Online hair loss treatment is mostly two drugs in different wrappers. Finasteride 1 mg is a daily tablet. Minoxidil 5% is a liquid or foam you rub into the scalp. Almost every subscription brand builds its plan from those two, then adds a shampoo, a chewable or a compounded topical.
So the logo matters less than three things: which molecules you actually need, what the plan costs across twelve months, and how much clinician contact comes with it. Hims vs Keeps cost questions usually stall on the sticker price shown at signup, which is the least useful number on any of these sites.
Before you look at a single brand, decide which one thing you are optimising for: lowest total cash outlay, HSA or FSA use, real clinician access, speed to the first delivery, or a company you can cancel without a fight. Very few people want all five equally, and the cheapest plan is rarely the one with the most medical support behind it.
Start with the molecule, not the brand name
There are only a handful of treatments with meaningful evidence for male pattern hair loss, and every subscription sells some mix of them.
- Oral finasteride 1 mg: a prescription tablet that lowers scalp DHT, the hormone that shrinks follicles in pattern hair loss.
- Topical minoxidil 5%: sold over the counter as a solution or a foam, applied once or twice daily depending on the format.
- Low dose oral minoxidil: prescribed off label by some clinicians, usually with blood pressure and heart rate questions attached.
- Compounded topical finasteride with minoxidil: mixed by a compounding pharmacy, not an approved off the shelf combination product.
- Ketoconazole shampoo: 1% over the counter, 2% by prescription, used as a supporting player rather than a main treatment.
- Chewables, gummies and biotin blends: supplements, not drugs, and the weakest link in any plan that charges for them.
Women are usually offered topical minoxidil rather than finasteride, because finasteride carries a pregnancy warning and is not approved for use in women. Anyone with sudden diffuse shedding, patchy bald spots, scaling, pain or scarring needs a diagnosis first, not a subscription.
Once you know which molecule you want, the shopping problem gets simple. Right now 9 tracked programs carry finasteride, and the range between the cheapest and the dearest is wide enough to matter over a year.
Step 1 of 3
What do you need help with?
Step 2 of 3
How will you pay?
Step 3 of 3
What matters most?
Your starting point
Every list is ranked by the same public formula - nothing here can be bought.
What a monthly hair loss price actually covers
Every subscription price is really four costs bundled together: the drug itself, the clinician review, shipping, and the company margin. Brands split those four differently, which is why two plans with the same tablet can look nothing alike at checkout.
Generic finasteride 1 mg is an old, inexpensive drug at retail pharmacies, and minoxidil 5% sits on the shelf without a prescription. You are paying a subscription for convenience, the prescription review, refills that arrive without a reminder, and packaging. That can be worth it. It is only worth it if you know the size of the premium.
Price the year, not the month. Add the advertised monthly rate, shipping across twelve refills, any one time consult or medical fee, and the higher rate that kicks in when an introductory offer ends.
What a year actually costs
Programmes quote a monthly headline. Add the medication, the labs and the renewal price and the real number is usually different.
Advertised prices change often and intro pricing rarely lasts. Ask what the renewal rate is before you commit to a plan.
Quick tip: write down the annual total for each plan on the same piece of paper before you enter a card number.
A monthly price is only comparable when you know what is inside it. Check whether the number includes the tablet strength you were prescribed, the minoxidil format you will actually use, shipping, and the clinician follow up.
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Subscription mechanics that move the real price
The Hims vs Keeps cost gap that people argue about online is often a promotional gap, not a price gap. First month offers, three month starter rates and prepaid bundles all renew at a different number, and the renewal is the price you will live with.
Read the billing cadence closely. Quarterly billing looks cheap per month but takes a larger single payment, and it usually means a shipment leaves before you can pause. Prepaid six or twelve month plans cut the per month figure further, and they also lock you in before you know whether you tolerate the drug.
- The rate after the introductory period ends, in writing.
- Whether shipping is free at every plan length or only on longer commitments.
- How many days before a refill you must cancel to avoid being charged.
- Whether pausing is possible, or only full cancellation.
- Whether cancellation happens in the account settings or requires a phone call or chat.
- What happens to a prepaid balance if you stop at month three.
Side effects are the most common reason people quit in the first ninety days. A plan that bills quarterly and refuses partial refunds turns a medical decision into a financial one, and that is the wrong order.
Insurance, HSA and FSA for hair loss
Pattern hair loss is treated as cosmetic by most health plans, so finasteride 1 mg and minoxidil are commonly excluded even when the same molecules are covered for other uses. Finasteride 5 mg for an enlarged prostate is often on formulary; the 1 mg hair dose frequently is not. That single line in the plan document explains most of the confusion.
