Best Hair Loss Treatment for Men

For over 60% of men under 35 — and over 80% of men by age 50 — hair loss is a serious issue.1 With numbers like that, you can be sure of two things: the odds that you might lose your hair are high, and hair loss is common enough that nobody should feel embarrassed about it.

Some men resign themselves to increasingly patchy scalps or ever-receding hairlines. Others go nuclear and shave the whole thing at the first sign of loss. There is good news, though: your chances of stopping male pattern hair loss and regrowing hair are excellent if you choose the proper treatment and take action.

We’ve thoroughly tested the best products and services on the market and explored all the pros, cons, evidence, success rates, and deals so you can figure out which is the best hair loss treatment for you in 2025. For those of you in a hurry, here’s a quick rundown of our recommendations you can use when consulting with a doctor.

First, we’ll provide a quick map of the landscape of individual and combination treatment options. Then, we’ll list the specific places we recommend you look for those recommended treatment options.

Single treatments

Many men use a single treatment approach, which in some cases can save money and also lessen or avoid risks posed by underlying health concerns.

• Most effective single medication: Oral dutasteride
• Best oral medication for men concerned about sexual side effects: Minoxidil
• Best oral medication for men with cardiovascular concerns: Dutasteride
• Best drug-free approach: Low-level laser therapy (LLLT)
• Best topical treatment: Finasteride sprays
• Best for tight budgets: Topical minoxidil

Combined treatments

Quite often, men and their doctors approach hair loss from multiple angles simultaneously to more effectively stop hair loss and increase regrowth. This can produce the most dramatic results. Here is a quick map of that complex landscape.

• Combination with the most direct, supportive research: Finasteride and minoxidil
• Most aggressive treatment combination: Oral dutasteride, oral minoxidil, topical finasteride, and a laser cap
• Combination with the lowest risk of serious side effects: Topical minoxidil and a laser cap
• Least expensive combination: Oral finasteride and topical minoxidil

Where to find the best hair loss treatments

• Most comprehensive treatment options (oral and topical): Happy Head
• Best for compounded treatment combinations (one pill, multiple drugs): Hims
• Best for oral minoxidil and hair loss shampoo and conditioner: Roman
• Best for oral minoxidil: Roman
• Best for oral dutasteride: Happy Head
• Best for oral finasteride: Strut Health
• Best for topical finasteride: Hims
• Best for topical dutasteride: Strut Health
• Best laser device for most people: Kiierr 272 Premier laser cap
• Best for topical minoxidil: Amazon Basic Care
• Best for supplements: Nutrafol

When it comes to combination treatments, it's also not uncommon to mix and match treatments from numerous providers. In some cases, that could save you the most money. In others, it could ensure access to all the treatments you want (like oral minoxidil from Roman alongside a laser cap from Kiierr, which Roman doesn’t sell). Keep in mind that characterizations like “best” and “most effective” above don’t necessarily mean best for you; what's best for you will become clear through consultation with a doctor.

At Innerbody Research, we extensively test each health service we review, including those dedicated to hair loss. All told, our team has spent over 565 hours testing and researching the products and services these companies offer for hair loss, from prescription drugs to surgeries.

By testing these companies ourselves, we’ve been able to determine the quality of their products and customer service. Tempered by more than 100 scholarly research articles our team has read regarding hair loss and its potential treatments, we’re able to make more confident recommendations than many other sources. Additionally, like all health-related content on this website, this guide was thoroughly vetted by one or more members of our Medical Review Board for accuracy. Where applicable, we included specific statements and perspectives from Dr. Scott Bukoski, a dermatologist serving on our review board.

Over the past two decades, Innerbody Research has helped tens of millions of readers make more informed decisions to live healthier lifestyles.

While there are numerous hair loss treatments on the market, including high-powered laser devices, prescription drugs, and holistic remedies, one treatment regimen as of 2025 can boast the most research and greatest documented success rate. That regimen combines a daily prescription for 1mg oral finasteride (generic for Propecia) with a 5% topical minoxidil solution or foam. You and your doctor may determine that this or a similar version of this combination would be best for you (e.g., oral versions of both or topical versions of both instead of either in oral form). More aggressive treatments can combine multiple oral medications and blended topicals, and you can explore them with your consulting physician if you want a more robust approach.

On their own, oral finasteride and topical minoxidil have decades of positive research behind them, as well as FDA approval and an enormous amount of satisfied customers. In combination, the therapies work more powerfully than the sum of their parts, suggesting a synergistic effect between them that, while not entirely understood, is hard to deny when you look at the evidence.2

However, in working with dermatologists to fine-tune our selection process for this guide, we discovered just how popular oral minoxidil has become among patients and medical professionals as a dependable treatment for hair loss in men and women alike. It’s certainly not for everybody, as it carries a risk of cardiovascular complications that can exclude anyone with heart trouble. Your doctor will determine whether you’re a good candidate.

Roman offers the best price for oral minoxidil among telehealth providers. For $30/month (billed quarterly at $90/quarter), you can get a daily 2.5mg dose, which aligns nicely with most of the research we reviewed on oral minoxidil. Most competitors offer the same 2.5mg tablets but start their prescriptions at 1.25mg, asking you to cut your pills in half. Fortunately, many of them allow you to go up to the full 2.5mg dose without increasing the price. The thing is, Roman does the same but at a higher dose. It allows you to go up to 5mg (the high end of the effective dose range we’ve seen in oral minoxidil hair loss studies) without a price increase.

