Discussion This study has not yielded any evidence for efficacy of borage oil in the treatment of atopic dermatitis. We found no significant benefit over placebo in the sign score, symptom scores, global assessments of response by patients,or corticosteroid dose sparing effect.Subset analysis of adults and children did not indicate any difference in response between these groups. Both borage oil and placebo were well tolerated, with no significant differences between the treatment groups. The greatest level of response to borage oil likely to be compatible with these data is a two point improvement in the SASSAD score.If a benefit of this magnitude occurred (approximately 7% of the baseline sign score), this would be of limited clinical value. A two point improvement might represent, for example, an improvement of a single sign by one grade in two areasoroftwodifferentsignsinoneoutofthesixareasassessed. However, the data do not exclude the possibility of such a small degreeofbenefit.Thedatadonotsuggestthatalongerduration of treatment would have been more likely to have yielded a positiveoutcome.Indeed,figure2wouldsuggestthat,ifanything,the difference in favour of placebo was widening.