Actinic Keratosis vs Bowen's Disease
How to tell the difference — key features compared side by side.
Feature
Actinic Keratosis
Bowen's Disease
Category
Pre-cancerous
Pre-cancerous
Key feature
Rough, sandpaper-like patches from years of sun damage. The most common precancer - 5-10% progress to squamous cell carcinoma.
Early-stage SCC confined to the top skin layer. A persistent, well-defined red scaly patch - 3-5% progress to invasive cancer.
Risk factors
Cumulative lifetime sun exposure; Fair skin, light hair, light eyes (Fitzpatrick I-III); Age over 40
Chronic sun exposure; Fair skin; Age over 60
Action needed
Any rough scaly patch on sun-exposed skin persisting more than two weeks
A persistent red scaly patch not responding to eczema or fungal treatments
Actinic Keratosis
Actinic keratosis (AK) is the most common precancerous skin lesion, affecting an estimated 58 million Americans. It develops from cumulative ultraviolet radiation damage and represents the earliest stage toward squamous cell carcinoma.
Read full guide →Bowen's Disease
Bowen's disease is squamous cell carcinoma in situ - malignant cells present but not yet invaded beyond the epidermis. It represents the stage between actinic keratosis and invasive SCC.
Read full guide →Does yours look more like actinic keratosis?
Quick self-check
Does this look like actinic keratosis? Answer 2 questions.
Does the spot feel rough or sandpaper-like?
Is it on a chronically sun-exposed area?
Still not sure?
Our full ABCDE checker evaluates 5 clinical criteria dermatologists use.
Full ABCDE check →