Atopic dermatitis (AD) is a chronic inflammatory skin condition affecting over 10% of children, characterized by skin irritation, redness, and itching. It is associated with genetic, environmental, and immune factors, including mutations in the filaggrin (FLG) gene, which weaken the skin barrier and increase AD risk. AD is categorized into infantile, childhood, and adult subsets, each with distinct clinical features. The disease involves complex interactions between immune cells, skin barrier dysfunction, and microbial factors, such as Staphylococcus aureus, which exacerbate inflammation. AD is linked to various comorbidities, including asthma, allergies, and cardiovascular issues, though the underlying mechanisms remain unclear. The pathogenesis of AD involves dysregulated immune responses, particularly Th2, Th17, and Th22 pathways, leading to skin barrier dysfunction, increased IgE levels, and chronic inflammation. Recent therapeutic advances include biologic medications targeting specific cytokines, such as IL-4, IL-13, and IL-31, as well as JAK inhibitors like baricitinib, upadacitinib, and abrocitinib. These therapies have shown efficacy in reducing inflammation and improving symptoms. Additionally, non-biologic targeted therapies, including small molecules, are being explored for AD treatment. Emerging therapies focus on modulating the skin microbiome, enhancing epidermal barrier function, and controlling immunological responses. Strategies such as microbiome transplantation, topical treatments targeting S. aureus, and nanotechnology-based drug delivery systems are being investigated. Nanoparticle formulations, including lipid nanoparticles and chitosan-based systems, offer targeted drug delivery with reduced side effects. These systems enhance drug penetration, improve skin hydration, and support barrier recovery. Current treatment approaches aim to reduce inflammation, heal skin, and alleviate itching, with a focus on personalized medicine. However, challenges remain in long-term safety, cost, and accessibility of these therapies. Future research emphasizes understanding the complex interplay between immune pathways, skin microbiota, and environmental factors to develop more effective and targeted treatments for AD.Atopic dermatitis (AD) is a chronic inflammatory skin condition affecting over 10% of children, characterized by skin irritation, redness, and itching. It is associated with genetic, environmental, and immune factors, including mutations in the filaggrin (FLG) gene, which weaken the skin barrier and increase AD risk. AD is categorized into infantile, childhood, and adult subsets, each with distinct clinical features. The disease involves complex interactions between immune cells, skin barrier dysfunction, and microbial factors, such as Staphylococcus aureus, which exacerbate inflammation. AD is linked to various comorbidities, including asthma, allergies, and cardiovascular issues, though the underlying mechanisms remain unclear. The pathogenesis of AD involves dysregulated immune responses, particularly Th2, Th17, and Th22 pathways, leading to skin barrier dysfunction, increased IgE levels, and chronic inflammation. Recent therapeutic advances include biologic medications targeting specific cytokines, such as IL-4, IL-13, and IL-31, as well as JAK inhibitors like baricitinib, upadacitinib, and abrocitinib. These therapies have shown efficacy in reducing inflammation and improving symptoms. Additionally, non-biologic targeted therapies, including small molecules, are being explored for AD treatment. Emerging therapies focus on modulating the skin microbiome, enhancing epidermal barrier function, and controlling immunological responses. Strategies such as microbiome transplantation, topical treatments targeting S. aureus, and nanotechnology-based drug delivery systems are being investigated. Nanoparticle formulations, including lipid nanoparticles and chitosan-based systems, offer targeted drug delivery with reduced side effects. These systems enhance drug penetration, improve skin hydration, and support barrier recovery. Current treatment approaches aim to reduce inflammation, heal skin, and alleviate itching, with a focus on personalized medicine. However, challenges remain in long-term safety, cost, and accessibility of these therapies. Future research emphasizes understanding the complex interplay between immune pathways, skin microbiota, and environmental factors to develop more effective and targeted treatments for AD.