Bowen's disease

What is Bowen's disease?

Bowen's disease is a skin lesion that affects the topmost layer (epidermis) of the skin. It appears as a red or brown scaly patch and it is usual to have a single lesion. It commonly occurs on sun-exposed skin, especially the face, scalp and neck, as well as the hands and lower legs.

People over the age of 60 are more likely to develop these lesions and they are rare in the under-30 age group.

Bowen's disease is thought to be caused by long-term exposure to ultraviolet radiation in the sunlight. The changes in the skin are confined to the top layer of the skin but in about 3% of cases it progresses into an invasive skin cancer called squamous cell carcinoma.

Various treatment options are available such as creams (topical chemotherapy), freezing (cryotherapy), laser surgery or exposure to special light (photodynamic therapy). Your doctor will advise which of these is suitable for you.

Once the lesion is adequately treated it rarely comes back. However, there is a small probability of developing new lesions and for that reason you must take the following steps:

  • Examine your skin regularly and seek medical advice for any lesion that does not heal in 6 weeks.
  • Protect your skin from ultraviolet radiation in strong sunlight:
    • Avoid exposure to the sun.
    • Cover up with loose fitting but closely woven clothes.
    • Wear a wide-brimmed hat and protective sunglasses.
    • Use a high SPF sunscreen (15 or more). When choosing a sunscreen look for one which protects against UVB, has the UVA circle logo and/or 4 or 5 UVA stars to protect against UVA. Apply plenty of sunscreen 15 to 30 minutes before going out in the sun, and reapply every two hours and straight after swimming and towel-drying.
    • Avoid tanning under sunlamps.

Last updated: March 2023