Chronic AD is a recalcitrant dermatosis which is suboptimal managed in the primary health care setting and has a significant disease burden to the society. The main pathogenesis is an innate or acquired epidermal barrier defects, immune function aberrancy with early stage Immunoglobulin E (IgE) sensitization and the cognitive itch – scratch viscous cycle. Topical corticosteroids, calcineurin inhibitors, systemic antibiotics, immunosuppressants and recently introduction of immune target specific biologics are considered to be the mainstay of treatments. Correct and accurate use of these armamentarium has evidence - based benefits and may provide adequate control of chronic AD. However, all these medicines are not without side effects and some of them could be of public health concern. For example, the injudicious use systemic antibiotics have produced the most widespread antibiotics resistance in the world which is especially worst in China, Korea and Hong Kong. Moreover, biologics are expensive; mostly unaffordable in less affluent geographies and the long- term consequences are still unknown.