Atopic dermatitis affects approximately 20% of children internationally and is commonly associated with the development of other allergic conditions, such as peanut allergy.1 With an increase in peanut allergy, especially in children at high risk, such as those with atopic dermatitis, focus has shifted from treatment to prevention, in part through determining the mechanism of peanut sensitization. In this Viewpoint, we discuss the current understanding of the causal mechanisms of peanut allergy; describe recent guidelines on peanut allergy prevention, including in infants with atopic dermatitis; and propose possible ways that dermatologic interventions might modify the development of peanut allergy.