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Atopic dermatitis (AD) is a chronically relapsing dermatitis associated with pruritus, sleep disturbance, psychosocial symptoms and impaired quality of life. Avoidance of triggering factors, optimal skin care, topical corticosteroids and calcineurin inhibitors are the mainstay of therapy for AD. Recent advances in the understanding of the pathophysiological process of AD involving filaggrin and ceramide metabolism has led to the concept of barrier therapy and production of new moisturizers and topical skin products targeted to correct reduced amounts of ceramides and natural moisturizing factors in the skin. Although some of these commercial products show promising effects, efficacy on skin biophysiologic, clinical and psychosocial parameters have not been consistently demonstrated. Well-designed, large scale, randomized, placebo-controlled trials to document therapeutic effects on disease severity, dermatologic biophysical parameters, quality of life and patient acceptability are needed. The ideal skin barrier therapeutic agent is yet to be invented
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