Atopic dermatitis (AD), also known as atopic eczema, is a chronic inflammatory skin disease characterized by pruritic skin lesions, dryness, and skin pain. It affects 20% of children and 1-3% of adults, with a female predominance. AD is associated with sleep disturbance, anxiety, hyperactivity, and depression. The disease is caused by a combination of epidermal barrier dysfunction and immune dysregulation. Skin serves as a mechanical and natural barrier against toxins and water loss. Factors such as genetics, family history, diet, immune triggers, and environment contribute to AD. Prevention, early diagnosis, and effective treatment are essential for managing AD. Nano-delivery systems offer a promising approach for targeted drug delivery to the skin without systemic effects. This review explores the current understanding and approaches of AD, including the role of nano-dermatology, skin immunology, epidermal barrier dysfunction, immune dysregulation, and filaggrin gene mutations. The review also discusses the role of Th17 lymphocytes, TSLP, IL-4, IL-13, IL-5, IL-17, and other cytokines in AD pathogenesis. The review highlights the importance of skin microbiota, skin pH, and environmental factors in AD development. The review also discusses the role of filaggrin gene mutations, immune cell interactions, and the impact of environmental factors such as air pollution, humidity, and temperature on AD. The review concludes that a comprehensive understanding of AD pathogenesis is essential for developing effective treatments and prevention strategies.Atopic dermatitis (AD), also known as atopic eczema, is a chronic inflammatory skin disease characterized by pruritic skin lesions, dryness, and skin pain. It affects 20% of children and 1-3% of adults, with a female predominance. AD is associated with sleep disturbance, anxiety, hyperactivity, and depression. The disease is caused by a combination of epidermal barrier dysfunction and immune dysregulation. Skin serves as a mechanical and natural barrier against toxins and water loss. Factors such as genetics, family history, diet, immune triggers, and environment contribute to AD. Prevention, early diagnosis, and effective treatment are essential for managing AD. Nano-delivery systems offer a promising approach for targeted drug delivery to the skin without systemic effects. This review explores the current understanding and approaches of AD, including the role of nano-dermatology, skin immunology, epidermal barrier dysfunction, immune dysregulation, and filaggrin gene mutations. The review also discusses the role of Th17 lymphocytes, TSLP, IL-4, IL-13, IL-5, IL-17, and other cytokines in AD pathogenesis. The review highlights the importance of skin microbiota, skin pH, and environmental factors in AD development. The review also discusses the role of filaggrin gene mutations, immune cell interactions, and the impact of environmental factors such as air pollution, humidity, and temperature on AD. The review concludes that a comprehensive understanding of AD pathogenesis is essential for developing effective treatments and prevention strategies.