The single thing that matters most here is evidence. Most products marketed for hair loss have no clinical data behind them. Two treatments do: finasteride and minoxidil. Everything else is measured against those two.
The Ranked List
1. Generic Oral Finasteride (1 mg daily)
The gold standard for male pattern hair loss. Blocks DHT conversion at the scalp level. Costs as little as $10-15 a month through GoodRx at a local pharmacy. Takes 6-12 months to show real results. A minority of users report sexual side effects; those usually resolve if the drug is stopped. You need a prescription, and you need to stay on it indefinitely or the hair gained will shed.
2. Generic Minoxidil (Topical, 2% or 5%)
Available over the counter everywhere. Rogaine is just brand-name minoxidil. The 5% version works faster for most men. Women typically use 2%. Apply twice daily to a dry scalp. Messy, requires consistency, and causes an initial shed in weeks 2-8 that panics a lot of first-timers. Stick through it.
3. Hims (Subscription Telehealth)
Hims is the only major telehealth platform offering topical finasteride, which some men prefer when they want to minimize systemic exposure. Their lineup includes oral finasteride, oral minoxidil, topical minoxidil, and combination formulas. The breadth of options is genuinely wider than competitors. Pricing varies by formula, and subscription bundles bring costs down. Fully online, no in-person visit required.
4. Keeps (Budget-Focused Telehealth)
Keeps runs on a hair-loss-only model, which keeps things simple. Their 3-month plans are cheaper per unit than paying monthly. Shipping runs about $5. They carry finasteride and minoxidil, no exotic compounds. For someone who knows exactly what they want and wants the lowest price for it, Keeps is hard to beat.
5. Happy Head (Custom Compounded Topical)
Happy Head uses prescription compounding pharmacies to mix finasteride and minoxidil into a single topical solution, sometimes with added ingredients. Custom formulas appeal to people who cannot tolerate oral finasteride or want a one-step topical. Pricing is higher than generic oral options, and compounded medications are not FDA-approved as finished drugs. A legitimate path for the right patient.
6. Roman (Oral Generic, Simple Setup)
Roman offers oral finasteride and solution-form minoxidil. No foam option. The signup process is fast, and pricing is competitive. Roman is straightforward rather than feature-packed, which suits people who dislike decision fatigue.
7. Oral Minoxidil (Low-Dose, Prescription)
This deserves its own slot because many people still do not know about it. Low-dose oral minoxidil (0.625-2.5 mg daily for women, 2.5-5 mg for men) is increasingly prescribed off-label by dermatologists. Studies show strong efficacy. Side effects include fluid retention and body hair growth. Available through Hims, Happy Head, and many dermatologists. Ask your doctor directly.
8. Ketoconazole Shampoo (2% Prescription or 1% OTC)
Ketoconazole has legitimate supporting evidence as a DHT-blocking adjunct when used on the scalp. It does not regrow hair on its own, but several small studies suggest it slows progression and improves scalp environment when combined with minoxidil or finasteride. Nizoral 1% is sold OTC. The 2% version requires a prescription. Cheap, low-risk, easy to add to any regimen.
9. Derma Rolling (0.5-1.5 mm Roller, Weekly)
Controlled microneedling improves minoxidil absorption and may independently stimulate growth factors. A 2013 randomized trial showed derma rolling plus minoxidil significantly outperformed minoxidil alone. Rollers cost $15-30. Use on the scalp once weekly, not daily. Sanitize the roller between uses.
10. BosleyRx / Bosley (Transplant Heritage + Rx Access)
Bosley started as a hair transplant clinic chain and now offers Rx products through BosleyRx. The Rx side gives access to finasteride and minoxidil with the option to escalate toward in-person evaluation or transplant consultation at a physical clinic. A reasonable pick for anyone already considering a surgical route long-term.
Before committing to any of the above, getting a clear picture of your Norwood stage helps. HairLine AI is a free browser tool that uses a photo or webcam to classify your stage and estimate graft counts using AI vision, giving you a neutral read before any telehealth quiz or clinic sales conversation.
Quick Comparison Table
| Option | Rx Required | Evidence Level | Approx. Monthly Cost | Best For |
| Generic Oral Finasteride | Yes | High | $10-15 | Most men with MPB |
| Topical Minoxidil 5% | No | High | $10-20 | First-line OTC |
| Hims (combo plans) | Yes (finasteride) | High | $30-60+ | Widest formula choice |
| Keeps (3-month plan) | Yes (finasteride) | High | $15-25/mo equiv. | Budget subscribers |
| Happy Head | Yes | Moderate-High | $50-80+ | Topical-only preference |
| Roman | Yes (finasteride) | High | $20-40 | Simple no-frills setup |
| Oral Minoxidil (low-dose) | Yes | Growing | $15-30 | Topical intolerant |
| Ketoconazole Shampoo | No (1%) | Moderate | $8-15 | Add-on to main regimen |
| Derma Rolling | No | Moderate | One-time $15-30 | Absorption booster |
| BosleyRx / Bosley | Yes (Rx side) | High | Varies | Transplant track |
FAQ
How long before I see results from finasteride or minoxidil?
Most people see meaningful change at 6-12 months. Some notice shedding slow down earlier. Do not judge either treatment before the 6-month mark.
Can I use finasteride and minoxidil together?
Yes. Dermatologists often recommend both. They work through different mechanisms and the combination outperforms either alone in several studies.
Is topical finasteride safer than oral?
Topical finasteride produces lower serum DHT reduction than oral, which may mean fewer systemic side effects for some users. The evidence base for topical is smaller but growing. Hims is currently the main telehealth source for it.
What about hair supplements like biotin or saw palmetto?
Biotin deficiency is rare, and supplementing above baseline does not regrow hair in people without a deficiency. Saw palmetto has weak, mixed evidence. Neither replaces finasteride or minoxidil for androgenic alopecia.
When should I see an actual dermatologist instead of using a telehealth app?
If your hair loss is patchy, rapid, accompanied by scalp symptoms, or does not fit the standard receding-and-thinning pattern of androgenic alopecia, see a board-certified dermatologist in person. Telehealth is convenient for clear-cut cases, not for ruling out alopecia areata, scarring alopecias, or thyroid-related shedding.
References
- AAD clinical guidance on diagnosing and treating hair loss (aad.org)
- Suchonwanit P. et al., “Minoxidil and its use in hair disorders,” *Drug Design, Development and Therapy*, 2019
- Dhurat R. et al., “A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia,” *Journal of Cutaneous and Aesthetic Surgery*, 2013
- Leyden J. et al., “Finasteride in the treatment of men with frontal male pattern hair loss,” *Journal of the American Academy of Dermatology*, 1999
- GoodRx pricing data for generic finasteride (goodrx.com, accessed 2025)
- Hims, Keeps, Roman, Happy Head, Bosley official product pages (publicly accessible, accessed 2025)
