Eczema is exhausting. The itch wakes children at night, the scratching breaks the skin, the skin gets infected, the treatment gets stopped because someone said steroids are dangerous, and the whole cycle starts again. Families often arrive at this clinic after months of it.

Atopic dermatitis cannot be cured, but it can be controlled extremely well – and the difference between a family who is coping and a family who is not is almost always the quality of the plan, not the severity of the disease.

Types of eczema and dermatitis we treat

  • Atopic dermatitis (eczema) – the chronic, itchy, relapsing type, usually starting in childhood and often running with asthma and allergic rhinitis in the family.
  • Contact dermatitis – irritant (detergents, disinfectants, water, cement) or allergic (nickel, hair dye, fragrance, rubber, some plants and topical medicines).
  • Seborrhoeic dermatitis – flaking and redness on the scalp, eyebrows, sides of the nose and chest; dandruff at its mildest, and very common.
  • Discoid (nummular) eczema – coin-shaped patches, frequently mistaken for ringworm and treated with the wrong cream for months.
  • Hand eczema – an occupational problem for nurses, cleaners, hairdressers, chefs and mechanics.
  • Pompholyx – deep, intensely itchy blisters on the palms and sides of the fingers.
  • Lichen simplex chronicus – a thickened, leathery patch created and maintained by chronic scratching.

Getting the type right matters. Discoid eczema treated as ringworm gets worse. Ringworm treated with a strong steroid spreads and becomes almost unrecognisable. That is why a scraping is taken when the picture is not clear – see fungal and bacterial skin infections.

Why eczema is so common here

Nairobi’s climate is harder on eczema-prone skin than people expect. The city is dry and dusty for much of the year, with a real chill in July and August, then humid during the rains. Hard water, strong detergents, “medicated” antiseptic soaps and antibacterial bar soaps strip an already fragile barrier. Dust mites thrive in bedding and carpets. And smoke from cooking and traffic pollution add another layer of irritation.

The result is a barrier that leaks water and lets irritants in, which is why moisturiser is not a nice-to-have in eczema – it is the treatment.

How we treat eczema

Step 1: settle the flare

Active, inflamed eczema needs an anti-inflammatory strong enough to switch it off. Topical corticosteroids are chosen by potency and by site – a mild one for a baby’s face, a stronger one for thickened patches on the limbs – and used properly for a defined period. Under-treating with a steroid that is too weak for too long causes far more harm than a short, correct course. Steroid-sparing options such as topical calcineurin inhibitors are used for the face, eyelids and skin folds.

Step 2: treat any infection

Weeping, crusting, sudden worsening or a golden crust means bacterial infection, which needs antibiotics alongside the eczema treatment. Clusters of punched-out blisters can indicate a viral (herpetic) infection, which is urgent.

Step 3: repair the barrier

An emollient used generously, several times a day, and applied straight after bathing while the skin is still damp. We will help you pick something affordable that you can actually buy in bulk in Nairobi – the best moisturiser is the one you will still be using in three months.

Step 4: find and remove triggers

Soaps and detergents, fragranced products, wool, overheating at night, dust mites, and in some patients specific allergens. Where allergic contact dermatitis is suspected, patch testing or an elimination approach is used. Food allergy is over-blamed for eczema in general, but it is genuinely relevant in a minority of infants and is assessed properly rather than guessed at.

Step 5: maintenance

Once clear, most patients continue emollients daily plus intermittent anti-inflammatory treatment on the two or three days a week when flares usually start. This “proactive” approach dramatically reduces the number of flares.

Severe or resistant eczema

Where topical therapy is not enough, systemic treatment options are discussed and monitored appropriately, and a skin biopsy may be taken if the diagnosis needs confirming.

Eczema in babies and children

Infantile eczema typically starts on the cheeks and scalp and later moves to the elbow and knee creases. It is intensely itchy, and a scratching baby does not sleep – which means neither does anyone else in the house.

Our paediatric approach is practical: a bathing and emollient routine that fits a real family’s evening, a clear written plan for what to use when the skin flares, mittens and nail care for the scratching, and honest reassurance about topical steroids, which are safe and effective when they are used correctly and are far safer than months of uncontrolled inflammation. Read more about paediatric dermatology at SkinByDrNancy.

The bath routine that works

  • Short, lukewarm baths – not hot, not long.
  • A soap substitute or gentle non-foaming wash. No antiseptic bar soaps.
  • Pat dry – do not rub.
  • Emollient within three minutes of getting out, on damp skin.
  • Anti-inflammatory cream on the active patches, as prescribed, then emollient over everything else.

Living with eczema in Nairobi

A few local specifics that make a measurable difference:

  • Water: if your borehole water is hard, it will sting. Rinse and moisturise immediately afterwards.
  • Laundry: use a plain detergent, skip fabric softener, and run an extra rinse.
  • Bedding: wash sheets weekly in hot water; keep soft toys off the bed.
  • Dust: damp-dust rather than sweeping, especially in the dry, windy months.
  • Cold season: July and August flares are common – increase emollient use before they start, not after.
  • Avoid herbal preparations and unlabelled creams applied to broken skin. They cause a large share of the contact dermatitis we see.

Eczema & dermatitis in Nairobi – questions patients ask

Are steroid creams safe for eczema?

Yes, when they are prescribed at the right potency, for the right site, for a defined period. The harm people worry about comes from unsupervised long-term use of strong steroids – typically the ones sold over the counter for skin lightening – not from a correctly used prescription.

Can eczema be cured?

Atopic eczema is not cured, but it is very controllable, and many children improve substantially as they grow. The aim is long stretches of clear, comfortable skin with quick control of any flare.

Is my child’s eczema caused by food?

Usually not. Food allergy plays a role in a minority of infants with moderate to severe eczema. Cutting out foods without evidence risks nutritional harm, so we assess it properly rather than guessing.

Why does my eczema keep getting infected?

Broken, scratched eczema skin is easily colonised by bacteria. Better control of the underlying inflammation is the long-term answer; antibiotics treat the infection but do not prevent the next one.

What is the difference between eczema and ringworm?

Ringworm is a fungal infection with a raised, scaly, advancing edge and central clearing, and it responds to antifungals. Eczema is inflammatory. They look similar enough that a skin scraping is often the only reliable way to tell – see skin infections.

Do you treat adult hand eczema?

Yes, and it is common in nurses, cleaners, hairdressers, mechanics and chefs. Treatment combines anti-inflammatory therapy with practical protection at work, since the hands cannot simply be rested.

Book eczema treatment in Nairobi

If the itch is not settling, if your child is not sleeping, or if you have been going round in circles with creams that half work, book a consultation and get a proper plan.

SkinByDrNancy is at Landmark Plaza, 2nd Floor, Argwings Kodhek Rd, Nairobi. Call or WhatsApp 0728 566990, email info@skinbydrnancy.com, or use the online booking form. We are open Monday to Friday 7:00am – 6:30pm and Saturday 7:00am – 12:00pm, and most medical insurance schemes are accepted.

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Book eczema treatment with Dr Nancy Omwenga

Landmark Plaza, 2nd Floor, Argwings Kodhek Rd, Nairobi. Same-day appointments and walk-ins are available where the diary allows, and most medical insurance schemes are accepted.

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Book with Dr Nancy Omwenga

Same-day appointments and walk-ins are available. Most medical insurance schemes are accepted.

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Clinic details

SkinByDrNancy
Landmark Plaza, 2nd Floor, Argwings Kodhek Rd, Nairobi
0728 566990
info@skinbydrnancy.com

Mon – Fri 7:00am – 6:30pm
Sat 7:00am – 12:00pm
Sunday closed

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