Cancer Skin Cancer Prevention Causes and Risk Factors of Bowen's Disease By Elizabeth Pratt Elizabeth Pratt Elizabeth Pratt is a medical journalist based in Australia. She has a Master's degree in Health Communication and a Bachelor's degree in journalism. Learn about our editorial process Published on September 07, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by William Truswell, MD Medically reviewed by William Truswell, MD Facebook LinkedIn William Truswell, MD, is a board-certified facial plastic surgeon and otolaryngology (head and neck) surgeon. He is president of the American Board of Facial Plastic and Reconstructive Surgery and treats skin cancer patients as part of his practice. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Sun Exposure Age Genetics Weakened Immune System Human Papillomavirus (HPV) Other Rare Risk Factors Lifestyle Changes That Can Help Reduce Risk Bowen's disease is an early form of skin cancer that affects the outermost layers of the skin. It may also be referred to as squamous cell carcinoma in situ. The exact cause of Bowen's disease remains unknown, but there are a number of risk factors that can make a person more susceptible to the disease. These include age, exposure to ultraviolet (UV) radiation through sunbathing or tanning beds, having fair skin, or having a weakened immune system. In this article, you'll learn more about the common causes and risk factors of Bowen's disease. Verywell / Theresa Chiechi Sun Exposure Those who have had unprotected exposure to UV radiation are at an increased risk of developing Bowen's disease. Exposure to UV radiation can come from being out in the sun or using tanning beds. The cumulative time spent exposed to UV radiation throughout life can influence the risk of developing Bowen's disease. Those who have a high amount of UV exposure are more likely to develop Bowen's disease as well as a more serious form of skin cancer, known as squamous cell carcinoma. Those who work outdoors or spend a lot of their free time in the sun are at heightened risk. People who use tanning beds are also at risk. They have a 67% greater risk of developing squamous cell carcinoma than those who don't use tanning beds. Over the past three decades, the number of women under age 40 who receive a diagnosis of squamous cell carcinoma has been on the rise, and experts believe this is related to the use of indoor tanning beds. Age Bowen's disease is most common in people in their 60s and 70s. It is believed that the reason Bowen's disease affects older people more than younger people is due to the cumulative effect of sun exposure over a person's lifetime. However, younger people are increasingly being diagnosed due to the use of indoor tanning beds. Genetics Bowen's disease is not a hereditary condition that is passed on in families. However, some of the risk factors for Bowen's disease, such as fair skin, do run in families. Fair Skin Bowen's disease can affect people of all skin colors, but those with fair skin are at an increased risk. This is particularly the case for those with: Red hairBlond hairBlue eyesGreen eyesSkin with frecklesSkin that burns easily Those with darker skin can still get Bowen's disease and other skin cancers, but Black people are more likely to have squamous cell carcinoma. Recently, researchers have also noticed an increase in cases of squamous cell carcinoma among Latinx individuals. Weakened Immune System Those who are immunosuppressed are more likely to develop Bowen's disease. This includes people who might have reduced immune function due to: Human immunodeficiency virus (HIV)Receiving chemotherapyImmunosuppressive medication taken for autoimmune diseases The risk is particularly significant for those who have received an organ transplant and take immunosuppressive anti-rejection drugs. They are 100 times more likely to develop squamous cell carcinoma than their peers. Those with an already weakened immune system are also at further risk of developing Bowen's disease due to sun exposure. That's because being out in the sun for an excessive amount of time weakens the immune system as well as damaging the skin with UV rays. Therefore, it's especially important for those who are immunocompromised to prioritize sunscreen and minimize time spent in direct sunlight. Human Papillomavirus (HPV) Those who have certain forms of human papillomavirus (HPV) may be at greater risk of Bowen's disease. HPV is an umbrella term for more than 150 viruses. Some of these can cause cancer. HPV viruses 16, 18, 34, and 48 are believed to cause Bowen's disease in the genital area. HPV virus types 2, 16, 34, and 35 have also been associated with Bowen's disease in parts of the body other than the genitals. Other Rare Risk Factors Occasionally, Bowen's disease may appear following radiotherapy treatment. Chronic arsenic exposure is another possible risk factor. Arsenic is used in manufacturing and may cause Bowen's disease 10 years after initial exposure. These days, exposure to arsenic is less common. Lifestyle Changes That Can Help Reduce Risk While some risk factors for Bowen's disease are out of your control, such as your genetics, age, or having a weakened immune system, there are lifestyle changes you can make to protect your skin and reduce your chances of developing the condition. Healthy behaviors like eating an antioxidant-rich diet, exercising, and getting enough sleep may help, but most important is protecting your skin from the sun. Protecting Against UV Damage UV rays from the sun are one of the most damaging elements to the skin, and cumulative exposure to UV rays over your life span increases your risk of Bowen's disease. That said, using sunscreen, avoiding tanning beds, and minimizing your exposure to direct sunlight can make a big difference in reducing your exposure to UV damage. Other ways to protect your skin from UV radiation, and lower your chance of developing Bowen's disease and other skin cancers, include: Covering up your skin with clothing when out in the sunStaying in the shade if spending time outdoorsUsing a broad-spectrum daily sunscreen with SPF 15 or higherUsing an SPF of 30 or higher if you are going to be outside for longer than 15 minutesReapplying sunscreen every two hours, or immediately after swimmingNever using tanning bedsDoing monthly skin self-examsSeeing a dermatologist every year A Word From Verywell The exact cause of Bowen's disease is unknown, but it is believed that a number of risk factors may play a role in developing the disease. These include exposure to the sun, being over age 50, having fair skin, having an HPV infection, and having a weakened immune system. Even so, there are ways to lower your chance of developing this condition. Making a point to keep your skin protected from the sun with sunscreen, protective clothing, and reduced exposure is a great first step. Was this page helpful? Thanks for your feedback! Limiting processed foods and red meats can help ward off cancer risk. These recipes focus on antioxidant-rich foods to better protect you and your loved ones. Sign up and get your guide! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. NHS. Bowen's Disease. Skin Cancer Foundation. Squamous Cell Carcinoma Risk Factors. National Organization for Rare Disorders. Bowen Disease. British Association of Dermatologists. Bowen's Disease (Squamous cell carcinoma in situ). Oxford University Hospitals. Bowen's disease. Skin Cancer Foundation. UV Radiation & Your Skin. Skin Cancer Foundation. Sun Protection.