Rogaine 5%, along with DermaSmoothe?

One more to join the chorus and say thank you for offering your expertise...

I'm 30, male.  I've been experiencing moderate hereditary hair loss for a little while, and I'm ready to start using Rogaine (Propecia's out of my price range at the moment).  I have an area of concern I wanted to ask you about before I started.

I have dry-scalp that leaves my scalp flakey every few weeks.  I then use prescription DermaSmoothe oil for 3-4 nights, the flakiness goes away and I'm good for another few weeks.  I've been doing this for six years and it's proven an effective, fairly convenient way to control my dry-scalp.

In reading about Rogaine, I've seen that the risk of side effects is higher if there's an increased absorption of the medication into your system.  The literature says that corticosteroids (like DermaSmoothe for instance) can cause increased absorption.  On top of that, so can an inflamed scalp due to dry-scalp.  Should I be concerned about either of these factors in considering whether to use Rogaine?

My friend reports using Rogaine foam is an easy way to incorporate the ritual into your life.  The foam is only offered at 5%.  Should my choice of 2% or 5% be important here, i.e., should I use the less concentrated stuff because of the higher risk of absorption I face due to the DermaSmoothe/dry-scalp?  Or should I just start with the foam and not be too concerned unless I start to feel any side effects?

The official drug info for Rogaine actually warns against using the medication in combo with a corticosteroid for this very reason.  However, it seems some derm's believe the corticosteroid use will only improve the desired effects of Rogaine BECAUSE of the increased absorption, and downplay the concern over unwanted side effects (dizziness chest pains etc.).

I'd appreciate your take on this issue.  I did some searching through your previous answers, and I did see some Rogaine-related responses but none specific to this.

Thanks very much!

[Alan Rockoff, MD]

DermaSmoothe is a weak steroid.  If you're just using it now and then, it may not be a problem.  I assume that you have no problems with heart or blood pressure, but since I don't know you in person, you should check with the doctor who prescribed the DermaSmoothe.

Best.

Dr. Rockoff