TSW was first described in 1979, but scientific interest surged after 2020. By 2026, 85 relevant publications have been indexed in PubMed. This article summarises the key research milestones in chronological order.
→ For practical symptom information: TSW syndrome: symptoms, stages and diagnosis
1979
Kligman & Frosch — first description of rebound phenomenon
First described the rebound phenomenon after topical corticosteroid discontinuation. On healthy volunteer skin, inflammation appeared after stopping treatment that was not present beforehand. The term "steroid addiction" was coined.
2015
Hajar T et al. — systematic review (J Am Acad Dermatol)
1,206 patients from 34 studies. Described two clinical types: erythematoedematous and papulopustular. Risk factors: women (81%), prolonged potent corticosteroid use, facial application (97% in papulopustular type). The most cited review on TSW to date.
2021
MHRA officially recognises TSW
The UK Medicines and Healthcare products Regulatory Agency acknowledged TSW as an adverse effect of topical corticosteroids. First regulatory recognition — a turning point for the diagnosis.
March 2025 — BREAKTHROUGH
Shobnam N et al. — NIH: TSW mechanism is distinct from eczema (J Invest Dermatol)
Using transcriptomics and metabolomics, demonstrated excess NAD+ in mitochondria of TSW-affected skin cells and activation of the kynurenine pathway. A pilot study with metformin and berberine (complex I inhibitors) — after 3–5 months most participants reported significant improvement.
Significance: The definitive breakthrough. First proven biological mechanism distinguishing TSW from eczema. Opens the door to targeted therapy.
October 2025
Zemlok SK et al. — Delphi consensus on TSW management (J Cutan Med Surg)
21 physicians and patient advocates reached consensus: corticosteroid cessation, psychosocial support and dupilumab as first-line systemic treatment. First management guidelines for TSW.
January 2026
Lu MY et al. — NIH case series: 16 patients (J Clin Med)
Detailed assessment of 16 patients at NIH. All reported severe itch, heat and light sensitivity, erythema and pain. 9 of 16 reported metallic taste and metallic-smelling skin — a symptom not described in other dermatoses.
February 2026
Myles IA — dissecting the controversy (Frontiers in Medicine)
Narrative review from NIH. 85 relevant publications in PubMed, most after 2020. Calls for bridging the gap between research and patient communities.
What this means for patients
TSW research has evolved from a controversial topic to a recognised diagnosis with an identified biological mechanism. TSW is a real condition with a measurable biochemical basis. At the same time, it primarily affects people after prolonged inappropriate use of potent corticosteroids. Short-term correct use as directed is safe.
References
[1] Kligman AM, Frosch PJ. Steroid addiction. Int J Dermatol, 1979; 18:23-31.
[2] Hajar T et al. J Am Acad Dermatol, 2015; 72(3):541-549.
[3] Shobnam N et al. J Invest Dermatol, 2025. doi:10.1016/j.jid.2024.11.026
[4] Zemlok SK et al. J Cutan Med Surg, 2025. doi:10.1177/17103568251388635
[5] Lu MY et al. J Clin Med, 2026; 15:361. doi:10.3390/jcm15010361
[6] Myles IA. Front Med, 2026. doi:10.3389/fmed.2026.1786331
MUDr. Jiří Skalický
Founder of EPIDERMA®
This article is for educational purposes and does not replace medical advice.