Cash pricing is therefore the default here, and the comparison is straightforward: subscription total against a local pharmacy fill with a discount card, plus whatever the consult costs.
HSA and FSA cards are a different question. Many administrators will reimburse prescription hair loss treatment if a clinician documents a medical reason, and some ask for a letter of medical necessity. To have any chance, you need an itemised receipt showing the drug name, strength, quantity, date and the prescribing clinician, not a generic subscription charge.
Ask before you sign up whether the brand issues that kind of receipt. Some produce one on request; others only send a card statement line that no administrator will accept.
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Who reviews your case, and how deeply
All of these services run on a clinician review, but the depth varies a lot. Some are a text based intake form answered asynchronously within a day. Others include photo review, messaging with the same clinician, or a video visit if your case is complicated.
That difference shows up when something goes wrong or when the diagnosis is not simple pattern hair loss. Thyroid disease, iron deficiency, rapid weight loss, new medications, alopecia areata and scarring alopecia all cause shedding, and none of them respond to finasteride. A good intake asks about sudden onset, scalp symptoms, family history and recent illness. A weak one asks your age and shows you a plan.
- Can you message a clinician after starting, at no extra charge?
- Will they adjust the dose or switch you to a topical if you report side effects?
- Do they ever order labs such as ferritin or thyroid tests, or refer you out?
- Are the clinicians licensed in your state, and is that stated before payment?
- Is there a follow up at three months, or does the plan just keep shipping?
If you have patchy loss, scalp pain, redness or scaling, book a dermatologist first. Telehealth is well suited to ordinary pattern hair loss and poorly suited to anything that might be scarring, because scarred follicles do not come back.
Best on clinical care
The quality of the medical side.
- Happy Head8.3 / 10
- Hims8 / 10
- Ro Body8 / 10
- XYON Health7 / 10
- Keeps6.8 / 10
Best on support
What happens when something goes wrong.
- Ro Body7 / 10
- Happy Head6.8 / 10
- Keeps6.6 / 10
- Lemonaid Health6.5 / 10
- Hims6.5 / 10
Ranked from our own scores, recomputed as data changes. Providers cannot pay for a place.
Side effects, monitoring and stopping
Finasteride is generally well tolerated, but the risks are specific and worth knowing before the first tablet. Reported effects include reduced sex drive, erectile difficulty, lower ejaculate volume, breast tenderness or enlargement, and mood changes. Most reports involve a small number of users, and symptoms often settle after stopping, though some men describe symptoms that persist.
Two practical points get skipped by fast intake forms. Finasteride lowers PSA readings, so any clinician ordering a prostate test needs to know you take it. And women who are or may become pregnant should not handle crushed or broken finasteride tablets, because the drug can cause abnormalities in a male fetus (MedlinePlus, US National Library of Medicine). Whole tablets are coated for that reason.
Topical minoxidil causes scalp itching, dryness or flaking in some users, usually from the propylene glycol in solutions rather than the drug. Foam avoids that ingredient. Both can cause unwanted hair growth if the liquid runs onto the forehead or is transferred to a partner or pet. A burst of shedding in the first two to eight weeks is common and expected, not a sign of failure.
Oral minoxidil is a blood pressure drug used off label at low doses for hair. It can cause fluid retention, ankle swelling and a faster heart rate, so it needs a clinician who takes a cardiac history seriously.
Contact a clinician promptly for breast lumps or discharge, depression or thoughts of self harm, chest pain, breathlessness, swelling, or a rash that spreads beyond the scalp.
Best on trust and safety
Certification, prescribing and transparency.
- RedBox Rx8.5 / 10
- Happy Head8.4 / 10
- XYON Health8 / 10
- Ro Body7.6 / 10
- Lemonaid Health6.6 / 10
Best on clinical care
The quality of the medical side.
- Happy Head8.3 / 10
- Hims8 / 10
- Ro Body8 / 10
- XYON Health7 / 10
- Keeps6.8 / 10
Ranked from our own scores, recomputed as data changes. Providers cannot pay for a place.
Topicals, foams and chews: what you are really buying
Compounded topical finasteride with minoxidil is the format that drives most of the online debate, and it is also the least standardised. Compounded preparations are mixed by a pharmacy for an individual prescription; compounded drugs are not FDA approved, which means the agency does not verify their safety, effectiveness or quality before they are dispensed (US Food and Drug Administration). That is not a reason to rule them out. It is a reason to ask which pharmacy compounds it and at what concentrations, and to write the answer down so you can match it if you ever switch.
The appeal is lower systemic absorption than a tablet, which some men want after sexual side effects. The trade offs are daily application, a scalp that must stay treated, and formulas that differ between suppliers.
