Objectives : The purpose of this study is to determine clinical efficacy of herbal medicine by evaluating SCORAD Index and total level of ceramaides in the skin of 13 children with atopic dermatitis Methods : Subjects are divided into two groups : Group 1(non-differentiation children treated with Saenghyeoryunbueom) and group 2(differentiation children treated with either pyungwisan, onchungum or gamitongsungsan). We determine SCORAD Index and total level of ceramaides in the skin of 13 children with atopic dermatitis before and after taking each of herbal treatment for 12 weeks. Results : After herbal prescription for 12 weeks, A SCORAD index of both group 1 and group 2 was decreased. However, the total level of ceramides in group 1 and group 2 was not altered after 12 weeks. When the correlation between the alteration of SCORAD index and ceramides levels was determined, the SCORAD index in group 1 was inversely correlated with the total level of ceramides(r=-0.994, p=0.006) In contrast, the alteration of SCORAD index in group 2 was not correlated with ceramide levels. Conclusions : The clinical efficacy of Saenghyeoryunbueom for non-differentiation children with atopic dermatitis is paralleled with the increased level of ceramides in skin. The clinical efficacy of pyungwisan, onchungum or gamitongsungsan for differentiation children with atopic dermatitis is not correlated with ceramide level in skin.