The prevalence of atopic eczema (AE) in adulthood is 1-3%. A positive family history, early disease onset, a severe disease course in childhood, and comorbidity of other disorders among the circle of atopic forms are predictors for persistence of AE into adulthood; furthermore, genetic risk factors are assumed. Initial manifestation of AE in adulthood is also possible. Stress/psychological burden have been classified as the most important triggering factor of AE. To date a causal therapy for AE is not available. The basis of symptomatic treatment consists of stage-appropriate skin care and moisturizing local therapy, antiseptic agents for external application, and antipruritic agents. In cases of exacerbation topical corticosteroids and/or topical calcineurine inhibitors are used. For the adult patient with severe AE who cannot be treated effectively with the topical treatment options available, UV therapy and immunosuppressive or immunomodulatory systemic drugs are recommended.