What should you know about Bowen's disease skin cancer?

The abnormal cells are confined to the outer layer of the skin, which is why doctors describe this condition as in situ. It is not the same as invasive squamous cell carcinoma, but it can develop into that form when it is left untreated. A dermatologist may suspect Bowen's disease when a patch is scaly, crusted, or persistently irritated and does not settle like ordinary dermatitis.

The patch may be red, pink, brown, or close to the surrounding skin colour. It can occur on sun-exposed areas such as the face, scalp, hands, arms, and lower legs, although other sites are possible. It may itch, feel tender, bleed after minor contact, or cause no symptoms at all. A history of cumulative sun damage can be relevant; see [Sun-Damaged Skin](/conditions/photoaging/).

Arrange a skin examination for a patch that persists, changes, crusts, or bleeds. Examination may include dermoscopy, followed by a skin biopsy when the diagnosis is uncertain or treatment needs confirmation. Do not repeatedly cover a changing lesion with over-the-counter steroid or cosmetic products before it is assessed, because this can blur its appearance.

Treatment depends on the patch's size, location, thickness, number of lesions, and your general health. Options can include a prescribed cream such as [Topical 5-Fluorouracil](/treatments/medical-dermatology/topical-5-fluorouracil/), freezing with [Cryotherapy (Lesion Removal)](/treatments/surgical-dermatology/cryotherapy-lesion-removal/), or light-activated treatment known as [Photodynamic Therapy](/treatments/laser-and-energy/photodynamic-therapy/). A procedure to remove the lesion may be considered in some situations. Follow-up checks help identify recurrence or new sun-related lesions.

Book a dermatology appointment promptly for a persistent scaly patch, especially if it is enlarging, becoming thicker, painful, ulcerated, or bleeding. Seek earlier review when a lesion is on the eyelid, lip, ear, or another area where treatment may affect function or appearance. Urgent assessment is appropriate for uncontrolled bleeding, rapidly increasing pain, marked swelling, or signs of infection such as spreading redness and pus.

After treatment, contact your clinician if the area does not heal as expected, develops a growing lump, or forms a recurring crust. Protect treated and exposed skin from ultraviolet light with clothing, shade, and sunscreen selected for your skin type.

Ask whether a biopsy is needed, what the results show, and whether the lesion is fully within the outer skin layer. You can also ask which treatment fits its location and size, how the area will look while healing, what wound care is required, and when a follow-up examination should take place. If you have had similar lesions, ask how to check your skin and reduce further sun exposure.