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Hair Loss: Corticosteroid, Betamethasone, Hydrocortisone

About Betamethasone: Betamethasone is a kind of topical corticosteroids commonly prescribed for the treatment of skin and scalp disorders such as severe psoriasis, itching, redness, dryness, crusting, scaling, eczema, and inflammation etc. Corticosteroids are anti-inflammatory medicines. Inflammation of the skin happens due to the irritation of the skin, and is caused by the release of various substances that are important in the immune system. These substances cause blood vessels to widen, resulting in the irritated area becoming red, swollen, itchy and painful.

Topical corticosteroids remain one of the most widely used treatment modalities for psoriasis. Corticosteroids have anti-inflammatory, immunosuppressive and antiproliferative properties. They bind to a receptor in the cytoplasm of cells and are transported to the nucleus, where they affect gene transcription. The efficacy of an individual topical corticosteroid is related to its potency and its ability to be absorbed into the skin.

Corticosteroids or Betamethasone works by acting inside the skin cells to decrease the release of these inflammatory substances.

Brand Name: Alphatrex; Beta-Val; Betalene; Betatrex; Diprolene; Diprosone; Maxivate; Valisone; Val, Betatrex, Luxiq Foam, Valisone Topical, Valnac Topical


Side effects: Note that betamethasone is not intended for long term use. If corticosteroids are used long-term, There is the possibility of systemic absorption with corticosteroids and result inside effects such as skin thinning, a decrease in the production of natural hormones by the adrenal glands as well as a decrease in the production of collagen in our skin tissues. For this reason, continuous, long-term use of this medicine should be avoided wherever possible. Patients should avoid using betamethasone based hair products on a daily basis. Other side effects include:

dryness of the skin
acne
itching
burning
discoloration of the skin

Topical application: Use topically as directed. If you are using topical minoxidil separately, try to apply minoxidil prior to betamethasone.

Vendors

Dr. Oscar Klein - minoxidil formula with hydrocortisone or betamethasone.


Comparing the strength of various corticosteroids

Corticosteroid Potency Comparison

Generic name Trade name and strength
Class 1--superpotent  
Betamethasone dipropionate
Diflorasone diacetate
Clobetasol propionate
Halobetasol propionate
Diprolene gel/ointment, 0.05%
Psorcon ointment, 0.05%
Temovate cream/ointment, 0.05%
Ultravate cream/ointment, 0.05%
Class 2--potent  
Amcinonide
Betamethasone dipropionate
Desoximetasone
Diflorasone diacetate

Fluocinonide
Halcinonide
Cyclocort ointment, 0.1%
Diprosone ointment, 0.05%
Topicort cream/ointment, 0.25%; gel 0.05%
Florone ointment, 0.05%; Maxiflor
ointment, 0.05%
Lidex cream/ointment, 0.05%
Halog cream, 0.1%
Class 3--upper mid-strength  
Betamethasone dipropionate
Betamethasone valerate
Diflorasone diacetate
Mometasone furoate
Triamcinolone acetonide
Diprosone cream, 0.05%
Valisone ointment, 0.1%
Florone, Maxiflor creams, 0.05%
Elocon ointment, 0.1%
Aristocort cream, 0.5%
Class 4--mid-strength  
Desoximetasone
Fluocinolone acetonide

Flurandrenolide
Triamcinolone acetonide
Topicort LP cream, 0.05%
Synalar-HP cream, 0.2%; Synalar
ointment, 0.025%
Cordran ointment, 0.05%
Aristocort, Kenalog ointments, 0.1%
Class 5--lower mid-strength  
Betamethasone dipropionate
Betamethasone valerate
Fluocinolone acetonide
Flurandrenolide
Hydrocortisone butyrate
Hydrocortisone valerate
Prednicarbate
Triamcinolone acetonide
Diprosone lotion, 0.05%
Valisone cream/lotion, 0.1%
Synalar cream, 0.025%
Cordran cream, 0.05%
Locoid cream, 0.1%
Westcort cream, 0.2%
Dermatop emollient cream, 0.1%
Kenalog cream/lotion, 0.1%
Class 6--mild  
Alclometasone dipropionate
Triamcinolone acetonide
Desonide
Fluocinolone acetonide
Desonide
Betamethasone valerate
Aclovate cream/ointment, 0.05%
Aristocort cream, 0.1%
DesOwen cream, 0.05%
Synalar cream/solution, 0.01%
Tridesilon cream, 0.05%
Valisone lotion, 0.1%
Class 7--least potent  
Topicals with hydrocortisone,
dexamethasone, flumethasone,
methyprednisolone and prednisolone
 

Studies:

1) Comparison of a modified hydrocortisone/urea cream and betamethasone valerate cream in the treatment of dry eczema.

Williamson DM.

A half-sided, single-blind, comparative study of a new modified formulation of 1% hydrocortisone/10% urea and 0.1% betamethasone valerate cream in the treatment of dry eczema showed that the two products were equally effective at the end of 1, 2 and 3 weeks of treatment in terms of efficacy and speed of action. No statistically significant differences could be detected between either preparation in any of the trial's measures (i.e. overall severity score, dryness/scaling, erythema, papules, itching, excoriation or lichenification) at any of the weekly assessments. The incidence of side-effects was the same with both treatments and patients' preference was equally divided between the two creams.

2) Comparison of the effect of hydrocortisone, hydrocortisone-17-butyrate and betamethasone on collagen synthesis in human skin in vivo.  Haapasaari KM, Risteli J, Koivukangas V, Oikarinen A.

Department of Dermatology, University of Oulu, Finland.

It has been shown previously that topical corticosteroid treatment decreases collagen synthesis in human skin in vivo and that the adverse effects are due to reduced collagen synthesis. The aim of the present study was to evaluate the effect of hydrocortisone, hydrocortisone-17-butyrate and betamethasone on collagen synthesis in human skin in vivo.

Fourteen healthy male volunteers applied hydrocortisone, hydrocortisone-17-butyrate, betamethasone and vehicle twice a day for one week to four separate areas marked on their abdominal skin. The collagen synthesis rate in the skin was measured by assaying collagen propeptides from the suction blisters induced on the treated areas. Aminoterminal propeptide of type I procollagen (PINP) and aminoterminal propeptide of type III procollagen (PIIINP) were measured from skin blister fluid using radioimmunoassays. Skin thickness was measured with ultrasound. Hydrocortisone decreased the two propeptides studied in the suction blister fluids less than did hydrocortisone-17-butyrate and betamethasone, but the interindividual variation was great. Hydrocortisone-17-butyrate and betamethasone had almost similar decreasing effects on the propeptides in the suction blister fluid. Hydrocortisone decreased the concentrations of PINP and PIIINP by about 35%. In some subjects (4/14) the decline of the collagen propeptide levels was over 50%. The decline in the concentration of PINP was 63% by hydrocortisone-17-butyrate and 69% by betamethasone, while the decrease in PIIINP was 55% by hydrocortisone-17-butyrate and 62% by betamethasone. None of the treatments had any effect on skin thickness within one week.

In conclusion, it seems that hydrocortisone is less atrophogenic than hydrocortisone-17-butyrate and betamethasone, as shown by radioimmunoassays for collagen propeptides. The order of inhibitory potency of the three glucocorticoids on collagen synthesis was hydrocortisone < hydrocortisone-17-butyrate < betamethasone. Thus, assay of collagen propeptides from suction blisters can be used to screen various steroids with respect to their action on collagen synthesis.

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