Format matters more than people expect. Solution spreads further and costs less; foam dries faster and irritates less. Minoxidil 5% is over the counter either way, so you can buy a generic bottle at any pharmacy and reserve the subscription for the prescription items only. That single split is often the cheapest route available.
Chewables and gummy blends built on biotin are supplements. Unless you have a documented deficiency, they do not treat pattern hair loss, and they inflate a bundle price without adding much.
Across tracked programs, minoxidil pricing runs from $10 to $59, with a median around $25.
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If neither brand fits, here is what else exists
Hims and Keeps are the two names people search, but they are not the whole market. Other telehealth companies sell the same molecules, some specialise in custom topical formulas, and plenty of people do better with a local prescription and an over the counter bottle.
Hair Loss Treatment Routes at a Glance
| Best for | Watch for | |
|---|---|---|
| Hair subscription | One plan, refills handled, minimal decisions | Renewal rates, bundled supplements, cancellation terms |
| Multi-condition telehealth | Managing other health issues in one account | Marketing upsells, thinner hair-specific follow-up |
| Compounded topical service | Oral finasteride caused intolerable side effects | Formula concentrations, pharmacy name, higher monthly cost |
| Dermatologist + local pharmacy | Unclear diagnosis or lowest drug cost | Visit fee, wait time, plan exclusions for hair drugs |
| OTC minoxidil only | Early thinning, no prescription wanted | Twice-daily use, no clinician oversight, slower results |
| Route | Suits you if | Watch for |
|---|---|---|
| Hair specific subscription | You want one plan, refills handled, minimal decisions | Renewal rates, bundled supplements, cancellation terms |
| Multi condition telehealth brand | You may also want treatment for other issues in one account | Marketing upsells, thinner hair specific follow up |
| Custom compounded topical service | Oral finasteride caused side effects you could not tolerate | Formula concentrations, pharmacy name, higher monthly cost |
| Dermatologist plus local pharmacy | Diagnosis is unclear, or you want the lowest drug cost | Visit fee, wait time, your plan’s exclusion for hair drugs |
| Over the counter minoxidil only | Early thinning, no prescription wanted | Twice daily use, no clinician oversight, slower results |
Keeps is a hair focused brand; Hims sells across several men’s health categories. They are separate companies with separate clinician networks and pharmacies, whatever the similar branding suggests. If you want to confirm who you are actually dealing with, read the pharmacy name on the shipping label and the legal entity on the card statement.
Sanity-check one provider before you commit
Pick a single service, then run it through the same short audit you would use for any recurring charge attached to a prescription.
Audit Any Hair Loss Subscription Before You Commit
- Total the first 12 months including shipping, consult fees, and post-promotion rate
- Confirm exact drug strengths and formats match what a clinician recommends
- Find cancellation instructions and note the cutoff days before each refill
- Verify clinicians are licensed in your state and reachable after starting
- Ask whether an itemised receipt is available for HSA or FSA reimbursement
- Check the policy on side effects: dose changes, topical switch, or refund on unshipped months
- Take baseline photos of hairline and crown before the first dose
- Total the first twelve months, including shipping, consult fees and the post promotion rate.
- Confirm the exact strengths and formats included, then match them against what a clinician recommends.
- Find the cancellation instructions before you sign up, and note the cutoff days before each refill.
- Check that clinicians are licensed in your state and that you can message one after starting.
- Ask whether an itemised receipt is available for HSA or FSA reimbursement.
- Look for a stated policy on side effects: dose changes, switching to topical, or a refund on unshipped months.
- Read the marketing consent boxes, and decline anything that shares your health details with advertisers.
- Take baseline photos of the hairline and crown in the same light before the first dose.
Then give it time. Nothing here works in six weeks. Three to six months is the earliest fair check, and twelve months is the honest one. Both drugs are maintenance treatments, so gains fade after you stop, usually within about a year.
The decision comes down to one trade: pay more for closer clinician contact and easier cancellation, or pay less and manage the plan yourself. Both are defensible; the expensive mistake is a locked in annual plan chosen from a homepage price.
Best on value
What you get for what you pay.
- RedBox Rx8.5 / 10
- Keeps8.4 / 10
- Strut Health8 / 10
- Happy Head7.4 / 10
- Lemonaid Health7.2 / 10
Lowest monthly price
Cheapest verified plan for a new self-pay patient.
- Keeps$10/mo
- RedBox Rx$20/mo
- Hims$22/mo
- Strut Health$25/mo
- Happy Head$59/mo
Ranked from our own scores, recomputed as data changes. Providers cannot pay for a place.
This content is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified clinician or pharmacist about your situation, and seek urgent care or call your local emergency number for severe or worsening symptoms.