Topical drug delivery is a cornerstone of dermatological therapy, offering targeted treatment with minimized systemic side effects. However, the formidable barrier function of the stratum corneum limits the penetration of most therapeutic agents. Nanocarrier-based delivery systems, including liposomes, ethosomes, solid lipid nanoparticles (SLNs), and polymeric nanoparticles, have emerged as promising strategies to enhance skin permeation and retention. This review provides a comprehensive overview of the mechanisms, advantages, and clinical applications of nanocarriers in dermatology. Special emphasis is placed on their role in the treatment of chronic inflammatory skin diseases, infections, and cosmetic applications. Future perspectives highlight the integration of stimuli-responsive systems and personalized medicine approaches.