Types
Bowen's disease is also called squamous cell carcinoma in situ. It grows very slowly. Doctors call Bowen's disease pre invasive. That means that there are cancer cells there, but they are only in the outermost layer of skin, the epidermis. Sometimes it can spread along the skin surface.
Without treatment, there is a small chance that Bowen's disease can spread into the deeper layers of the skin. This is very rare. This means it has become an invasive cancer called . But most Bowen’s disease does not progress. Only 3 to 5 out of every 100 Bowen’s disease (3 - 5%) becomes SCC.
So, because of this your doctor either treats or monitors the disease.
Bowen's disease can grow anywhere on your body. It is most common on the:
head and neck
legs – especially the lower part of the legs
arms
In many cases of Bowen's disease, we don't know what has caused it.
Doctors don’t always know what has caused your Bowen’s disease. But it's most often linked to sun exposure or sunbed use over a long period of time. But as it can occur in areas of the body not normally exposed to the sun, this is not the only cause.
Another cause is long term exposure to arsenic. This could be through drinking contaminated water and food over a long period of time. This happens very rarely nowadays.
Having a weak can increase your risk of Bowen’s disease. Your immune system might be weak because of an illness, or as a side effect of medicines. For example, after an such as a liver or kidney transplant.
Bowen's disease is a very early form of skin cancer. Rarely, it can develop in the area. Research into this condition has shown that infection with can increase the risk of developing Bowen’s disease.
Usually, Bowen's disease appears as red scaly patches. Often the affected skin looks red and sore. As the patches grow, they may become crusty or turn into an open sore (ulcer). If it turns into an open sore, this could be a sign it has become a SCC.
Often there are no symptoms apart from a patch on the skin. In some cases, the affected skin may become sore and bleed.
Some GPs have had special training and are able to diagnose and treat Bowen's disease. So you might not need to see a skin specialist.
Your doctor can usually diagnose Bowen’s disease with the following tests:
a physical examination of your skin
looking closely at your skin with a special instrument (dermatoscope)
If your doctor is uncertain about your diagnosis, they might discuss you with the skin cancer at the hospital.
They might take photographs of the abnormal area of skin. This is called teledermatology.
Or they might need to take a sample () of the abnormal area. They send it to the laboratory for examination under a microscope. You usually have a biopsy under , which numbs the area.
If your GP thinks you might have a SCC, they should refer you to a skin specialist at the hospital.
Find out more about getting diagnosed with non melanoma skin cancer
Your GP might be able to treat you rather than referring you to a specialist. They will discuss the different treatment options with you. Or they might refer you to a skin specialist at the hospital. If you have surgery, you might also see a plastic surgeon.
There are several treatments for Bowen's disease. The treatment you have depends on several factors including:
where the Bowen’s disease is on your body
how large the Bowen’s disease is
how well the skin in that area is likely to heal
your personal wishes
All these treatments can work well. Because there are many treatments and this is a very early type of skin cancer, the cure rates are high.
Your doctor might offer you a cream to put on the Bowen’s disaease. There are different types of cream.
A drug called fluorouracil (5FU) comes as a cream called Efudix. Usually, you put on the cream once or twice a day for up to 4 weeks.
Find out more about chemotherapy cream
Imiquimod cream is a type of . It helps your immune system produce natural substances which help fight Bowen's disease.
Find out more about imiquimod cream
Your doctor puts liquid nitrogen on to the area of skin. The liquid freezes the area. It turns white as it freezes. After a few minutes the liquid nitrogen dissolves and the area thaws.
There are different types of for Bowen's disease.
A common type is called curettage and cautery (C and C). Your doctor scrapes away the cancer and the around it, layer by layer. They then use an electric needle to kill any cancer cells in the surrounding tissue.
A surgical excision is when the doctor cuts out the area of Bowen's disease. You usually have stitches to close the skin up afterwards.
Mohs surgery aims to remove all the Bowen's disease and leave as much healthy skin tissue as possible. It is a specialised surgery you have at the hospital. You might have this if the Bowen’s disease is in a difficult place – for example close to your eye.
Find out more about the types of surgery for skin cancer
You have a drug that makes cells sensitive to light. Then the doctor shines a particular type of light on the treatment area. This destroys the cancer cells.
Read more about photodynamic therapy
Radiotherapy uses high energy waves similar to x-rays to kill cancer cells. It isn’t a common treatment for Bowen’s disease. But you might have it if your Bowen’s disease come back or other treatments don’t work. Or if you are unable to have surgery.
Find out more about radiotherapy for skin cancer
Laser therapy uses a narrow, thin beam of light. The laser removes or destroys abnormal or cancerous cells. It isn’t a common treatment for Bowen’s disease. Many hospitals do not have this treatment available.
Find out more about the treatment for non melanoma skin cancer
You might not need any follow up appointments after treatment. This depends on your situation. Your doctor will tell you whether they need to see you again after treatment.
Your doctor will tell you how to look after your skin to stop any more patches of Bowen’s disease developing.
Check your skin regularly for any new patches. The earlier you notice any new patches the easier it is to treat. So it is important you contact your doctor straight away if you notice any changes.
Contact your doctor straight away if you notice any changes to the patch, for example bleeding or a lump. It’s important to protect your skin when out in the sun.
Find out more about how to protect your skin
Being diagnosed with Bowen’s disease cancer can be a shock. Even if treatment is likely to cure you, you may feel worried about developing squamous cell skin cancer. Talking about your feelings can help.
You may have a small scar after treatment. This may not affect you very much. But you might have treatment on a very visible part of your body. This can affect how you feel about yourself.
Find out about the emotional, physical and practical effects of cancer and how to manage them
Last reviewed: 19 Mar 2026
Next review due: 19 Mar 2029
Non melanoma skin cancer includes basal cell skin cancer, squamous cell skin cancer and other rare types.
The 2 main types of non melanoma skin cancer are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
Symptoms of skin cancer can include: a sore that doesn't heal, an area of skin that looks unusual, red, itchy, bleeds or scabs for more than 4 weeks.
You usually have surgery to treat skin cancer, but you may have other treatments such as chemotherapy cream, radiotherapy, targeted and immunotherapy or photodynamic therapy.
Coping with a skin cancer diagnosis can be difficult. Help and support is available. There are things you can do and people who can help.
Non melanoma skin cancer includes basal cell carcinoma, squamous cell carcinoma and other rare types. They tend to develop most often on skin that has been exposed to the sun.
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