Photo by Innerbody Research
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 2023. For those of you in a hurry, here’s a quick rundown of our recommendations based on the specific hair loss issue you’re experiencing and approach you may wish to take. We’ve also included our top pick for each recommendation so you know not only what treatments to choose but also the best places to find them right now.
Keeps oral finasteride + topical minoxidil is the most reliable and affordable way for most men to stop hair loss and regrow hair.
After a free doctor’s consultation, you can get a prescription for 1mg finasteride (ideal for receding hairlines) paired with a 5% minoxidil solution (great for thinning at the crown). These two treatments have decades of successful research and customer testimonials behind them, they work great together, and Keeps’ discounted price is best-in-class as you try the combination for the first three months.
Hims has more individual products for hair loss and overall health than its closest competitors, and its Power Pack bundle gets you four outstanding products for a great price.
Hims has the best bundling option we’ve come across in its Power Pack, which contains oral finasteride, topical minoxidil, Thick Fix thickening shampoo, and daily biotin gummies for just $60/month. For guys who want convenience and value, this bundle should satisfy.
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 the nearly 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.
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 2023 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.
On their own, finasteride and 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
Keeps gets our recommendation for men seeking this combined therapy. The company offers minoxidil in solution or foam formats, and it bundles either version with prescription finasteride for the lowest price among its peers. Keeps also has a steep discount for first-time customers.
However, you could save a few extra dollars by utilizing that discount for the first three months and then switching to Roman for your finasteride while keeping Keeps for your minoxidil. The trade-off is convenience — two separate accounts for your hair loss treatment rather than one — but you’d be paying an average of $29 monthly moving forward with Roman/Keeps at that point instead of $32 with Keeps alone.
Here’s a quick look at how different therapies address hair loss with a little information on the companies we recommend for each scenario:
Note: The high success rate for oral minoxidil is based on fewer studies and studies that are much smaller in scale than the bountiful research done on oral finasteride. As more research is conducted, the mean success rate among studies is likely to come down closer to finasteride levels.
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, Keeps, 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 all three companies offer to get a sense of the comparison:
|Topical minoxidil solution|
|Topical minoxidil foam|
|Thickening shampoo and conditioner|
|Other healthcare, including sexual wellness support|
Based on the number of check marks alone, Hims comes out on top. When we look closer, however, there are circumstances in which Keeps or Roman offers better pricing than Hims. For example, Roman’s oral finasteride and hair care products are less expensive. But Hims has more hair care products to choose from and offers finasteride in a large hair loss bundle that comes with minoxidil, shampoo, and biotin gummies. And while Keeps has a lower price for topical minoxidil and oral finasteride — including an added discount when you get them together — Hims doesn’t charge the $5 Keeps does for shipping, and both Hims and Roman have comprehensive healthcare support to address any potential side effects directly.
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.
If you want a comprehensive, no-holds-barred regrowth plan that doesn’t involve surgery, we recommend combining three treatments: oral finasteride, topical minoxidil, and an effective laser cap. As for which providers or devices to select, we recommend Keeps (and possibly Roman) for the medications and the Kiierr 272 Premier laser cap for your laser device.
Photo by Innerbody Research
Several studies suggest that using finasteride and minoxidil together is much more effective than either therapy on its own, without causing any additional adverse reactions.2 Because minoxidil and laser treatments can each have mild skin-related side effects on the scalp, you might reasonably worry that combining those treatments would double your risk of such a reaction. But fortunately, another study shows that combining minoxidil with laser treatments is safe and effective, with no apparent uptick in side effects and a noticeable increase in the speed of treatment.3
Using all three simultaneously should 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’ll have to continue with what might be a hefty investment over time.
You won't be able to beat Keeps' discounts for the first three months of the combination of finasteride and minoxidil; it will cost between $18 and $22 per month, depending on your preference of solution or foam minoxidil. Starting there, for most men, makes sense.
