Atopic eczema, or atopic dermatitis, is a chronic inflammatory skin disease that affects 15-20% of children and 2-10% of adults in industrialised nations. Having a substantial negative impact on quality of life, eczema represents a significant disease burden that has produced a global market worth over US$1 B. Despite this, there have been relatively few new therapies to appear over the past few decades. This article looks at underlying causes of eczema, both genetic and environmental, and discusses the existing treatment regimes as well as novel therapies currently in development.