LAUSR

We thank you for showing interest in the study and for your valuable insights. 1 This study was aimed to compare efficacy of a commonly available paraffin-based moisturizer with a ceramide-based moisturizer in a real-world setting. 2 While we acknowledge that the concentration of ceramides in the moisturizer used may be lower compared to some other available moisturizers, the study design was intended to reflect the choices available to practitioners and patients in a typical clinical setting in India. This product (Aquaoat cream), like many others in the market, contains ceramides in combination with other ingredients. The placement of ceramides lower down the ingredient order is not unique to our chosen product. In fact, many ceramide-containing moisturizers, including those frequently cited in dermatological research, follow a similar formulation approach where ceramides are not the sole or primary ingredient. Paraffin is a common ingredient in multiple skincare formulations, well-recognized for its moisturizing benefits. Our study aimed to evaluate the products as whole formulations rather than individual ingredients. It is common for moisturizers to contain a blend of ingredients, and our focus was on the overall clinical efficacy of the products. The presence of paraffin in both moisturizers ensures that the comparison focuses on the additional benefits provided by cera-mides, allowing us to evaluate their specific contribution to the treatment of atopic dermatitis effectively. We agree that further research, including trials using ceramide-based moisturizers with higher ceramide concentrations and without paraffin,