However, if you know you'll be particularly worried about possible side effects of finasteride and want greater peace of mind, you might want to pay a little more at first and opt for Roman finasteride alongside your Keeps minoxidil. Using Roman for your finasteride gets you ready access to follow-up consultation about any potential side effects you might experience; the company also offers convenient remedies like ED medications. Keeps does not offer any medication to address sexual side effects at this time.
Plus, after the three-month discounting at Keeps ends, you would begin to save $3 per month if you maintain Keeps for minoxidil but switch to Roman for finasteride. You'll have to decide whether saving $36 in a year is worth the inconvenience of twice the deliveries along with billing processes from two different companies.
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:
If you’ve ever heard the term male or female pattern baldness, you’ve heard of androgenetic alopecia.4 It’s caused by an excess of dihydrotestosterone (DHT) on the scalp and throughout the body, and it’s the most common cause of hair loss. You couldn't tell just by looking at someone that this is the cause of their hair loss; it doesn’t cause thinning of one pattern or another. The most common treatments for androgenetic alopecia are 5-alpha reductase inhibitors, which mitigate the formation of DHT in the body, as well as topical treatments that increase blood flow and nutrient delivery to the scalp.
Telogen effluvium refers to hair loss caused by stress.5 This means more than just the kind of stress you might experience from a hectic work environment or pressing deadlines. It applies to any kind of stress your body might experience, from physical and psychological to emotional. You could have telogen effluvium from exposure to toxic chemicals just as easily as you could from a toxic relationship. The same treatments that work for androgenetic alopecia may also work for telogen effluvium, but you’d be wise to pair them with steps to remove stressors from your environment.
In some cases, the body can interpret some of your hair follicles as foreign invaders and sick your immune system on them. This results in alopecia areata, a condition in which one or more patches of hair are attacked by the immune system, leading to bald spots.6 An extreme version of this disorder — alopecia totalis — causes your body to attack all of its hair follicles.
Chemotherapy is intended to attack rapidly growing cells, a feature that tumors share with hair follicles. As a result, many people undergoing chemo will experience some degree of hair loss.7 Despite this, insurance companies typically do not cover any hair loss treatments, even during chemotherapy, as they consider it an elective, cosmetic treatment.
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.
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 and nature of your hair loss will largely influence which course of treatment will be most effective.
If your hair loss is new and mainly happening at the crown, you can save a little money and avoid potential sexual side effects by sticking to minoxidil over finasteride. If you have a receding hairline — with or without crown balding — you may need finasteride to tackle the problem, though there is growing evidence that an oral form of minoxidil could offer similar efficacy, albeit with its own set of side effects.
Of course, there are non-medicinal paths you can take if you prefer. We’ll dive deeper into those a little later, but these include laser treatments and replacement methods that can give you instant results.
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.
Those on a tight budget need to know which path is likeliest to succeed without breaking the bank. Both Keeps and Hims offer well-priced subscriptions to their most popular products, which invariably save you a little extra money. 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.
The lowest-cost intervention we’ve found comes from the Kirkland brand, which you can get through Costco. There, 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 Keeps, Hims, and Roman offer as part of your plan. Talking to a medical expert during your hair growth journey is highly valuable.
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 medications like finasteride and oral 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 have been 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 that can require little to no maintenance moving forward. That said, most surgical procedures include follow-up treatments with finasteride, minoxidil, or both to maximize 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.
Photo by Innerbody Research
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.
Between topical and oral minoxidil, there’s much more evidence supporting the safety and efficacy of the topical application. And there are some known cardiovascular and dermatological side effects with oral medication that topical doesn’t have. As such, we recommend the topical form over the oral at this time, and to get it, we recommend Keeps. It’ll save you a few dollars each month compared to competitors like Hims and Roman. Over a year, ordering from Keeps saves you about $60 compared to the nearest competitive price.
And you can choose between minoxidil in its transitional solution format or as a foam, which we highly recommend. Our testers have consistently found that foam minoxidil is easier to apply than the solution. It also doesn’t contain any propylene glycol, a standard ingredient in the solution that is a known irritant and the culprit behind much of the scalp discomfort minoxidil users sometimes report.
