Bowen’s Disease

Overview

Bowen’s Disease—also called squamous‑cell carcinoma in situ—is an early, non‑invasive form of skin cancer. It usually appears as a slowly enlarging, scaly red patch that can be mistaken for eczema or psoriasis. Although the lesion grows only within the top skin layer, around 3–5 percent will become invasive squamous‑cell carcinoma if left untreated.

At The Royal Buckinghamshire Hospital, Aylesbury you receive rapid consultant‑led diagnosis, on‑site minor‑surgery and laser suites, and personalised after‑care—all without NHS waiting lists.

Why Early Treatment Matters

• Stops progression to invasive skin cancer
• Eliminates irritation, bleeding or infection risk
• Allows choice of minimally invasive treatments with smaller scars
• Provides peace of mind through expert histology confirmation

What to Look For

• Persistent, flat or slightly raised red or pink patch
• Surface feels rough, scaly or crusted; may ooze or bleed
• Slow enlargement over months to years
• Common on sun‑exposed areas such as lower legs, face, hands and scalp
• Sometimes multiple lesions in those with sun‑damaged skin or immune suppression

Risk Factors

• Long‑term sun or tanning‑bed exposure
• Fair skin that burns easily
• Age over sixty
• Chronic arsenic exposure (historical water sources, industrial work)
• Previous radiotherapy to the area
• Weakened immune system after organ transplant or HIV infection
• Human papillomavirus (HPV) infection, particularly on genital skin

When to Seek Medical Advice

Phone 01296 678 800 for an appointment if you notice a new persistent scaly patch, especially if it is growing, bleeding or not responding to moisturiser or steroid cream.

Urgent review is advised if the lesion becomes painful, develops a firm nodule or the surrounding lymph nodes enlarge.

How We Diagnose and Monitor Bowen’s Disease

1  Consultant Dermatology Examination – detailed skin check with dermoscopy in our Dermatology Suite.
2  On‑Site Punch or Shave Biopsy – local‑anaesthetic sampling for fast histology confirmation.
3  Digital Photography Mapping – baseline images stored for comparison at each follow‑up.
4  Histopathology Review – results typically available with a quick turnaround via our laboratory partner.
5  Annual Full‑Skin Review – recommended for patients with multiple lesions or high sun exposure.

Treatment Options

• Cryotherapy – quick liquid‑nitrogen freezing for small lesions.
• Topical Chemotherapy (5‑fluorouracil) or Immunotherapy (imiquimod) – applied at home for superficial patches.
• Photodynamic Therapy (PDT) – a special light and light sensitive drug are used to kill cancer cells.
• Curettage and Cautery – scraping away abnormal cells under local anaesthetic, followed by heat sealing.
• Excisional Surgery – complete removal with a margin of healthy skin when deeper involvement is suspected.
• Laser Ablation – CO₂ laser vaporises thin lesions with minimal bleeding and downtime.
• Sun‑Protection and Skin‑Care Education – SPF advice, protective clothing strategies and regular self‑checks guided by our dermatology nurses.

Why Choose The Royal Buckinghamshire Hospital

• Consultant‑delivered dermatology clinics with appointments usually within one week
• Fast histology turnaround for quick reassurance or further planning
• Integrated care: dermatology, plastic‑surgery referral and rehabilitation under one roof
• Private ensuite rooms, free parking and easy access from Oxford, Milton Keynes and London

Frequently Asked Questions

Is Bowen’s Disease the Same as Skin Cancer?
It is an early, non‑invasive form of squamous‑cell carcinoma. Treated promptly, the cure rate is very high.

Will Treatment Leave a Scar?
Most therapies cause minimal scarring. Photodynamic therapy and topical creams often heal with excellent cosmetic results. Surgical options leave a small line scar that fades over time.

Could the Patch Come Back?
Recurrence is uncommon after complete treatment but can happen, especially in sun‑damaged skin. Regular follow‑up and sun protection reduce the risk.

Book Your Skin‑Cancer Check Today

Call 01296 678 800 or enquire online to arrange a Bowen’s‑disease assessment and personalised treatment plan.