Here’s a quick look at how different therapies address hair loss with a little information on the companies we recommend for each scenario:

There are a lot of nuances in the product lineups from one company to the next, making this a difficult question to answer. The top three choices are definitely Hims, Strut, and Roman, each of which offers comprehensive approaches that can combine several prescription and non-prescription options to address hair loss.

Let’s take a quick look at what the top companies offer to get a sense of the comparison:

Based on the number of check marks alone, Hims and Happy Head come out on top. When we look closer, however, there are circumstances in which Roman or Strut offers better pricing than either. For example, Roman’s oral minoxidil and haircare products are less expensive, and Strut has the best price on oral finasteride among the top players on the market. But Hims has more haircare products to choose from and offers finasteride in a large hair loss bundle that comes with minoxidil, shampoo, and biotin gummies. Hims also offers compounded chewables that can combine finasteride, minoxidil, multivitamins, and even tadalafil (for ED).

When you take all of these major and minor differences into account, Hims seems to be the best one-stop shop for anyone interested in utilizing multiple treatments at once. However, you can get the best prices, best medical support, and best chances of success by combining offerings from multiple companies into one aggressive treatment plan.

Oral minoxidil, oral dutasteride, topical finasteride spray, and an effective laser cap

In the past, if you wanted a comprehensive regrowth plan that didn't involve surgery, we recommended talking to your doctor about combining three treatments: oral finasteride, topical minoxidil, and an effective laser cap. However, the emergence of oral minoxidil and some companies’ ability to compound multiple drugs into a single capsule or chewable tablet has caused us to reconsider this approach.

Calling it “one of our go-to first-line recommendations,” Dr. Scott Bukoski, dermatologist and member of our Medical Review Board, talked with us about oral minoxidil and its increasing popularity. “In clinical practice, many have switched to oral minoxidil as a first choice for hair loss,” he says, “especially in men where the sexual side effects can create a lot of issues. Topical minoxidil can be just as effective as the oral form; however, the regular use of it can be difficult for people, as well as the textural changes it can have on the hair and scalp."

So, oral minoxidil has begun to play a major role in the most aggressive treatment plans. If you’re willing to risk the sexual side effects associated with oral finasteride in 2-3% of users, you can safely take both oral medications together, at least according to a 12-month study from 2018.44 21 However, oral minoxidil carries a risk of cardiovascular complication you’ll need to discuss with your provider.15 As Dr. Bukoski points out, “Finasteride/dutasteride are both clinically more effective, and the side effect profiles, while they can be difficult, are probably less dangerous overall than what we've seen with minoxidil (though still very safe overall).”

Hims offers a compounded oral therapy that includes 1mg of finasteride and 3mg of minoxidil in a single chewable pill, and it can be modified to include a daily dose of tadalafil — a prescription ED medication — to counter potential sexual side effects. If you’re clear of cardiovascular risk factors that could preclude you from taking minoxidil, this could become a potent combination for you.

It’s also likely that you could combine oral minoxidil with oral dutasteride — a medication similar to finasteride with an even greater potential for efficacy — though high-quality research combining them is not yet available. Dr. Bukoski says, “Happy Head offers dutasteride and spironolactone. Dutasteride has been shown to be more effective than finasteride with a similar side effect profile.”

Alongside these effective oral treatments, you can apply laser therapy topically, which has been shown to be about as effective as topical minoxidil.3 That said, the two aren’t mutually exclusive, so adding a topical finasteride or topical dutasteride product to the mix (which is typically compounded with topical minoxidil) should only increase your odds.

Among laser caps for hair loss, Kiierr has consistently topped our rankings for offering an effective cap for a reasonable price, with options to save by buying refurbished models or simply filling out a hair loss questionnaire.

Using all four simultaneously could deliver the most dramatic results on a slightly accelerated timeline. The only real downside to this approach is that you may never know which treatment or combination of treatments is helping you most. Unless you want to risk your progress by using an experimental process of elimination, you’d have to continue with what might be a hefty investment over time. You might also have a hard time identifying the source of certain side effects, should they arise, which could force you to stop all four treatments at once and reintroduce them one at a time. Ultimately, discussion with a consulting physician will determine your best course of action.

While most people will see some thinning in their hair as they advance in age, men and women may experience more pronounced hair loss earlier in life for various reasons. Knowing the potential causes of your hair loss can help orient you in the direction of treatment and possibly help you make lifestyle changes that can slow or even stop its progress.

There are numerous potential causes for hair loss, but the most prevalent are relatively well-understood. Let’s take a quick look at each of the most common causes of hair loss:

We’ve thoroughly tested the products and services in this guide and have analyzed data about the effectiveness of various treatment options. Along with this information, you need to consider what treatment path fits best into your life. The treatment should be a good, sustainable fit for you and the hair loss you’re experiencing to enjoy lasting success. Here are some essential factors to consider.

Where is your hair loss?

Androgenetic alopecia (male or female pattern baldness) is the most common form of hair loss, and it can occur at the crown or top of the head and along the hairline. Both crown balding and a receding hairline can occur concurrently, as well. The location of your hair loss used to be a somewhat larger concern, as oral finasteride was known to work better than topical minoxidil for hairline thinning, and vice versa for thinning at the crown.

Now, with dermatologists commonly combining treatments for patients without contraindications, it’s easier to find a blend of treatments that can tackle hair loss globally.

