The most common mistake men make when hair starts thinning? Buying a shampoo. It feels like action. It isn’t. The only interventions with real clinical backing are systemic, and most people don’t find that out until they’ve spent a year on biotin gummies and $40 caffeine conditioner. This list is for people who are ready to skip that phase.
Below are five options ranked by how useful they are as a starting point and ongoing strategy, covering everything from AI-assisted self-assessment to prescription telehealth to over-the-counter fallbacks.
1. HairLine AI: Start Here Before Spending a Dollar
Free. No signup. No quiz trying to sell you a bundle.
HairLine AI is a browser tool that takes a single photo (webcam or upload), runs facial detection through MediaPipe, and then classifies your Norwood stage using Gemini 2.5 Pro as the underlying vision model. The output includes a Norwood classification, a rough graft-count estimate, and a ballpark transplant cost range, all on a results dashboard you can read in under two minutes.
Why does that matter before you pick a treatment? Because Norwood stage shapes what makes sense. Someone at Norwood 2 and someone at Norwood 5 are not good candidates for the same plan. Most telehealth brands will send you finasteride regardless, because the drug works across a range of stages. Knowing your stage before you talk to anyone puts you in a better position to ask specific questions rather than just accepting whatever a quiz recommends.
The tool does not prescribe anything, sell medication, or replace a dermatologist. The AI read is a starting estimate, not a clinical diagnosis. But as a free, private, zero-friction orientation step before you spend money on a subscription, it earns the top spot here.
2. Hims: The Broadest Prescription Menu in Telehealth
Hims is currently the only major telehealth brand offering topical finasteride, which matters for men who want to minimize systemic absorption. Oral finasteride works well, but a small percentage of users report sexual side effects. Topical finasteride applies the drug directly to the scalp, theoretically reducing systemic levels, though it is still Rx and still requires a clinician consult through the platform.
Beyond that, Hims carries oral minoxidil, topical minoxidil, oral finasteride, combination products, and various OTC add-ons. It is the widest menu of any single telehealth service in this category. Pricing varies by product and plan, but the range runs roughly $20 to $60+ per month depending on what you choose. Worth noting: prices change, so check current rates directly before committing.
For someone who already knows their Norwood stage and wants a one-stop prescription service with options, Hims is the practical pick.
See also: The Rise of Buy Now, Pay Later Technology
3. Keeps: Leaner, Cheaper, Hair-Loss Specific
Keeps does fewer things than Hims, and that focus works in its favor. The platform sticks to finasteride and minoxidil, the two treatments with the strongest evidence base, and prices 3-month plans more aggressively than most competitors. Shipping runs around $5. No foam minoxidil, no topical finasteride, no frills.
If you’ve already done the research, know you want standard oral finasteride or topical minoxidil, and want to spend less, Keeps is a reasonable choice. The clinical process is similar to other telehealth platforms: you answer intake questions, a licensed clinician reviews your case, and a prescription ships if appropriate. Results take 3 to 6 months minimum, and the drug has to be continued or the benefit reverses. That part is true regardless of which platform you use.
4. Happy Head: When a Custom Compound Makes Sense
Happy Head works a little differently. Rather than standard generic formulations, the brand offers prescription topical compounds mixed by compounding pharmacies, combining finasteride, minoxidil, and sometimes other ingredients into a single custom formula applied to the scalp. The idea is convenience (one product) and dose customization.
This approach appeals to people who dislike the two-product routine of separate finasteride pills and minoxidil applications. Compounded topicals are not FDA-approved products in the same way that the branded or generic originals are, which is worth understanding before you sign up. They are legal, and many dermatologists use or recommend compounded formulas, but they sit outside the standard approval pathway. Happy Head requires a prescription and has an online consultation process. Pricing is generally in the mid-to-high range for telehealth options.
For someone who wants a streamlined topical-only routine and has already tried standard products, this is a logical next step rather than a first stop.
5. Generic Minoxidil + Ketoconazole Shampoo: The OTC Baseline
Not glamorous. Still valid.
