Atopic dermatitis (AD) is a frequent chronic remittent skin disease. The pathophysio-logy of AD has been increasingly better understood within the last years. This may help to identify different endotypes which are suitable for defined therapies. A patient oriented therapy considers besides phenotypical features also genetic and biologi-cal markers. The most recent developments regarding biologics and small molecule drugs are presented in this article. Such molecules will change the treatment perspec-tives for atopic dermatitis in the future if they will be approved. Dupilumab is the first approved biologic for the treatment of moderate to severe atopic dermatitis in adolescence and adulthood and has led to a significant impro-vement of the treatment of this chronic disease. In the present article we show real-li-fe data on the efficacy of dupilumab in adult dermatitis patients and discuss other relevant data, but also open questions, which are important for the standard care of atopic dermatitis patients.