“Chilo-poda,” we called him in school. Why? Well, he had a chronic acne condition, and his face was a ruin. One might ask, why that particular name?
Boys are a mischievous set, especially schoolboys. Chilo means dirt in the Luo dialect, and poda, well, what are homophones for if not to play bandy with words. And so, the moment we heard the name for the first time in our biology class, it stuck, and we ran away with it for the rest of our four-year secondary tuition.
It was quite fascinating then, because in a school full of adolescents, acne and pimples were a daily encounter, but his were different.
Now that I’ve grown to learn, my shame is almost palpable at the thought of my boyhood cruelty and pranks. It was a vice we enjoyed, creative name-calling and teasing to the very edge of sanity.
As fate would have it, I bumped into my friend, Okiya, during one of my numerous escapades in the streets of Nairobi, and his was unblemished. Beyond words, I stood there in awe.
“It’s me, Okiya,” he said, stretching his hand.
“Of course,” I replied, firmly shaking his hand.
“I know, I know. Chilopoda no more!” He went on, smiling ear to ear. He was obviously enjoying what he was seeing. My face must have been a quagmire of confused emotions, caught flatfooted.
And my fascination sparked. The curse of a curious mind, I sought to know how that was possible. When we got to talking, I learned that dermatology in Kenya has shifted dramatically, over the past few years.
Skincare is no longer niche; it’s public health, lifestyle, and economics. And with the advent of social media and ballooning urbanization, skin care is being reshaped, and gaps are being addressed.
Moreover, expert opinion was important to understand the transition in dermatology in the country. And so, we had a conversation with Dr. Roop Saini
Dermatology in Transition: A Q&A with Dr. Roop Saini
Dr. Roop Saini is a consultant dermatologist at Kenyatta National Hospital and a leader in dermatology training in Kenya. She shares insights on how skin health is changing amid urbanization, climate pressures, and shifting patient behavior.
Q1: You’ve practiced dermatology in Kenya for over a decade. What drew you here, and how has the field transformed since 2014?
I was born and raised in Nairobi and trained in medicine at the University of Nairobi, which exposed me early to local disease patterns. I later completed my postgraduate dermatology training at Cardiff University in the UK.
I returned to Kenya because dermatology here is both diverse and impactful. At Kenyatta National Hospital, the largest referral hospital in East and Central Africa, we manage complex cases from across the region. Since 2014, dermatology has evolved from a purely disease-focused specialty to one that also emphasizes prevention, maintenance, and long-term skin health.
Q2: What training or resource gaps still limit dermatology care in Kenya?
The most significant challenge is the shortage of trained dermatologists, particularly outside major cities. To address this, I was part of the pioneer team that launched the Master of Medicine in Dermatology program at JKUAT in collaboration with KNH, allowing us to train specialists locally.
However, dermatopathology remains a major gap. Accurate diagnosis in dermatology depends heavily on specialist skin pathology, yet access to trained dermatopathologists is still limited. Strengthening this area would greatly improve patient outcomes.
Q3: Which skin conditions dominate Nairobi clinics, and how do they differ from rural referrals?
In Nairobi, we commonly see acne, eczema, psoriasis, vitiligo, hyperpigmentation, hair loss, and cosmetic-related concerns, many of which require long-term management.
At Kenyatta National Hospital, referrals are often more advanced, including severe inflammatory skin diseases, infectious dermatoses, and late-presenting skin cancers from across the country.
Q4: Eczema is rising among Kenyan children. What’s driving this trend?
Urban lifestyles have brought the hygiene hypothesis into focus. Children today have less exposure to everyday microbes, which affects immune development.
As a result, we’re seeing more exaggerated immune responses, eczema, allergies, and reactions to environmental triggers. Harsh skincare products further damage the skin barrier, especially in children.
Q5: How has teledermatology changed access to care, and what would unlock its full potential?
Teledermatology has improved access to specialist care, particularly for patients outside Nairobi, enabling earlier diagnosis and treatment.
The main barrier to scaling it nationally is not technology but regulation and reimbursement. Formal recognition and insurance coverage would allow teledermatology to significantly expand access, especially in underserved areas.
Q6: What long-term complications do you see from skin-lightening products?
We frequently treat complications from unregulated skin-lightening products, including ochronosis, steroid-induced acne, and chronic skin thinning.
Many patients present late after prolonged unsupervised use. Management focuses on education, stopping harmful products, and transitioning to safer, evidence-based dermaceuticals that support gradual pigment correction.
Q7: What myths about “natural” skincare concern you most?
A common misconception is that natural means safe. Ingredients like lemon juice, baking soda, and certain herbal remedies can severely damage the skin barrier.
Dermatologist-tested dermaceuticals are formulated for both safety and efficacy. Patient education is essential in correcting these beliefs.
Q8: How is climate change showing up in dermatology clinics?
We’re seeing clearer effects of cumulative sun exposure, including a rise in sun-related skin diseases linked to long-term UV damage.
People living with albinism are particularly vulnerable, often developing severe sun-related conditions due to limited access to sunscreen. This highlights the growing importance of affordable photoprotection.
Q9: What practical skincare advice do you give during extreme weather conditions?
I advise keeping skincare simple and consistent, sun protection, hydration, gentle cleansing, and products that support the skin barrier.
These basics are especially important during very hot months and cooler periods when the skin becomes dry.
Q10: Cosmetic dermatology is growing in Nairobi. What’s fueling this trend?
Greater awareness, social media influence, and improved access have increased demand for cosmetic procedures. While this reflects positive engagement with skin health, specialist guidance remains essential to ensure safety and realistic expectations.
Q11: How do you make dermatology care less intimidating for patients?
Listening is key. Taking time to explain conditions and treatment options helps reduce anxiety and build trust.
A supportive, non-judgmental environment encourages patients to engage actively in their care, improving adherence and outcomes.
Q12: Looking ahead to 2030, what could transform dermatology in Kenya?
Expanding specialist training, strengthening dermatopathology services, integrating teledermatology into insurance systems, and improving access to preventive care, especially sunscreen, would be transformative.
A shift toward prevention and education would move dermatology from reactive treatment to long-term skin health.