What is your budget?

If you’re willing to spend the money, then you can double- or even triple-down on a set of treatments that work in different ways to maximize your potential for dramatic success. These include expensive surgeries, micro-tattooing, top-tier replacement pieces, and more.

Unfortunately, most insurance carriers consider any hair loss treatments cosmetic — even for chemotherapy-induced hair loss. As a result, they seldom cover any of the available protocols. So, those on a tight budget need to know which path is likeliest to succeed without breaking the bank. Top telehealth companies like Roman and Hims offer well-priced subscriptions to their most popular products, which invariably save you a little extra money. But, the lowest-cost interventions we’ve found are Costo’s Kirkland brand and Amazon Basic Care.

Through Costco, you can acquire a six-month supply of Kirkland minoxidil solution for around $18. That’s $3/month, less than a third of the best price you’ll get from Keeps or Hims. Costco also recently added minoxidil foam to its catalog, which costs about $50 for a six-month supply.

If you’re one of the many people who don’t have a Costco membership, though, topical minoxidil will still be your most affordable option, and we’ve found you can find the best deals for it alone through Amazon. Note, however, that you won’t get to take advantage of consultation opportunities that providers like Hims and Roman offer as part of your plan. Talking to a medical expert during your hair growth journey is highly valuable.

Low maintenance is key

If given a choice, most men likely wouldn’t mind putting in a little effort if it meant keeping or even regrowing their hair. But you need to know yourself and your habits to understand which treatment option will be low-maintenance enough for you to see it through. Finasteride and minoxidil are forever treatments, which means that you have to keep using them for them to work. As soon as you suspend either medication, your hair loss will come back.

Between the two, oral forms of finasteride and minoxidil are easier to use than topicals. You take a pill without having to apply anything to your scalp. There are trade-offs here, of course, such as the side effect profile. And if the side effects are too significant for you to continue treatment, you may be better off with the more cumbersome daily routine.

Among non-medicinal options like the replacement methods provided by HairClub, you can get instant results that require infrequent trips to a clinic or a more dramatic surgery, though surgical procedures are often accompanied by some combination of finasteride and minoxidil.

How quickly do you hope to see results?

It’s important to set realistic expectations to avoid disappointment. You also don’t want to risk abandoning a potentially effective treatment prematurely.

While the medicinal treatments in this guide start working positively as soon as you begin, their positive effects will not be visible for a while. It takes about four months before you predictably begin to see positive results from finasteride or minoxidil. So once you choose a plan, stick to it unless there are adverse side effects. You won’t know if it’s effective until you give it enough time.

Scientists discovered minoxidil’s hair growth potential while studying it as a blood pressure treatment.8 Clinical testing shifted to hair growth for many companies, and it persisted through the 1970s and 80s until Rogaine, the branded form of topical minoxidil, finally hit the market. To this day, topical minoxidil remains one of the most trusted hair loss treatments, widely used either by itself or in conjunction with one or more other treatments.

In more recent years, oral minoxidil has gained traction as an off-label prescription treatment for hair loss among men who might balk at finasteride’s sexual side effect risk. And since finasteride isn’t suitable for use by women, oral minoxidil offers an alternative once-daily pill women can take to address hair loss.

Our bottom-line recommendation for minoxidil

After years of topical versions dominating the minoxidil landscape, oral minoxidil has become as popular, if not more popular, and the dermatologists we’ve talked to all agree that oral minoxidil is more often than not a first line of treatment in modern practice.

When used as directed, minoxidil can not only arrest hair loss in many men but also regrow some hair for a significant portion of users. The oral medication is typically administered once daily at 2.5mg, with the best possible prices coming from Roman. But you can get novel drug combinations from Hims that put oral minoxidil in the same pill as oral finasteride and, if desired and physician-approved, oral tadalafil — an effective ED medication.

It’s important to note that while minoxidil can reactivate follicles that have gone dormant, it cannot revive follicles that have died completely. Your best bet is to start a course of treatment as soon as possible and stick with it.

How minoxidil works

The actual science behind how minoxidil works for hair loss remains unsettled, but there are some theories based on what the topical form does when you apply it. Minoxidil acts as a vasodilator, and it widens blood vessels to allow better blood flow to hair follicles.41 The blood brings oxygen and nutrients to keep follicles alive and healthy and restore weak follicles to fuller health and thickness. The increased blood flow also resets the growth stages for struggling hair follicles, kicking them into an anagen phase (the initial new growth stage).

There is also some evidence that minoxidil influences activity on the Wnt/β-catenin signaling pathway, which plays an important role in follicle regeneration.9 This may be why minoxidil is capable of regrowing hair from follicles that have become dormant but have not yet died outright.

Whatever the mechanism or mechanisms of action, it’s undeniable that minoxidil works for the majority of men and women who use it.

Recommended provider: Amazon Basic Care

How effective is topical minoxidil?

Here are the facts based on data from clinical studies:40

• For about 66% of men, minoxidil stops hair loss.
• About 52% of men enjoyed moderate hair regrowth when applying minoxidil at the crown and top of the head.
• About 20% of men enjoyed significant regrowth using minoxidil in these areas.

What kind of hair loss is topical minoxidil best at treating?

Topical minoxidil is best for hair loss at the crown around the top of your head. There is some evidence that it can help stop a receding hairline and maybe even regrow some of that hair, but we don’t recommend relying on minoxidil for this hairline regrowth if that is your hair loss pattern. If your hair loss is global, you might consider pairing topical minoxidil with finasteride to address the whole head.

