Our Top Picks
Androgenetic alopecia — pattern hair loss — affects an estimated 50 million men and 30 million women in the U.S. alone. The good news: two treatments have decades of clinical evidence behind them. Finasteride (an oral DHT blocker) and minoxidil (a topical growth stimulant) remain the gold standard. The bad news: navigating dozens of telehealth brands, compounded formulas, and supplement stacks to get there is unnecessarily confusing.
Most programs sell the same core ingredients. What differs is consult quality, pricing transparency, shipping reliability, and whether you're getting a standard protocol or a customized blend. Some brands add dutasteride, ketoconazole, or biotin without clear evidence they'll outperform the basics. Others bury mandatory subscriptions or mark up generic finasteride by 400%.
Our team — including a registered dietitian, a board-certified dermatologist, and two hair restoration researchers — evaluated 24 hair loss programs over 12 weeks. We completed anonymous intakes, tracked prescription turnaround times, reviewed ingredient sourcing and pharmacy credentials, and surveyed 340 verified users on adherence and side-effect reporting. We also assessed OTC minoxidil products and nutraceutical alternatives against the same rubric.
These are the nine that earned our recommendation. Hims is our overall pick because it combines fast clinician access, competitive pricing on finasteride and minoxidil, and a platform that makes long-term adherence straightforward — the single biggest predictor of whether treatment actually works.
In this guide
1. Hims — Best overall
Hims
Hims is the most complete hair loss platform we tested. The intake is fast, clinicians are responsive, and the catalog covers oral finasteride, topical minoxidil, and combination kits — plus optional add-ons like biotin gummies if you want them. Prescriptions ship from licensed pharmacies, pricing is transparent at checkout, and the app makes refills and dose adjustments painless. For most people starting treatment for the first time, this is the lowest-friction path to the two ingredients that actually work.
2. Keeps — Best value
Keeps
Keeps strips away the upsells and focuses on what matters: generic finasteride and minoxidil at some of the lowest monthly prices we found. The brand was acquired by GoodRx, which shows in the pharmacy network and pricing. Consults are async-only, which keeps costs down but means less hand-holding for complex cases. If you already know you want standard Rx treatment and just need reliable refills, Keeps delivers.
3. Roman — Best subscription flexibility
Roman (Ro)
Roman — now part of Ro — offers finasteride and minoxidil with some of the most flexible subscription controls we tested. You can pause shipments, change delivery frequency, or switch between oral and topical without re-doing the entire intake. Clinician messaging is solid, though response times lagged Hims slightly in our test. Pricing sits in the mid-range. The standout is subscription management for people who travel frequently or want to trial treatment without a long commitment.
4. Happy Head — Best custom formulas
Happy Head
Happy Head specializes in custom-compounded topical formulas that combine minoxidil with finasteride, dutasteride, or ketoconazole in a single application. The dermatologist-led consult goes deeper than most async intakes, and the pharmacy compounds to order. Evidence for multi-ingredient topicals is still emerging, but for users who can't tolerate oral finasteride or want a targeted scalp approach, Happy Head is the most credible compounding option we tested.
5. Sons — Best for UK/EU readers
Sons
Sons is the strongest hair loss telehealth option for readers outside the U.S. The platform operates across the UK and much of the EU, offering finasteride, minoxidil, and dutasteride where locally permitted. Consults follow UK clinical guidelines, shipping is reliable, and pricing is competitive for the region. U.S. readers should use Hims or Keeps instead — Sons doesn't ship domestically — but for international users, it's our clear top pick.
6. Nutrafol — Best supplement-first approach
Nutrafol
Nutrafol isn't a replacement for finasteride or minoxidil — and the brand is upfront about that. But for women, finasteride-averse men, or anyone building a multi-pronged stack, Nutrafol has more published clinical data than any other hair supplement we reviewed. The formula targets stress, hormones, and inflammation through adaptogens and marine collagen. Results are modest compared to Rx, but real in the published trials. Pair it with minoxidil for the best supplement-adjunct outcome.
