The present review aims at giving a condensed view on the current status of therapy of atopic eczema - a common chronically relapsing inflammatory skin disease. Atopic eczema is a multifactorial disease with a tendency for chronification. Owing to the associated genetic factors, therapeutic amelioration of skin symptoms is often only transient. Therefore, treatment basically focuses on symptomatic relief. Atopic treatment should more than any other disease be guided by an individualized approach taking not only the phenotype and genotype of the disease but also psychosocial and gender aspects into account. Significant gains have been made in our understanding of atopic eczema, especially recent insights into genetic and immunologic mechanisms, but still, there is no single treatment to date that has proven to be the quantum leap for atopic patients. Novel treatments have been developed and trialled, however, more studies on novel therapies such as biologicals addressing efficacy, optimum dose and duration of treatment and the target phenotype are urgently needed. Hopefully, the tremendous progress in basic research in the last years will provide new targets for prevention and treatment in the future.