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. In its topical form, you simply apply it to your scalp twice a day and let it dry for several hours before touching your hair, showering, or sleeping. The oral medication is typically administered once daily at 2.5mg.
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.
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. 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: Keeps
Photo by Innerbody Research
Here are the facts based on data from clinical studies:40
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.
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 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.
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 to 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. But telehealth companies have begun to catch up with demand, and two prominent players currently offer prescriptions for oral minoxidil through their platforms.
Those two companies are Roman and Happy Head, and the best value between the two 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. Let’s take a look at a handy chart that breaks it down.
|Price per month||$30||$22|
|Tablets per month||30||15|
|Dose per tablet||2.5mg||2.5mg|
|Cost per mg of minoxidil||$0.40||$0.59|
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.
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. 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
There hasn’t been a ton of research into whether you could or should combine oral and topical minoxidil. What research exists 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. So, to mitigate your risk for what are ultimately disparate sets of side effects, we suggest going with one or the other.
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 risk below.
Photo by Innerbody Research
While Keeps 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 Roman is the best choice for oral finasteride. Of the three, Hims is the most expensive monthly, and while the first-year cost of finasteride through Keeps can come down just below Roman’s price if you order a year’s supply, Keeps’ shipping cost just about evens things out.
Here’s what the numbers look like:
|Roman finasteride, quarterly billing||Keeps finasteride, annual billing||Hims finasteride, quarterly billing|
|Cost per month||$20||$19.50||$26|
|Cost per month with shipping||$20||$19.92||$26|
|Cost per month after first year||$20||$20||$26|
|Cost per month after first year with shipping||$20||$20.42||$26|
It’s also important to remember that Keeps doesn’t offer the wide range of additional telemedical support that Roman and Hims do. So, if you go through Keeps and are among the unlucky few to experience sexual side effects from oral finasteride, you’ll either have to see a doctor in person or reach out through Hims or Roman anyway.
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). 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 women seeking intervention for hair loss.
Recommended provider: Roman
Photo by Innerbody Research
Finasteride is one of the most reliably effective treatments for hair loss on the market. Here are the facts, based on studies:
These numbers imply that finasteride should work well for most men, but 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.
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:
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
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.
At this point, there hasn’t been enough research into these oral medications in combination to warrant anyone starting out with that therapy profile. A dermatologist from any of the companies in this guide is more likely to start you out on one or the other, depending on your specific goals and health history.
That said, 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, and many dermatologists might want to see more comprehensive research first.
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 currently unavailable on the telehealth market as a standalone treatment.
Photo by Innerbody Research
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:
|Topical finasteride and minoxidil combo||Oral finasteride with topical minoxidil|
|Keeps||$30 first three months, $60 after that||$19 first three months, $38 after that|
|Hims||$35 biannual subscription, $50 quarterly subscription||$41|
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 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.
Photo by Innerbody Research
Finasteride + minoxidil is undeniably the best choice for men experiencing global hair loss. The treatments work together to help stop hairline recession and thinning at the crown.
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.
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.
Photo by Innerbody Research
Hims offers 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. Unfortunately, topical finasteride won’t work quite as well as oral finasteride. It’s also more expensive to compound in topical form, and it costs more for consumers as a result.
The good news is that 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 will certainly have its benefits.
Recommended provider: Kiierr
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
Photo by Innerbody Research
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.
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.
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 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 And in one study, a 655nm laser array proved effective in achieving robust hair growth in 40% of men.
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.
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.
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 normally grown hair.
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, 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 you 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:
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 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. HairClub provides the surgery at its roughly 100 locations around the country, but Keeps also recently opened a center in New York City to perform the procedure, with plans to open additional clinics in the coming years.
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.
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 clinical evidence backing their efficacy in the fight against hair loss. One company, Nutrafol, bases its entire hair loss approach on supplementation. Some other products on the market show promise but require further study.