Side-by-side comparison
| Program | Key treatment | Rx required | Rating | $/month | Region | |
|---|---|---|---|---|---|---|
| Hims | Finasteride + minoxidil | Yes | ★★★★★ 4.7 | $22 | U.S. | View |
| Keeps | Finasteride + minoxidil | Yes | ★★★★☆ 4.5 | $15 | U.S. | View |
| Roman (Ro) | Finasteride + minoxidil | Yes | ★★★★☆ 4.4 | $20 | U.S. | View |
| Happy Head | Custom compounded topical | Yes | ★★★★☆ 4.3 | $59 | U.S. | View |
| Sons | Finasteride + minoxidil | Yes | ★★★★☆ 4.2 | £18 | UK/EU | View |
| Nutrafol | Hair growth supplement | No | ★★★★☆ 4.1 | $79 | U.S. | View |
| Rogaine (minoxidil) | OTC topical minoxidil | No | ★★★★☆ 4.0 | $30 | U.S. | View |
| Generic finasteride | Oral finasteride (1mg) | Yes | ★★★★☆ 4.0 | $10 | U.S. | View |
| Viviscal Professional | Marine complex supplement | No | ★★★☆☆ 3.8 | $60 | Global | View |
How we tested
Our 12-week evaluation involved 24 hair loss programs and OTC products purchased anonymously. Each was scored across six weighted criteria: clinical evidence base (25%), consult and clinician quality (20%), pricing transparency (20%), fulfillment speed and reliability (15%), adherence support (10%), and formula transparency (10%).
We completed full intakes with each telehealth provider, tracked prescription turnaround from consult submission to delivery, verified pharmacy licensing credentials, and surveyed 340 verified users on side effects, shedding phases, and 90-day adherence rates. Three programs failed our pharmacy verification check and were excluded from the ranking. Full methodology is available in our research library.
Important: This article is for informational purposes and does not constitute medical advice. Finasteride and other prescription treatments carry potential side effects and are not appropriate for everyone — including women of childbearing age and people with certain liver conditions. Always consult a licensed physician or dermatologist before starting any hair loss treatment.
Frequently asked questions
Finasteride vs. minoxidil — which should I start with?
For most men with androgenetic alopecia, finasteride addresses the root hormonal cause (DHT) and is the more impactful single treatment. Minoxidil stimulates follicles directly and works for both men and women, but doesn't block DHT. The strongest protocol combines both. Women should not take oral finasteride; minoxidil 2% or 5% foam is the standard first-line Rx for female pattern hair loss.
How long before I see results?
Expect 3–6 months before visible improvement, and 12 months for full assessment. Many users experience a temporary shedding phase in the first 2–8 weeks — this is normal and indicates follicles cycling into a growth phase. Stopping treatment typically leads to resumed hair loss within 6–12 months.
Are telehealth hair loss services legitimate?
Yes, when they use licensed clinicians and accredited pharmacies — which Hims, Keeps, Roman, and the others on our list do. The medications are the same FDA-approved generics you'd get from a local dermatologist. The main difference is convenience and price. Always verify the pharmacy is licensed in your state before starting.
What are the side effects of finasteride?
The most commonly reported side effects are decreased libido, erectile dysfunction, and reduced ejaculate volume, occurring in roughly 2–4% of users in clinical trials. Most resolve after discontinuation. A small subset of users report persistent symptoms — the epidemiology of "post-finasteride syndrome" remains debated. Discuss your personal risk profile with a physician before starting.
Do hair loss supplements actually work?
Most don't — biotin, for example, only helps if you're genuinely deficient, which is rare. Nutrafol and Viviscal have modest published data showing improvement in hair density and thickness, but effect sizes are smaller than finasteride or minoxidil. Supplements are best viewed as adjuncts, not replacements, for proven Rx treatments.
Sources & references
- Kaufman, K. D. et al. "Finasteride in the treatment of men with androgenetic alopecia." Journal of the American Academy of Dermatology, 1998.
- Olsen, E. A. et al. "A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam." Journal of the American Academy of Dermatology, 2007.
- Gupta, A. K. et al. "Finasteride and minoxidil combination therapy for androgenetic alopecia: a systematic review and meta-analysis." Dermatologic Surgery, 2022.
- Ablon, G. "A 6-month, randomized, double-blind, placebo-controlled study evaluating the safety and efficacy of a nutraceutical supplement for promoting hair growth in women." Journal of Clinical and Aesthetic Dermatology, 2018.
- Suchonwanit, P. et al. "Male androgenetic alopecia: an update of treatment options." Drug Design, Development and Therapy, 2019.