Squamous Cell Carcinoma vs Bowen's Disease

How to tell the difference — key features compared side by side.

Feature
Squamous Cell Carcinoma
Bowen's Disease
Category
Malignant
Pre-cancerous
Key feature
Second most common skin cancer. More aggressive than BCC - can spread to lymph nodes if not treated early.
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 (more important than acute burns for SCC); Fair skin (Fitzpatrick types I-III); History of actinic keratosis - the primary precursor lesion
Chronic sun exposure; Fair skin; Age over 60
Action needed
A firm, red nodule on sun-exposed skin that persists or grows
A persistent red scaly patch not responding to eczema or fungal treatments

Squamous Cell Carcinoma

Squamous cell carcinoma (SCC) of the skin develops in the flat squamous cells that form the outer layer of the epidermis. It is the second most common skin cancer after BCC, with over one million cases diagnosed annually in the US.

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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.

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Does yours look more like squamous cell carcinoma?

Quick self-check

Does this look like squamous cell carcinoma? Answer 2 questions.

Is the spot firm, raised, or nodular with a rough or scaly surface?

Is it on a chronically sun-exposed area (face, ears, hands, scalp)?

Still not sure?

Our full ABCDE checker evaluates 5 clinical criteria dermatologists use.

Full ABCDE check →