About Bowen’s disease
Bowen’s disease affects the squamous cells. These are in the outermost layer of skin.
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.
Bowen's disease itself isn't usually serious. It tends to grow very slowly over months or years. 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.
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 doesn't heal. Some people have more than one patch.
The patch may be:
- red or pink
- scaly or crusty
- flat or raised
- up to a few centimetres across
- itchy – but isn't always
The patch can appear anywhere on the skin. But the patch 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 has turned into squamous cell skin cancer.
When to get medical advice
See your GP if you have a persistent red, scaly patch of skin and don't know the cause.
If necessary, your GP will refer you to a skin specialist (dermatologist) to work out what the problem is.
If they're 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 older people in their 60s and 70s.
The exact cause is unclear, but it has been closely linked with:
- long-term exposure to the sun or use of sunbeds – especially in people with fair skin
- having a weak immune system – for example, it's more common in people taking medication to suppress their immune system after an organ transplant, or those with AIDS
- previously having radiotherapy treatment
- the human papillomavirus (HPV) – a common virus that often affects the genital area and can cause genital warts
Bowen's disease doesn't run in families and you can't pass it on to others.
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.
In a few 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 treatment, you may need follow-up appointments with your dermatologist or GP. This is to see if you need any further treatment.
If you had surgery, you may need to have any stitches removed at your GP surgery a week or two later.
- see your GP if an existing patch starts to bleed, change in appearance or develops a lump – don't wait for your follow-up appointment
- see your GP if you notice any worrying new patches on your skin
- make sure you protect your skin from the sun – wear protective clothing and use a sunscreen with a high sun protection factor (SPF) of at least 30