Various types of dressings have been used successfully in the treatment of atopic dermatitis. In this study we looked at the efficacy of two of the newer topical steroids when applied under wet wrap dressings for the treatment of refractory atopic dermatitis in children. Forty children with moderate to severe disease were randomized to receive either one-tenth-strength diluted 0.1% mometasone furoate ointment or one-tenth-strength diluted 0.005% fluticasone proprionate ointment. These were applied once a day over a 4-week period without wet wraps, or for 2 weeks without wet wraps followed by 2 weeks of application under wet wraps. There was a 2-week period for all patients when the topical treatment was standardized. At weekly follow-ups, patients were assessed by a single, blinded observer and objectively scored for disease extent and severity. A subjective score was also given for the impact of eczema on daily living. There was significant improvement in the disease severity from baseline during the first 2 weeks of the open application arm (p=0.043), however, additional beneficial effects were limited after week 2. Wet wraps further improved the disease severity and extent after week 2 (p < 0.05), and were well tolerated. We concluded that both 0.1% mometasone furoate and 0.005% fluticasone proprionate ointments are effective in the treatment of atopic dermatitis, and that wet wraps are useful in further improving refractory disease in children.