Summary: Atopic eczema is a common skin disease beginning in early childhood. In people with strong genetic background lasts the whole life. Therefore, the treatment is chronic. Most medications used in atopic eczema are applied topically. Systemic treatment with immunosuppressants or biological medications are utilized in the severe cases. Although the most common treatment should not cause systemic adverse events, many patients and doctors have concerns. In this review we concentrate on safety of local atopic eczema treatment. We also recall some major mistakes in the clinical practice. Finally, we suggest a simple algorithm leading to safe and efficient atopic dermatitis treatment.