There is no single clear cause of Bowen disease, but long‑term sun exposure, radiation, certain chemicals, chronic skin injury, some rare skin diseases, and possibly human papillomavirus (HPV) all increase the risk. Usually several of these factors act together over many years.
Bowen disease itself does not metastasize because it is confined to the top skin layer, but it can turn into invasive squamous cell carcinoma if left untreated. People with Bowen disease also have a higher chance of developing other skin cancers, so long‑term monitoring is important.
The main treatment for Bowen disease is complete removal of the lesion, usually by surgical excision with a safety margin of normal skin. In some cases, especially for smaller lesions or where surgery is difficult, carefully planned radiotherapy or other local treatments may be used under specialist guidance.