Here’s a quick look at the haircare, supplement, and alternative landscape:
A company called Divine Skin Laboratories (also called DS Laboratories) developed nanoxidil as an evolution of minoxidil. The compounds are strikingly similar but for nanoxidil’s lower molecular weight. Still, they’re different enough that nanoxidil has yet to receive FDA approval. It also lacks the robust study history behind minoxidil. If the FDA approves it, it could knock minoxidil off its pedestal, as early studies indicate that it bears similar efficacy with a lower side effect profile.34 We have a dedicated page that compares the two directly.
Keeps, Hims, HairClub, and a company called ScalpMED all offer thickening shampoos. So do most laser cap providers. These products often contain saw palmetto as their most effective ingredient, which performs well in many hair loss studies when applied topically or taken orally.35 Our preference for thickening shampoo is Hims for its price point, effectiveness, lather, and scent.
After using a strong cleansing shampoo, reintroducing a healthy amount of moisture is key to hair health and the appearance of thickness. The same four companies mentioned above boast effective conditioners bolstered by similar ingredients as those in their shampoos. But Hims is our favorite here because it includes niacinamide in its formula, which can help fight the main cause of dandruff and keep the scalp from becoming itchy or flaky.36
Keeps is the only company in the lot to offer prescription shampoo. It includes something called ketoconazole, which, like the niacinamide in Hims’ conditioner, is an anti-fungal treatment designed to treat dandruff.37 Ketoconazole is significantly stronger than niacinamide, however, which is why it requires a prescription. Studies show that it can be helpful in the fight against hair loss, and it’s especially good for men suffering from alopecia and dandruff.38 Divine Skin Laboratories, the company behind nanoxidil, also has a comprehensive shampoo containing ketoconazole, but it doesn’t require a prescription because the concentration is half that of the Keeps version.
Keeps, ScalpMED, and HairClub offer styling products intended to help with baldness. Keeps’ pomade is particularly well-designed, with saw palmetto, biotin, caffeine, and green tea in it. ScalpMED’s styling spray contains vitamins that help individual hairs absorb and hold onto water, allowing each strand to appear thicker while also helping keep them healthy and resistant to breakage. HairClub offers a slew of styling products, from pomade to gel. Some of these have ingredients that may help thicken hair, while others can simply help you achieve the look you want without damaging your hair. HairClub is our preference here for sheer variety.
ScalpMED happens to be the only one of these companies to offer a dedicated, non-medicinal scalp treatment, which it calls a scalp detoxifier. You should only use it before both the shampoo and conditioner, however. It contains alcohol as one of its main ingredients and may dry out your scalp if you use it without washing and conditioning afterward. You can read more about ScalpMED in our dedicated review.
Keeps is the only company in the bunch that doesn’t offer oral supplements. Hims limits its offering to biotin gummies, which can help promote healthier hair without necessarily making a difference in cases of alopecia. HairClub and ScalpMED offer a more complex supplement containing beta-sitosterol, bamboo extract, and a handful of other ingredients.39 Still, it’s Nutrafol that has to be the top choice for hair loss supplementation. Its formula is the most comprehensive by far, though it is also the most expensive. We go in-depth on Nutrafol in this complete review.
While haircare products by Keeps and Hims are largely cruelty-free, vegan hair loss alternatives are a niche unto themselves. All of Hims’ gummies contain gelatin that comes from cows. Not only is this an issue for vegans and vegetarians, but it also has religious implications for some people. A company like Hum Nutrition focuses on delivering vegan products, so its Hair Sweet Hair biotin gummies make a great example of the alternatives out there. In addition to biotin, these also contain zinc, folic acid, B12, and other hair-friendly ingredients.
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.
Innerbody uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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When it comes to hair loss treatments, Keeps vs Hims is the big battle. Find out who wins in 2023 for cost and service.
Our expert review of Keeps tells you everything you need to know about their hair loss treatments, pricing and service.
Our experts tell you everything you need to know about Hims services and products, as well as current deals and discount codes.
If hair regrowth is your goal, our 2023 ScalpMED reviews give you all of the details about its hair loss treatments.
Our experts rate and review all Hims ED products and services in terms of quality, cost, privacy, and customer support, as well as current discounts