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This review critically synthesizes clinical and preclinical evidence for herbal medicines, standardized extracts, food\u2010derived bioactives, functional\u2010food candidates, nutraceutical ingredients, and natural\u2010product delivery systems in AD, with particular attention to pediatric safety. Recurrent experimental signals include attenuation of Th2 cytokines and IgE, suppression of mast\u2010cell and IL\u201031\u2010related itch pathways, restoration of filaggrin and tight\u2010junction proteins, and modulation of MAPK\/NF\u2010\u03baB, JAK\/STAT, Nrf2\/HO\u20101, and NLRP3 signaling. However, efficacy is not inferred from pathway changes alone. Human evidence remains heterogeneous, and apparently promising agents have failed to outperform active comparators, produced neutral microbiome results, or raised barrier and sensitization concerns. We therefore integrate four issues that are often treated separately: food sources and processing\u2010dependent chemistry; oral bioaccessibility and food\u2010matrix effects; gut\u2010skin signaling and its uncertain causal direction; and compatibility with standard topical agents, cyclosporine, biologics, and JAK inhibitors. The evidence supports selected botanicals as investigational adjuncts rather than as replacements for guideline\u2010based care. Translation requires authenticated materials, quantitative chemical fingerprints, exposure\u2010response studies, age\u2010appropriate safety surveillance, interaction assessment, and controlled trials using validated clinical and barrier endpoints.<\/jats:p>","DOI":"10.1002\/fsn3.72239","type":"journal-article","created":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:10:11Z","timestamp":1789186211000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Herbal Extracts and Plant\u2010Derived Bioactives in Atopic Dermatitis: Evidence, Mechanisms, Pediatric Safety, and Translational Priorities"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1047-3598","authenticated-orcid":false,"given":"Muhuang","family":"Zeng","sequence":"first","affiliation":[{"name":"Shantou Hospital of Traditional Chinese Medicine  Shantou 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