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Hair Loss/Betamethasone valerate and minoxidil 5%

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QUESTION: Hello Dr Peter. Sir I live in Pakistan. In Pakistan betamethasone valerate/betamethasone dipropionate is available in lotion form and minoxdil 5% is available in liquid form, so sir can we mix lotion and liquid? Also how much quantity shall I take of betamethasone valerate/betamethasone dipropionate and how much of minoxidil?

Another thing is that what is the role of betamethasone valerate/betamethasone dipropionate in male pattern baldness?

ANSWER: I am not sure what the strength of the betamethasone solution is but my suggestion would be to add only 10 cc of it to your 5% minoxidil 50 cc to still give you a strong minoxidil lotion with enough of the betamethasone for it do its job. When hairs change their cycles from Telogen to Anagen -especially when they are getting to their end stage-- there is an accumulation of white blood cells around the base of the follicles. When the hairs are small and weak they can get scarred by this attack of lymphocytes and then never will be able to grow back. The cortisone lotions cause the lymphocytes to go away without damaging the new hair follicle. The also interfere with the androgen metabolism in the hair cells and help prevent the hairs from getting the message to die.

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QUESTION: 1) Sir betamethasone dipropionate 0.05% LOTION can be mixed with minoxidil 5% LIQUID and then applied?
2)How much is it normal to loose hair on the day of shampooing?
3) How to do hairpull test for telogen effluvium?
4) Sir incase of male pattern baldness , minoxidil needs to be applied only on those areas of scalp where there is thinning and baldness or shall we apply on whole scalp (excluding sides of scalp and donor area of scalp)?
5)Sir incase of telogen effluvium , minoxidil needs to be applied only on those areas of scalp where there is thinning or shall we apply on whole scalp?

ANSWER: 1. Yes - the two lotions can be mixed but only use one part betamethasone to 4 parts Minoxidil
2. Normal loss is 50 to 100 hairs are lost daily - most of that is seen at the time of shampooing,
3.  There are several different ways to do this. I grab about 20 hairs and pull lightly in several areas. The loose hairs come out. Usually there is less than one or two hairs per pull.
4. I have my patients apply it to the front and top in an area the size of the palm of your hand- not more than 1 ml per application.
5. Only on top as described. It will work its way down.


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QUESTION: 1) Sir ,betamethasone is in lotion form but minoxidil is in liquid form, so although there is difference of vehicle but still can we mixed lotion and liquid? And sir minxidil mixed with betamethasone can be used life long?
2)Sir for AGA, between the below 2 option which is more better and effective in your opinion
    a) Taking finisteride 5mg daily
    b) Taking finisteride 1mg 6 days a week and dutasteride 0.5mg once a week.
    Which option is more better in your opinion?
3) Sir if i pull around 60 hairs from different section of scalp, and if suppose less than 6 hair comeout so it means one do not have TE, correct? And if 6 or more than 6 hairs come out so it means one have TE, correct?

Answer
I do not know how thick your betamethasone lotion is compared to the solution of minoxidil but in most cases there is enough liquid to be able to shake it up before application and apply the mixture at one time. The mixture can be applied for a life time.

2. In my opinion there is little difference between option a) and b). If however you added Duasteride twice a week and 1mg finasteride the rest of the week -then I would consider that a better option.

3. Correct and Correct-- IF you pull with only mild tension as I do. Some dermatologist will extract 20 to 30 hairs and count how many hairs are in Telogen - They use a clamp which pulls all the hairs from the roots. I do not suggest that method.

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Peter J. Panagotacos, <B>M.D.</B>

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery.

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery. More information can be found at my website www.hairdoc.com

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