Is TSW Becoming More Accepted in Dermatology? With Brad P. Glick, DO, MPH

Topical steroid withdrawal (TSW) syndrome is considered by some to be a controversial topic in the dermatology world today, but it is becoming more widely discussed among clinicians and patients.1

Brad Glick, DO, MPH, a board-certified dermatologist and dermatologic surgeon known for his role at the Glick Skin Institute, spoke with the HCPLive team during the 2026 American Academy of Dermatology (AAD) Annual Meeting in Denver, Colorado, about this topic and others covered in his session at the conference. He was first asked whether TSW is becoming more accepted as a real condition in the dermatology space.

“[Just] ask the country of Canada…and Great Britain, where there are now specific warnings and package inserts for topical corticosteroids, about TSW,” Glick expressed.

He addressed the growing recognition of TSW, describing the condition as increasingly supported by emerging research and international regulatory acknowledgment around the world. Glick added, despite some remaining skepticism within the dermatology community, that mounting data and patient presentations are contributing to TSW’s broader acceptance as a real condition.

From a clinical standpoint, he described several characteristic features to aid clinicians in their identification of TSW. Such characteristics include diffuse erythema, especially involving the face, as well as more distinctive findings such as the “sleeve sign.” This sign is marked by the sharp demarcation of erythema located on patients’ wrists or ankles, as well as erythema of the lower extremities.

Glick further referenced recent mechanistic insights suggesting a potential role for metabolic pathways, including NADH-related processes, in driving rebound inflammation following chronic or moderate topical corticosteroid use, potentially helping to clarify the pathophysiology underlying TSW.

Additionally, he pointed to the role of patient awareness and social media in amplifying recognition of TSW. Specifically, Glick described a marked increase in inquiries among patients following educational presentations on the subject. Despite acknowledgement of online discourse sometimes overstating various concerns, he emphasized that clinicians are encountering individuals with symptoms aligned with TSW in clinical practice.

Beyond TSW, Glick also provided HCPLive with a broader perspective on therapeutic innovations in dermatology in 2026. Glick pointed to the expansion of non-steroidal topical agents’ availabilities as a notable advancement, adding that such shifts may help patients’ disease control and may diminish their reliance on intermittent corticosteroid use. Later, Glick noted the sustained impact of biologic drugs in the current armamentarium, particularly in psoriasis and atopic dermatitis.

Looking ahead, Glick expressed optimism regarding the development of novel oral medications, and this was described by Glick as especially true for psoriasis. Such developments may complement existing biologic and topical options for patients with dermatologic diseases. Nevertheless, the critical barrier of access was cited by Glick as remaining, with prior authorization requirements being described as a persistent obstacle.

The quotes used in this interview summary were edited for clarity.

Glick has served as an adviser, consultant, speaker, or investigator for Amgen, AbbVie, AstraZeneca, Almirall, Arcutis, Bausch Health/Valeant, Ortho Dermatologics, Boehringer Ingelheim, Bristol-Myers Squibb, Brickell Biotech, Cara, ChemoCentryx, Dermavant, Dermira, Eli Lilly, EPI/Novan, Incyte, Janssen Pharmaceuticals, LEO Pharma, Galderma, Nimbus Lakshmi, Inc, Novartis, Sun Pharma, Pfizer, Sanofi, Regeneron, UCB and the CorEvitas AD, CorEvitas PSO, and PROSE Registries and is a shareholder of Top MD

References

1. Lio P. Addressing Doubts About Topical Steroid Withdrawal (TSW), with Peter Lio, MD. HCPLive. June 10, 2025. Accessed December 12, 2025. https://www.hcplive.com/view/addressing-doubts-about-topical-steroid-withdrawal-tsw-peter-lio-md.

2. Glick B, et al. S065 What's New in Dermatology. Session presented at: 2026 American Academy of Dermatology Annual Meeting; March 27–31, 2026; Denver, CO.