In patients with atopic eczema, the quality of life is seriously affected by tormenting pruritus. As the pathogenesis of pruritus is not understood, symptomatic measures are the mainstay of treatment along with avoiding aggravating factors. They include emollients, topical and systemic active ingredients and physical therapy (e. g. phototherapy) adjusted to the acuity the disease. Behavioral therapy offers additional support. New treatment modalities, partly still in experimental stage, such as immunomodulators, immunosuppressive agents and opiate antagonists are reserved for nonresponding patients; they too are reviewed.