Are there potential side effects to topical minoxidil?

Topical minoxidil users report few side effects; when they do, those reports usually include scalp irritation and mild discomfort.10 Most men find that the solution form of minoxidil is more likely to cause adverse reactions than the foam, typically due to the presence of propylene glycol in the solution, a known irritant that’s absent from the foam.11 The foam is also a bit easier to apply. That’s one of the reasons we like Keeps, as it has the best deal on the foam form of minoxidil. If you notice severe discomfort, you should speak with a physician.

You need to wash your hands thoroughly after applying minoxidil to your scalp and wait several hours before touching your application area or going to bed after applying it. Until it’s completely dry, minoxidil can spread and absorb in places where it may cause unwanted hair to grow.

As minoxidil works, it can shift the growth phases of your follicles, causing some of them to prematurely shed their current, weakened strands and begin growing thicker, stronger ones. This process usually kicks in several weeks into treatment, and at the outset, you may experience a heightened degree of shedding. This additional hair loss is actually a sign that the minoxidil is working. Don’t stop your minoxidil routine if you experience this side effect, as it is temporary, and a phase of healthy growth will soon follow.

Topical minoxidil is abundantly available from telehealth companies like Hims and Roman, but you can find it cheaper elsewhere with little or no difference in the formulas. If you’re a Costco member, you can get a great deal on topical minoxidil as a solution or a foam, but non-Costco members would be better off accessing it through Amazon Basic Care.

Recommended provider: Roman

Oral tablets were the first versions of minoxidil ever tested, as the drug was being investigated as a blood pressure medication. After study participants reported unwanted hair growth — a condition typically called hypertrichosis — researchers began formulating topical solutions that could target hair growth at the scalp.

The success of topical minoxidil and the eventual lapsing of patents on oral minoxidil has created an unfortunate situation. Oral minoxidil is generating new interest as an alternative to finasteride or topical minoxidil application. The studies looking into its potential are impressive, but the amount of clinical research required to satisfy FDA requirements is prohibitively expensive for a drug of which no pharmaceutical company can claim ownership.12 So, no pharmaceutical company wants to put up the money to fund research, as they can’t recoup their investment with sales.

The result is that oral minoxidil will likely never be FDA-approved to treat hair loss. Fortunately, the drug is FDA-approved for hypertension, and the dose required to treat hair loss is equal to or lower than what’s prescribed for blood pressure. That means a dermatologist can prescribe minoxidil for off-label use as a hair loss treatment.

Until recently, that status meant that you’d have to find a local dermatologist to see in person and convince them that you were a good candidate for a drug they may not typically have prescribed in the past. However, telehealth companies have begun to catch up with demand, and multiple prominent players currently offer prescriptions for oral minoxidil through their platforms.

Those companies are Roman, Hims, and Happy Head, and the best value between them may not be clear at first, but Roman has a decided edge. That’s because Happy Head’s sticker price is lower, but Roman’s price per mg of minoxidil is better. Hims has interesting chewable options for its oral minoxidil, but the novelty drives up the price. Let’s take a look at a handy chart that breaks it down.

You might think you could be better off with Happy Head’s 1.25mg dose if that’s all you need for success, but it’s worth noting that the company ships 2.5mg tablets that you break in half for each 1.25mg dose. That’s pretty inconvenient, and you could do the same thing with Roman’s 2.5mg tablets for a better price.

Are there potential side effects from oral minoxidil?

One of the big selling points of oral minoxidil is that, unlike oral finasteride, it doesn’t put its users at risk for sexual side effects. The risk with finasteride is low (2-3%), but it’s still much higher than oral minoxidil.44 And for people who have adverse skin reactions when applying topical minoxidil, the oral version can be a safe alternative.13

There is a trade-off, however. Oral minoxidil is not without side effects of its own, and some of them can be quite serious. The most common side effect of oral minoxidil is hypertrichosis, the unwanted growth of hair on parts of the body other than the head. This growth can occur anywhere on the face or body and can range from a mild darkening or thickening of light downy hairs already present to significant growth in an outright unattractive region.

The diagnostic criteria for hypertrichosis set a low bar for its inclusion as an adverse effect in studies. So, while some studies report more than 90% of participants experiencing it, those same studies emphasize that the side effect was “well tolerated” and that it was not the cause of any dropouts.14 What this says exactly about the degree of unwanted hair growth in the study population is unclear, but the effect seems minor.

The next most common side effect of oral minoxidil is pedal edema — a buildup of fluid in the lower parts of the legs and feet. It affects far fewer participants in various studies than hypertrichosis, but it can be a cause for concern in some cases.

Less common than either of those effects, but probably the most troubling, is a risk for cardiovascular complications, specifically pericardial effusion and tamponade. These can lead to intense chest pains and difficulty breathing, and they can increase the risk of major adverse cardiovascular events in those already at risk. However, these effects have only been reported in case studies, not as part of clinical trials.15

Can you take oral and topical minoxidil together?

There hasn’t been a ton of research into whether you could or should combine oral and topical minoxidil. The research that does exist appears to imply that the combination is safe, but it also illustrates that there is no advantage to taking the oral medication and applying the topical concurrently. Rates of success between study arms that use one or the other or both are nearly identical.

