What is the first treatment for Bowen's disease?

Bowen’s disease, also called squamous cell carcinoma in situ, affects the full thickness of the outer skin layer without confirmed invasion beyond it. Treatment aims to clear the abnormal area and reduce the chance of progression. Cryotherapy freezes a selected lesion; topical 5-fluorouracil is applied to affected skin over a prescribed course; photodynamic therapy uses a light-sensitive preparation followed by controlled light. The best fit depends on lesion thickness, size, number, site, skin condition, and the need to preserve appearance.

Have the diagnosis and treatment plan confirmed by a dermatologist, especially if the patch is thick, ulcerated, bleeding, or changing. Use prescribed cream exactly as directed and expect the treated area to become red or sore as abnormal cells respond. Do not pick crusts or add unapproved products. Protect treated skin from strong sunlight as instructed, particularly around photodynamic therapy, and attend the planned review so persistent disease can be addressed.

Arrange prompt review if the patch becomes painful, ulcerated, rapidly thicker, or repeatedly bleeds, or if a treated area fails to heal. Seek earlier care for lesions on the lip, ear, eyelid, fingers, or genital skin, where treatment planning can be more delicate. A new rough patch that does not settle should be examined rather than assumed to be eczema or sun damage.

Ask why cryotherapy, topical 5-fluorouracil, or photodynamic therapy is suitable for your lesion, how the treated skin will look and feel, and when healing should be checked. Ask what would happen if a residual patch remains and how to monitor for new lesions.