What actually works for hair loss
For androgenetic alopecia (the male and female-pattern hair loss that affects roughly 50% of men by 50 and 40% of women by 70), two medications have decades of FDA-backed evidence:
- Finasteride (1mg oral daily) — blocks DHT, the hormone that miniaturizes hair follicles. Approved for men; off-label for women in specific contexts.
- Minoxidil (2% or 5% topical twice daily, or low-dose oral once daily) — stimulates follicle blood flow. Approved for men and women.
Both work better in combination than alone. Both take 3-6 months to show meaningful results — the single biggest reason patients quit is impatience. Plan to commit before starting.
Quick recommendation if you're not sure where to start
- Cheap, fast, mass-market → Hims at ~$25/mo is the default.
- Hair-loss-specialist provider → Keeps for a more focused brand.
- Topical-only combination protocol (no oral finasteride) → VytalRx compounded topical.
Hims
The default cheap option. Finasteride at the lowest mass-market price in the US, minoxidil topical and oral both available, plus optional anti-DHT shampoo bundles. Intake is fast; consult is functional. Right pick when cost is the priority.
Application in progressKeeps
Hair-loss specialist. Same medications as Hims (finasteride + minoxidil) but the brand focus is hair loss, with progress tracking, photo journals, and annual treatment plans. Worth it if you want a provider whose entire focus is hair loss rather than a multi-category platform.
Application in progressRo (Roman)
Roman covers hair loss as part of its broader men's-health platform. Finasteride and minoxidil at comparable prices to Hims, often with similar first-month promotional discounts. If you're already considering Roman for other men's-health needs, the bundle math gets attractive.
Application in progressVytalRx compounded topical combination
For patients who want the topical-only protocol with no oral medication. Compounded combination solutions are typically more concentrated than Rogaine's 5% minoxidil and add topical finasteride (lower systemic exposure than oral finasteride). Licensed-prescriber review. Available in 49 states (not Alabama).
Start eligibility intake →Side-by-side
| Provider | Format | Price range | Best for |
|---|---|---|---|
| Hims | Oral finasteride + topical or oral minoxidil | $25-$50/mo | Mass-market, cheap, fast |
| Keeps | Oral finasteride + topical minoxidil | $25-$60/mo | Hair-loss-specialist brand |
| Ro (Roman) | Oral finasteride + minoxidil | $20-$45/mo | Bundle with men's-health needs |
| VytalRx compounded | Compounded topical (no oral) | $199/mo | Patients avoiding oral finasteride |
Frequently asked questions
How long until I see results?
3-6 months for noticeable density change; full results take 12 months. Hair grows slowly. Most patients quit at week 6-8 because they don't see anything — that's normal, not a sign the medication isn't working. Photo-journal at the start so you can compare honestly later.
Is finasteride safe long-term?
Finasteride has been on the market since 1992 with extensive safety data. Sexual side effects (libido, erectile function) occur in <5% of men and typically resolve when the medication is stopped. Some men experience persistent symptoms (post-finasteride syndrome) which is rare and debated in the literature. Talk to your prescriber about risk-benefit.
Can women use finasteride?
Off-label, yes. Finasteride is not FDA-approved for women but is sometimes prescribed for female-pattern hair loss in specific contexts (post-menopause, documented hormonal patterns). Pre-menopausal women who could become pregnant should generally avoid finasteride due to birth-defect risk. Topical minoxidil 2% or 5% is the standard first-line option for women.
Topical vs oral minoxidil?
Topical is twice-daily, applied directly to the scalp. Oral (typically low-dose 1.25-5mg daily) is once-daily, avoids the topical mess, but requires monitoring for cardiovascular side effects (ankle swelling, increased heart rate). Most DTC platforms now offer both.
Will I keep my hair if I stop the medication?
No. Both finasteride and minoxidil work only as long as you take them. Stopping either typically results in resumed hair loss within 3-6 months. Plan for a long-term commitment if you start.
Sources
- FDA labeling for finasteride 1mg and minoxidil 5%
- American Academy of Dermatology guidelines for androgenetic alopecia
- Provider pricing pages current as of May 2026 (verify before enrolling)
Prices change. We update this page as providers shift pricing. Spot something out of date? Email editors@vytalrxonline.net.