoor job or living in hot climates. But it can develop following arsenic poisoning although this is very rare.

One form of this disease occurs as a result of an infection of the genitals, e.g. the human papillomavirus (HPV).

Symptoms of Bowen’s disease

Small, red scaly lesions form on parts of the body which are exposed to the sun, for example the hands and face. It can also develop in the genital area of both men and women.

These lesions look similar to raised spots or warts. They become itchy and develop a crusty appearance if scratched or catch on clothing which causes bleeding and soreness.

Diagnosing Bowen’s disease

Your GP will make a diagnosis based on a physical examination. He or she will then refer you to a dermatologist for a further assessment and treatment.

A skin biopsy will be performed to rule out other skin conditions which present with similar symptoms, for example psoriasis.

Treatment for Bowen’s disease

The earlier this is treated the greater the results. Treatments include:

  • Creams such as imiquimod or topical applications
  • Scraping away the lesion under a local anaesthetic (curettage)
  • Freezing the lesions with liquid nitrogen
  • Photodynamic therapy
  • Surgery, e.g. cutting away the lesion (excision)

Treatment is determined by the size and number of lesions and the extent of the condition. Learn more in our dermatology treatments section.

You will also be advised to cover up when out in the sun and to use a sun cream with a high sun protection factor (SPF). Check your skin on a regular basis to see if new lesions are forming. If you notice any changes to the lesions, e.g. bleeding or lumpiness then visit your GP.

This is important. There is a risk of this disease developing into the invasive squamous cell carcinoma so monitor the condition of your skin at regular intervals.