BACKGROUND Patients with atopic dermatitis show a defective barrier function. In atopic skin, ceramide is significantly decreased and the secretion of lamellar bodies is also impaired. To mimic lamellar bodies, we prepared lipid granules composed of ceramide, fatty acids and cholesterol. Because these lipid granules contain multiple lamellar structures, it is expected that they will have superior affinity to skin; hence, they should have a good moisturizing effect. This study was performed to evaluate the effects of moisturizer containing lipid granules on atopic dermatitis. METHODS Patients with mild atopic dermatitis (n = 30, aged 5-19 years) were recruited and instructed to apply a moisturizer containing physiologic lipid granules for 4 weeks. The SCORing Atopic Dermatitis (SCORAD) score and general symptoms were evaluated. In addition, transepidermal water loss (TEWL) and stratum corneum (SC) hydration were also measured. RESULTS Twenty-nine patients completed the study. The SCORAD value decreased dramatically after 4 weeks of moisturizer application (p = 0.000). The general symptoms of atopic dermatitis were also greatly improved. At baseline, most patients reported their symptoms as mild and moderate, but after 4 weeks 20 of the patients (69%) had no symptoms. The TEWL was not changed, but the SC hydration increased significantly (p = 0.000). No significant adverse effects were observed. CONCLUSIONS Moisturizer containing lipid granules effectively controlled atopic dermatitis.