“TSW is real. It occurs most commonly in the setting of long-term and daily medium to high potency steroid use, especially on the face. While topical steroids can be effective in improving inflammation in the skin of patients with eczema, research has confirmed the need for avoiding daily long-term use of topical steroids. For patients needing longer-term management, incorporating non-steroidal therapies and using topical steroids only intermittently (such as twice per week), will likely prevent most cases of TSW. We as dermatologists need to do a better job educating patients about how to use TCS safely long-term and we as dermatologists need to be better at recognizing this adverse effect in our patients.”