That said, you may want to combine oral minoxidil with topical finasteride or topical dutasteride, both of which are almost always compounded with topical minoxidil. Having those additional topicals might increase your success, but you’ll want to talk to your doctor about putting all those treatments together.

Like minoxidil, finasteride was developed for a reason other than hair loss.17 It was initially researched as a way to treat benign prostatic hyperplasia (BPH), a use for which it was first approved by the FDA. It later gained approval as a hair loss treatment. The doses for treating hair loss and BPH are a bit different, with hair loss prescriptions typically landing around 1mg/day and BPH prescriptions landing around 5mg/day. This difference will prove to be critical when we discuss safety profiles and side effect risks below.

Our bottom-line recommendation

While Roman and Hims are the two companies most often pitted against one another for quality and value in hair loss treatment (so much so that we have an entire guide comparing them directly), our research has led us to conclude that Strut Health is the best choice for oral finasteride.

Here’s what the numbers look like:

How finasteride works

Finasteride works differently from minoxidil in treating hair loss. This medication is what’s known as a 5-alpha reductase inhibitor. Rather than improving blood flow, finasteride prevents 5α reductase from converting testosterone into dihydrotestosterone (DHT).42 When taken orally, finasteride reduces DHT throughout the body. Applied topically, it can reduce the presence of DHT on the scalp.

DHT is the primary culprit in androgenetic alopecia, and reducing its presence on the scalp will dramatically affect its ability to harm your follicles.16 Because of its specific effect on male sex hormones, finasteride is not a suitable treatment for certain women seeking intervention for hair loss, specifically pregnant and nursing women or those hoping to become pregnant.

Recommended provider: Strut Health

How effective is oral finasteride for hair loss?

Finasteride is one of the most reliably effective treatments for hair loss on the market. Here are the facts based on studies:

• For about 80% of men, finasteride is effective at preventing further hair loss around the crown.17
• For roughly 70% of men, it prevents further receding hairline.18
• About two-thirds of men experience hair regrowth from taking finasteride.17

These numbers imply that finasteride should work well for most men. Degrees of success and timetables will vary from patient to patient, and you may also find you’re among the unlucky few for whom finasteride does very little. But the odds are in your favor.

If you want to see what finasteride is capable of, take a look at these before and after collections.

Is finasteride safe?

Finasteride is widely prescribed, so it’s hardly a rare treatment. The medical community generally regards it as safe, but there are potential side effects, some of which are serious.19

Though they are not common, side effects can include:

• Lower sperm count
• Erectile dysfunction (ED)
• Decreased libido

Close to 2% of men experience decreased libido, while closer to 1% of men experience ED or ejaculation problems.20 Occasionally, more frightening statistics are mentioned regarding finasteride’s rate of adverse sexual effects. But these numbers come from studies looking at finasteride as a BPH treatment, not as a treatment for hair loss. As we discussed above, the BPH dose is about five times the dose prescribed for hair loss. And as finasteride’s sexual side effect rate appears to be dose-dependent, the numbers from BPH trials don’t translate.

Other possible side effects, though also uncommon, include:19

• Confusion
• Depression
• Skin irritation
• Breast tenderness

Finasteride may not be ideal if you have underlying health conditions or take certain medications that could negatively interact with it. This is why it’s available only by prescription; a doctor will work with you to determine whether this is a suitable treatment path for you.

Can you take oral finasteride and oral minoxidil together?

Based on the conversations we've had with dermatologists, it’s clear that these oral medications are often combined in a clinical setting. Due to their respective risk profiles, your doctor would need to discuss potential sexual complications and get a baseline for your cardiovascular health before prescribing.

Fortunately, there don’t appear to be any negative synergies in which the combination of treatments might amplify side effects. For example, one study actually looked at a combination of oral finasteride, oral minoxidil, and topical minoxidil and found few side effects beyond what is typically seen in individual studies of each medication.21 There were some limitations in the study, most notably the limited demographic, which was exclusively men of Asian descent.

It’s possible that — if you find yourself moderately resistant to one or two of these treatments — your dermatologist might try combining them all. But this would be done on a case-by-case basis.

Recommended provider: Hims

Topical finasteride is a relatively new treatment compared to its oral counterpart. The most exciting thing about it is that it allows men who experience sexual side effects from oral finasteride despite success in hair loss treatment to continue using finasteride without those adverse effects.

Currently, Hims, Keeps, and Happy Head all offer topical finasteride, but Hims offers the best at-home access for long-term savings right now. Topical finasteride is regularly compounded with a minoxidil solution and is currently unavailable on the telehealth market as a standalone treatment.

One study of over 300 men throughout Europe found that topical finasteride provided similar results as oral finasteride, both of which significantly outperformed the placebo control.22 It also revealed a smaller impact on serum DHT concentration in the topical group, meaning that the treatment worked at the scalp without as much of it entering the bloodstream as you’d see with oral consumption.

One of the downsides to the product is that the compounding process combining the two drugs into a single topical treatment is more expensive for companies to undertake, and they pass that cost onto the consumer.

Here’s a look at the monthly cost of topical finasteride and minoxidil from Keeps and Hims compared with topical minoxidil and oral finasteride taken together:

The best deal here is the Hims biannual subscription, but since it’s billed every six months, you’ll need to have $210 handy to start that program. That said, the biannual approach from Hims is the only way to get the topical combination for less than what you’ll typically be charged for an oral finasteride and topical minoxidil combination.

