Treating Actinic Keratosis and Bowen Disease

Actinic keratosis

Actinic keratosis is usually considered to be a pre-cancer. It is often treated because it might turn into squamous cell skin cancer. But because this risk is low, treatments are generally aimed at avoiding scars or other disfiguring marks as much as possible.

Actinic keratosis is often treated with either cryotherapy or topical creams or gels such as fluorouracil (5-FU), imiquimod, diclofenac, or ingenol mebutate. These treatments destroy the affected area of the epidermis, the outermost layer of the skin, which usually cures actinic keratosis.

Other localized treatments (photodynamic therapy, laser surgery, chemical peeling) or types of surgery (shave excision, curettage and electrodesiccation) are also sometimes used.

Bowen disease

Bowen disease (squamous cell carcinoma in situ) is usually treated by excision (cutting out the tumor). Mohs surgery, curettage and electrodesiccation, radiation therapy, topical fluorouracil (5-FU), and cryosurgery are other options. Laser surgery or other topical therapies may be considered in special situations.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Aasi SZ, Hong AM. Treatment and prognosis of low-risk cutaneous squamous cell carcinoma. UpToDate. 2019. Accessed at https://www.uptodate.com/contents/treatment-and-prognosis-of-low-risk-cutaneous-squamous-cell-carcinoma on June 4, 2019.

Christensen SR, Wilson LD, Leffell DJ. Chapter 90: Cancer of the Skin. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.

Jorizzo J. Treatment of actinic keratosis. UpToDate. 2019. Accessed at https://www.uptodate.com/contents/treatment-of-actinic-keratosis on June 4, 2019.

National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Squamous Cell Skin Cancer. Version 2.2019. Accessed at www.nccn.org/professionals/physician_gls/pdf/squamous.pdf on June 4, 2019.

Xu YG, Aylward JL, Swanson AM, et al. Chapter 67: Nonmelanoma Skin Cancers. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.

Last Medical Review: July 26, 2019 Last Revised: July 26, 2019

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