Acne is the single most common reason patients walk into this clinic, and almost all of them arrive having already tried something – a face wash from the chemist, a “pimple cream” from a friend, an antibiotic course that half worked, a facial that made things worse, or a lightening cream that turned a few spots into a bumpy, discoloured mess.

Acne is a medical condition, not a hygiene problem. It responds extremely well to the right treatment and barely at all to the wrong one. At SkinByDrNancy, Dr Nancy Omwenga grades your acne, works out what is driving it, and puts you on a plan that is strong enough to work and simple enough to keep up.

What causes acne?

Four things happen together in an acne-prone follicle: the oil gland produces more sebum, dead skin cells block the pore, Cutibacterium acnes bacteria multiply in the blocked follicle, and the body mounts an inflammatory response. That inflammation is what turns a harmless blackhead into a red, painful spot – and in darker skin, it is also what leaves a brown mark that outlasts the spot by months.

Common drivers we see in Nairobi:

  • Hormones – puberty, polycystic ovary syndrome, and the jawline acne that flares in the week before a period.
  • Cosmetics and hair products – heavy oils, pomades and petroleum-based products cause a very recognisable pattern of acne along the hairline, temples and forehead (pomade acne).
  • Topical steroids – unprescribed steroid creams and lightening products cause a rebound eruption of monotonous small papules once you stop.
  • Friction and sweat – helmets, masks, sports gear and heavy backpacks on the back and shoulders.
  • Medication and supplements – some progestogens, anabolic steroids, high-dose B vitamins and lithium.
  • Diet – high-glycaemic diets and, in some people, skimmed dairy can worsen acne. Chocolate and fried food are not the villains they are made out to be.

The types of acne we treat

Type What it looks like Typical approach
Comedonal acne Blackheads and whiteheads, mainly forehead and nose, little redness Topical retinoid, gentle exfoliation, occasionally a superficial peel
Mild to moderate inflammatory acne Red papules and pustules with comedones Topical retinoid plus benzoyl peroxide or topical antibiotic
Moderate to severe acne Widespread inflamed lesions, some deep and tender Oral antibiotics or hormonal therapy alongside topicals
Nodulocystic acne Deep, painful nodules and cysts; scars readily Systemic therapy, intralesional steroid for individual cysts, early scar prevention
Hormonal / adult female acne Jawline, chin and neck; flares premenstrually Hormonal assessment and treatment plus topicals
Acne mechanica Follows the line of a helmet, strap or mask Remove the trigger plus standard acne therapy
Steroid-induced acne Uniform small bumps after using a lightening or steroid cream Supervised steroid withdrawal plus acne therapy

How acne is treated at SkinByDrNancy

Treatment is staged. We do not throw everything at the skin at once, because that is how you end up irritated, discouraged and back where you started.

1. Assessment

Dr Nancy grades the acne, maps where it sits, checks for scarring and pigmentation, and goes through everything you are already putting on your face and hair. Where the pattern suggests a hormonal cause – irregular periods, excess facial hair, sudden adult onset – blood tests or a pelvic ultrasound may be arranged.

2. Prescription topicals

Topical retinoids are the backbone of nearly every acne plan: they unblock pores, prevent new lesions and, usefully, improve pigmentation and fine scarring at the same time. They are combined with benzoyl peroxide, topical antibiotics, azelaic acid or salicylic acid depending on the picture. Getting the strength and the introduction schedule right is what stops the “my skin got worse” phase from derailing treatment.

3. Oral treatment where it is needed

Moderate to severe acne usually needs systemic therapy – an oral antibiotic course, hormonal therapy for suitable female patients, or systemic retinoid therapy for severe or scarring acne, which is prescribed and monitored carefully with the necessary blood tests and precautions.

4. In-clinic procedures

  • Chemical peels – salicylic and other superficial peels clear comedones and fade post-inflammatory marks.
  • Intralesional steroid injection – a painful cyst can be flattened within a couple of days, which also lowers the risk of it scarring.
  • Extraction – stubborn comedones removed sterilely rather than squeezed at home.
  • Microneedling – once the acne is controlled, for rolling and boxcar scars.

5. Treating what acne leaves behind

In melanin-rich skin, the mark is often more distressing than the spot. Post-inflammatory hyperpigmentation is treated with topical agents, peels and strict daily sun protection – see hyperpigmentation and melasma treatment. True scars (indented or raised) need different treatment again: microneedling for atrophic scars, and injection or excision for keloid and hypertrophic scars, which are common on the jaw, chest and back.

How long does acne treatment take?

Be realistic and you will do well:

  • Weeks 0-4: the skin adjusts to the retinoid. Some dryness and an initial purge are normal.
  • Weeks 6-8: fewer new spots appearing. This is the first honest checkpoint.
  • Weeks 12-16: substantial clearing of active acne.
  • Months 4-9: the dark marks fade – much slower than the spots themselves.
  • Maintenance: most people stay on a low-intensity topical afterwards. Acne relapses when treatment stops entirely.

Please stop doing these

  • Picking and squeezing – it is the fastest route to permanent scarring.
  • Using unprescribed steroid or lightening creams on acne.
  • Scrubbing with harsh exfoliants or medicated soap to “dry it out”.
  • Taking repeated short antibiotic courses from the chemist without a plan.
  • Skipping sunscreen – it is what stops the marks from darkening again.