It’s also worth noting that the Hims topical combination uses a 0.3% finasteride, 6% minoxidil solution, whereas typical minoxidil solutions are compounded at 5%. Keeps’ topical combo uses a 0.25% finasteride, 5% minoxidil solution. That extra percentage point might not make a huge difference one way or another, but it’s likely safe, as studies have shown minoxidil solutions as high as 10% to be well tolerated.23

Recommended provider: Keeps

This traditional treatment method typically combines the full strength of a 1mg oral finasteride prescription with a 5% minoxidil solution. Because the two drugs have different mechanisms of action and aren’t contraindicated to one another, they offer twice the ability to fight hair loss and potentially regrow hair. Of course, this also means you’re susceptible to the side effects associated with each. Fortunately, those side effects are relatively particular to each medication, so you can always discontinue one and continue with the other, depending on your reaction.

Our bottom-line recommendation:

Oral finasteride and topical minoxidil is the traditional choice for men experiencing global hair loss. The treatments work together to help stop hairline recession and thinning at the crown. You might get similar results from taking oral minoxidil on its own, which has led many dermatologists to start with that treatment over this older combination for new hair loss patients. However, if you want to start where there’s a longer track record of success, the traditional combo might be the way to go.

It’s a tight race between Hims and Keeps for the best company to provide this combination, but Keeps edges out Hims in the end. Hims’ free shipping and follow-up consultations are certainly a benefit, but we found that Keeps’ prices and ability to bundle finasteride with either the foam or solution forms of minoxidil gave it the edge.

How effective is the combination treatment?

Each of these two medications separately is quite effective for many men with male pattern baldness, but neither is universally effective, nor do they work the same way. Because of this, your chances of seeing dramatic positive results improve if you take both of them.24 Data from clinical research suggests that as many as 90% of men with male pattern baldness can experience at least moderate hair regrowth by taking this combination.

Is the topical combination just as good?

Most telehealth companies with a hair loss focus now offer a topical finasteride and minoxidil combination, as well. It’s a great choice if you’re determined to include finasteride in your treatment plan but have reservations about potential side effects. Studies show an increase in effectiveness for the topical finasteride and minoxidil combination over simple minoxidil.25 And Hims’ combination uses a 6% minoxidil solution rather than the typical 5%, which may also increase efficacy. So, if you want to spend the extra money to work with a topical formulation of finasteride, it could certainly have its benefits.

Dutasteride, like finasteride, is a 5-alpha reductase inhibitor, but it works on both of the two forms of 5-alpha reductase associated with increased scalp DHT. Finasteride only works on one of those two forms. As a result, research often reveals superior performance from oral dutasteride.43

However, that superior performance comes with some caveats, which we’ll discuss below. Fortunately, like finasteride, dutasteride has also been shown to work as a topical and has been developed by the same two companies offering its oral version. As with topical finasteride, topical dutasteride provides a similar efficacy without the risk of adverse sexual effects.

Recommended provider: Happy Head

Oral dutasteride is, in most cases, going to be more effective than oral finasteride simply because it works on both 5-alpha reductase types 1 and 2, whereas finasteride only works on type 1. But we referenced some critical caveats above, which we need to explore.

The most important for many men will be that you can see an increased risk of sexual side effects with dutasteride as compared to finasteride. Sexual adverse effects with finasteride are well-documented, and dutasteride’s incidence is higher in most studies. For example, this study from 2018 found that about 5% of those taking a standard 0.5mg dutasteride dose for hair loss experienced sexual side effects similar to those seen in finasteride.43 But finasteride’s sexual side effect rate is closer to 2-3%.44 You and your doctor will have to discuss how you’re willing to balance efficacy potential with the risk of such effects.

The other downside of dutasteride is that it tends to be more expensive and harder to find. Of the major telehealth companies we discuss in this guide, only two offer oral dutasteride. You could get finasteride for as little as $16/month, but dutasteride costs closer to $60/month from Happy Head.

For the record, Strut Health has a better price for its oral dutasteride, but it may not be compounded correctly, which could render it much less useful. Dutasteride is not soluble in water, which is why both brand name and generic forms are typically provided as softgels that the body can better absorb. As a tablet, there’s a high likelihood that the drug won’t meaningfully make its way into your bloodstream. We reached out to Strut Health for a deeper explanation of its compounding and potential additives to increase absorption, but we did not receive a satisfactory response.

Recommended provider: Strut Health

As is the case with finasteride, dutasteride is available in topical forms that allow it to work on the scalp without affecting DHT levels in the blood. As a result, topical dutasteride won’t cause the same incidence of sexual side effects as its oral version.

Topical dutasteride formulas look a lot like finasteride formulas, as well. They typically compound dutasteride alongside minoxidil, and they occasionally include other ingredients with some evidence to support their role in hair growth.

While Strut’s oral dutasteride is somewhat disappointing, its topical dutasteride is much better. Strut’s price significantly undercuts Happy Head, its closest competitor, which also offers topical dutasteride. Strut’s topical dutasteride costs just $69/month, compared to Happy Head’s $89/month (after a $49 first-month discount price).

Recommended provider: Kiierr

What are LLLT devices, and how do they work?

You may have seen laser hair loss devices advertised on TV or online. Some look like ballcaps, others like helmets or strange hair decorations that fit like a wedge over a portion of your head. Others take the shape of combs that you slowly run through your hair in the thinning area.

