Topical steroid withdrawal diagnostic criteria defined by NIH researcher

Researchers at the National Institutes of Health (NIH) have uncovered new insights into dermatitis caused by topical steroid withdrawal (TSW), revealing that it is distinct from eczema and linked to high levels of a key chemical compound called nicotinamide adenine dinucleotide (NAD+), a form of vitamin B3. In their study, published in the Journal of Investigative Dermatology, NIH scientists found that TSW symptoms—such as redness, burning, and itching—are associated with elevated NAD+ levels in the blood and skin.

The team discovered that NAD+ production, triggered by topical steroids, contributes to inflammation. They also found that drugs blocking NAD+ formation, such as metformin and berberine, may improve TSW symptoms, based on a pilot study. This research suggests that NAD+ could be a target for future treatments, and it provides new criteria for diagnosing TSW, helping healthcare providers identify the condition more accurately. While the study opens the door to potential therapies, further research is needed to understand the full scope of TSW and refine treatment approaches.

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Elevate-Derm Alliance Editorial Committee