Acne care for skin of colour

Two things are different in darker skin. First, inflammation leaves pigment – so controlling inflammation early matters more than in lighter skin. Second, aggressive treatments backfire: too strong a peel, too deep a needle or an over-enthusiastic laser causes more pigmentation than it clears. Every peel strength, needle depth and retinoid concentration used at SkinByDrNancy is chosen with that in mind.

It also means the pigmentation deserves its own treatment plan rather than being treated as an afterthought – which is exactly how we approach it.

What makes acne different in Nairobi

Acne is the same condition everywhere, but the things that aggravate it are local, and the treatment that works here is not always the treatment recommended in a magazine written somewhere colder.

Four things come up again and again in this clinic:

  • Equatorial UV at 1,795 metres. Nairobi’s sun is stronger than most people assume, and it darkens every acne mark it touches. Sun exposure does not cause acne, but it is a major reason the marks outlast the spots by months.
  • Dust and the dry season. The dry, dusty stretch from June to September sends people towards heavier occlusive products, which then block follicles.
  • Over-the-counter steroid creams. Widely sold, widely recommended by well-meaning friends, and a reliable way to produce a stubborn steroid-induced acne that looks like ordinary acne but behaves nothing like it.
  • Helmets, masks and headscarves. Anything that traps heat and friction along the jaw, forehead or chin will make acne worse in that exact distribution. Boda riders and commuters see this constantly.

Reading your own breakout pattern

Where acne sits on the face often hints at what is driving it. This is a starting point for the conversation, not a diagnosis:

Where it appears Often associated with What usually helps
Jawline and chin, flaring monthly Hormonal patterns Prescription therapy aimed at the hormonal driver, not scrubs
Forehead and temples Hair products, helmets, headwear Changing the product or the friction, plus topical treatment
Cheeks, widespread small bumps Occlusive skincare or make-up Simplifying the routine before adding anything new
Chest, back and shoulders Sweat, friction, occlusion Washing promptly after exercise, plus body-specific treatment
Sudden onset after starting a cream Steroid-induced acne Planned withdrawal of the cream alongside treatment

A checklist before your first appointment

Bring these and the first consultation will be far more productive than a conversation from memory:

  1. Every product you put on your face – cleansers, creams, oils, make-up, and anything a relative or salon gave you. The actual containers, not the names.
  2. Any tablets you have taken for it, including antibiotics from a chemist and how long you took them.
  3. Photographs at its worst. Acne has a habit of behaving on appointment day.
  4. A rough timeline – when it started, what has changed, and whether it tracks with your cycle.
  5. What you are actually hoping for – fewer spots, fewer marks, or less scarring. These need different plans.

If scarring is your main concern, say so at the start. Scar treatment such as microneedling works far better once active acne is quiet, so the order of treatment matters.

Acne Treatment in Nairobi – questions patients ask

How much does acne treatment cost in Nairobi?

It depends on whether you need topicals alone, oral therapy, or in-clinic procedures such as peels. Fees are quoted before you attend and most medical insurance schemes cover the consultation and medical treatment. Call 0728 566990 for an exact figure.

Will my acne come back after treatment?

Acne is controlled rather than cured, so most people stay on a light maintenance topical after clearing. Stopping everything abruptly is the most common reason for relapse.

Can a facial clear my acne?

A facial can help with comedones and skin texture, but it does not treat the inflammatory process that causes acne, and some salon treatments make it worse. Medical acne needs prescription treatment – a medical chemical peel prescribed by a dermatologist is a different thing entirely.

Is isotretinoin (Roaccutane) available in Nairobi?

Systemic retinoid therapy is prescribed where it is genuinely indicated – severe, scarring or treatment-resistant acne – with the required counselling, monitoring blood tests and pregnancy precautions. It is not a first-line treatment and it is not something to buy online.

Does diet cause acne?

High-glycaemic diets and, in some people, skimmed dairy can worsen acne. But diet alone rarely explains it, and no amount of clean eating replaces proper treatment.

I have dark marks left from old spots – can those be treated?

Yes. Post-inflammatory hyperpigmentation responds to topical treatment, superficial peels and daily sunscreen, though it takes months rather than weeks. See hyperpigmentation treatment.

Can teenagers be treated?

Yes, and the earlier the better – treating acne early is the most reliable way to prevent scarring. Teenagers are seen with a parent or guardian; see also paediatric dermatology.

Does diet cause acne?

For most people diet is a minor player next to hormones and genetics, so no single food is to blame. There is reasonable evidence that heavily sugary diets and, for some people, large amounts of skimmed milk can worsen it. Changing your diet alone rarely clears acne, and it should not delay proper treatment.

Should I stop wearing make-up?

No, but simplify. Non-comedogenic products, removed properly at the end of the day, are compatible with treatment. What tends to cause trouble is layering many heavy products, or using make-up to cover skin that is being irritated by something already in the routine.

Why did my skin get worse before it got better?

Several effective acne treatments cause an initial flare as blocked follicles clear, usually in the first few weeks. It is expected and it settles. This is exactly why people abandon treatment early, so it is worth knowing in advance rather than discovering it alone.

Book acne treatment in Nairobi

If your acne has not budged after months of over-the-counter products, if it is leaving marks or scars, or if it is affecting your confidence at work or school, book a consultation. Acne is one of the most treatable conditions in dermatology when it is handled properly.

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 acne treatment with Dr Nancy Omwenga

Acne is one of the most treatable conditions in dermatology when it is handled properly. Book a consultation at Landmark Plaza, Argwings Kodhek Rd.

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Book with Dr Nancy Omwenga

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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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