All of them glow red (but note: you shouldn’t look at the light), and all of them claim to help you stop your hair loss and potentially regrow your hair.

These devices glow red because they rely on low-level laser diodes to promote vasodilation and stimulate blood flow. There are other potential mechanisms of action at play, but like minoxidil, these are still being discovered. Low-level laser therapy (LLLT) is sometimes called cold laser therapy (because the diodes emit no heat) or photobiomodulation. Wavelengths of these lasers range from about 600 to 1100 nanometers in hair growth products, with a wavelength of roughly 655nm included in the bulk of scientific research.26 That’s typically the wavelength of the devices we recommend in our guide to the best laser caps for hair loss, as it has the most research support.

To be clear, these are not simple LEDs. Laser diodes are more precise and more powerful than LEDs. There are some cut-rate products on the market that claim to stop hair loss with LEDs alone. These are likely ineffective. That said, there is some evidence that caps combining laser and LED therapy may offer real benefits.27

Our bottom-line recommendation:

LLLT devices for hair regrowth are available in numerous forms — combs, ballcaps, or headbands. Prices tend to increase in direct proportion to the number of laser diodes built into a device, but for the best coverage and the likeliest efficacy, we recommend the caps. Several high-quality companies manufacture them, so here’s a quick look at the best options on the market and how they compare:

Of these, we consider the Kiierr 272 Premier to be the best choice for most people. The Capillus PRO and PRO S1 are outstanding caps with some enviable features, but the price difference between those products and the options from Kiierr outpace the advantages those features offer. Efficacy between the two companies’ products is nearly identical.

Effectiveness of laser hair regrowth devices

Researchers who have studied the effectiveness of LLLT theorize that several mechanisms might be at play in achieving hair regrowth. One of the likeliest is that the powerful laser light penetrates down to a deep layer of the scalp. It acts as a vasodilator, effectively improving blood flow to follicles and allowing them to benefit from increased oxygen and nutrient delivery.28

If this sounds familiar, increased blood flow to hair follicles is likely one of the reasons minoxidil works as well. Unlike minoxidil, though, you don’t need to apply anything to your head and let it dry, and then wash your hands to prevent growing unwanted hair on yourself or a loved one. With an LLLT device, all you have to do is set aside a few minutes each day to wear or utilize it. That said, you may be able to combine LLLT with topical minoxidil as long as you don’t apply them simultaneously.3

There is also some degree of activation in certain cells in and around hair follicles that can restart follicle growth phases.29 That means, again, like minoxidil, there can be a period of additional shedding at around the three-week point, but it’s completely natural and a sign the treatments are working.

One 2017 review illustrated successful results from 11 studies evaluating LLLT in nearly 700 participants.30 Improvements reached the level of statistical significance in hair density and thickness in nine of the 11 studies.

A different study of laser combs demonstrated that a 12-beam laser comb resulted in an average of 26 more hairs per square centimeter in the treated area after six months of use.31

One tricky aspect of LLLT is that the application for human hair growth hasn’t been studied long-term yet, so the most effective wavelength is unclear. We also don’t know if any long-term side effects might be associated with laser applications at a specific wavelength.

Is LLLT safe for hair loss treatment?

Scientists first discovered the capacity for LLLT to trigger hair regrowth in a study of mice over 50 years ago, and testing since then has yielded no major cause for concern.32 Occasional adverse reactions include mild skin pain, headache, redness, or itching, but in most studies, these resolve within days or weeks.

But if you have any unusual, questionable freckles on your scalp, you should talk to your primary care provider or dermatologist before using a laser device. And you shouldn’t use LLLT if you have active skin cancer of the scalp or unidentified lesions.

Hair replacement strategies have a few enormous advantages over medical treatments, the most prominent of which is their ability to treat just about anyone with balding issues. Treatments like finasteride and minoxidil are usually only effective in cases of androgenetic alopecia, where DHT is the primary cause of hair loss. But, chemotherapy patients and those suffering from stress-related hair loss are among those few for whom these drugs are often ineffective. Minoxidil and LLLT can help regrow hair faster once underlying health issues have been addressed or a round of chemo is complete, but they can’t help before that.

Because hair replacement is a practical, physical fix, it can apply to anyone. And these are advanced techniques with highly realistic results. Gone are the days of cringe-worthy toupees. There may be a few patients whose scalps might be sensitive to the adhesives used in the most advanced methods, but those may be the only ones for whom these treatments aren’t ideal. You could find yourself in a few uncomfortable conversations if you go from an advanced stage of baldness to having a full head of hair overnight, but that’s a minor inconvenience many men would happily suffer.

It’s also important to note that access can be an issue. A limited number of clinics perform hair replacement, and costs can be prohibitive for many, often running several hundred dollars monthly. Replacement also won’t stop or reverse hair loss, and some methods make it impossible to apply topical treatments while the hairpieces are in place. You could combine replacement with oral finasteride, thickening shampoos and conditioners, and even supplements, but minoxidil, topical finasteride, and even some laser treatments will be off the table.

The best provider we know of to deliver safe, effective, and reliable hair replacement is HairClub.

HairClub Xtrands

Men with balding in the crown area have an opportunity to address the problem that doesn’t require any medications or surgery and that can deliver results in just a few hours. HairClub’s Xtrands system invites customers into an in-person clinic, where a specialist will evaluate their hair’s color, thickness, density, and texture and discuss how they’d like their head of hair to look after the procedure. More often than not, HairClub will special-order your Xtrands hairs, and you’ll return for a follow-up visit, during which you’ll have your new hairs applied.

Your specialist will integrate the new Xtrands hairs into your existing hair, blending them to create a full, durable result that you can treat like your regular hair. You can swim with it, wash it, style it, and treat it how you would any naturally grown hair.

Xtrands+

The basic Xtrands package is ideal for men with balding in the crown area and, ideally, those in the early stages of baldness. Xtrands+ applies to men with much more advanced hair loss. Instead of just weaving new hairs into your existing locks, an Xtrands+ specialist will work with you to design a head of hair that you love. It can recreate the hair you lost or be a completely new style from the color to the whorl.

At first glance, the hairpiece that arrives at the clinic may remind you of a toupee, but it’s critical to remember that this has been custom-made for your head. If you aren’t entirely bald on top, your specialist will shave your head, leaving any frontal hairline intact. Then, they will adhere the hair to your head utilizing a medical-grade adhesive that can last for months or years at a time. Along the edges of the main hairpiece, your specialist will use the original Xtrands technique to blend the piece into your existing hair and create a seamless appearance. Once everything sets, you can utilize this hair as your own.

Despite the convenience and instant gratification of these processes, the cost and maintenance are serious considerations. As the hair you still have naturally grows, it can reduce the effectiveness of the Xtrands+ adhesive or make the integration points of regular Xtrands hairs seem less natural. That’s why HairClub charges for Xtrands and Xtrands+ on a subscription basis, allowing you to go into its clinics for maintenance and adjustments as needed.

The big problem with this system for many men is that HairClub runs its clinics on a franchise model, and at the time of this writing, there are only a little more than 100 clinics in the entire United States, with most located around major cities. If you live in a remote area or simply a part of the country without a clinic nearby, it may be more trouble than it’s worth to make those many trips for maintenance.

However, if you live within striking distance of a clinic and can afford the subscription, it would likely be well worth it. If you have the capital — and aren’t opposed to surgical intervention — you can even combine these Xtrands methods with hair restoration surgery.

Hair transplantation is a surgical procedure, making it very different from all other treatment options.33 There are two main types of hair transplant surgery:

• Follicular unit transplantation (FUT)
• Follicular unit extraction (FUE)

FUT involves a surgeon removing a sizable batch of healthy hair follicles from somewhere relatively inconspicuous (like the back of the head, commonly) and surgically transplanting it in the area of hair loss. This method is best suited for men with more severe hair loss, and HairClub clinics pair it with an Xtrands or Xtrands+ treatment for maximum efficacy.

FUE, by contrast, removes a much smaller follicle count with each pass and transplants them individually into areas of thinness. It’s ideal for men with thinning hair and those with receding hairlines.

Hair transplant surgery can cost from $3,000 to $15,000, depending on where you live and the extent of transplantation. And it’s important to remember that insurance does not cover these surgeries. HairClub provides the surgery at its roughly 100 locations around the country.

As with other cosmetic surgeries, you should also consider caring for the surgical sites and the recovery time. Complications may arise from these procedures. And, as with any cosmetic procedure, the positive outcome depends on the skills of the surgeon who operates on you. Surgeries have advanced enough over the years that scarring is primarily a thing of the past.

Because of these factors, we don’t consider surgery a recommendable treatment path for most men, compared to the non-invasive and effective options that cost much less.

RestoreInk

HairClub also provides a service similar to tattooing that can create a realistic hairline or manufacture the appearance of an extremely short haircut. It’s a minor, non-surgical procedure that provides fast results, and you can combine it with medical treatments such as finasteride. We would not recommend using any topical treatments until the tattoo sites have completely healed.

RestoreInk doesn’t provide particularly dramatic results on its own. Still, it is a nice addition to restoration and replacement techniques in men whose hairlines have more or less wholly receded, giving them an outline in which their new hair can reside.

Companies like Keeps, Hims, and HairClub all offer additional treatments in the form of haircare products. These include shampoos, conditioners, and styling products. Some of them also offer supplements that include vitamins and extracts, a few of which have some clinical evidence backing their efficacy in the fight against hair loss. One company, Nutrafol, bases its entire hair loss approach on supplementation. All that said, none of these is likely to combat hair loss on its own in a meaningful way. They are best considered as ancillary treatments within a more comprehensive regimen that includes prescription medication, topical OTC treatments, or laser therapy.

“Hair growth supplementation, including shampoos and conditioners, does not have substantial supportive clinical evidence as the previously discussed medications do,” Dr. Bukoski says. “People shouldn't go spending all of their money trying to supplement their way to hair growth.”

Here’s a quick look at the haircare, supplement, and alternative landscape:

If you don’t find a suitable or appealing option for hair loss treatment over time, it’s also worthwhile to reflect on how many balding or totally bald men have become iconic sex symbols. In fact, for men who embrace it, baldness can act as an impressive signal of confidence rather than a source of damage to self-esteem.

So, if you can embrace or celebrate baldness as a new phase in your life — maybe finding a new hairstyle or swapping out the hair on your head for some stylish or distinguished facial hair — then this is another viable path in approaching hair loss. It’s certainly the cheapest.

Whatever you choose, remember: you are the master of your hair. All you need to do is choose the path that feels best to you and then move forward confidently. Waiting is the only bad course of action. The best time to decide is now.