Generic minoxidil (the active ingredient in Rogaine) costs around $15 to $25 for a three-month supply at most pharmacies, and ketoconazole 1% shampoo (Nizoral) runs about $15 to $20 over the counter. Ketoconazole has some small-scale research suggesting it may reduce scalp DHT levels and improve hair density when used a few times a week, though it is not in the same evidence tier as finasteride.
Together, these two products form a low-cost, no-prescription starting point that is appropriate if you are not yet ready to deal with a telehealth consult, or if you are in a very early stage and want to buy time while you research further. Minoxidil works. It requires consistent use (twice daily for the topical, or once daily for low-dose oral, which is now available by prescription). Stop using it and any benefit reverses within months.
This is not a substitute for finasteride if you are dealing with pattern hair loss driven by DHT, which is the overwhelming majority of male cases. But it is better than nothing, and it costs almost nothing.
Quick Comparison
| Option | Cost to Start | Rx Required | Best For |
| HairLine AI | Free | No | Understanding your Norwood stage before choosing anything |
| Hims | ~$20-$60+/mo | Yes | Broadest product selection, topical finasteride option |
| Keeps | Lower on 3-mo plans | Yes | Straightforward finasteride or minoxidil, lower cost |
| Happy Head | Mid to high | Yes | Custom compounded topicals, single-product routine |
| Generic Minoxidil + Keto Shampoo | ~$30-$45 upfront | No (minoxidil) | OTC starting point, very early stages |
The Short Version
Figure out your stage first. Use a free tool, look at the Norwood scale, or see a dermatologist. Once you know what you’re working with, oral or topical finasteride combined with minoxidil is the standard evidence-backed protocol. Pick the telehealth brand that fits your budget and preferred format. Add OTC products as support, not replacements.
Hair loss treatment is long-game. Months, not weeks. The brands above are all legitimate options. None of them work if you stop.
Common Questions
Does knowing your Norwood stage actually change which treatment a telehealth platform prescribes?
In practice, most platforms prescribe finasteride across a wide range of stages because the drug works throughout active pattern loss. But knowing your stage helps you ask better questions, set realistic expectations about regrowth versus retention, and decide whether a transplant consultation is worth adding to your plan sooner rather than later.
Is topical finasteride from Hims meaningfully different from the oral version, or is it mostly a marketing angle?
There is a real pharmacological rationale. Topical application does produce lower serum finasteride levels than the oral pill, which is why some clinicians recommend it for men concerned about systemic side effects. Whether that translates to a clinically significant safety difference is still being studied. It is not purely marketing, but it is not a settled question either.
Why would someone choose Happy Head’s compounded formula over just getting separate finasteride and minoxidil from Keeps?
Mainly convenience and routine adherence. One topical application instead of a daily pill plus a separate liquid or foam reduces friction, which matters for long-term consistency. The trade-off is that compounded products sit outside standard FDA approval pathways, so you are accepting a different quality-assurance model in exchange for the simplified routine.
Can you use HairLine AI’s Norwood estimate to prepare for an in-person dermatologist appointment?
Yes, and that is one of the more practical uses for it. Going in with a rough self-assessment gives you a reference point to confirm or correct, and it makes the conversation more specific from the start. Treat the output as a starting hypothesis, not a diagnosis, and let the dermatologist either validate or revise it based on an actual exam.
If minoxidil and ketoconazole shampoo are available without a prescription, why bother with a telehealth service at all?
Minoxidil slows loss and can stimulate some regrowth, but it does not block DHT, which is the driver of androgenetic alopecia in most men. Finasteride does. Without addressing DHT, minoxidil alone is often a holding action. Telehealth services exist primarily to get finasteride prescribed efficiently. The OTC route makes sense as a low-commitment start, not as a permanent substitute.
Sources
- American Academy of Dermatology, finasteride and minoxidil treatment guidelines (aad.org)
- Rossi A et al., “Minoxidil use in dermatology,” *Dermatology and Therapy*, 2022
- Gupta AK et al., “Ketoconazole: a reappraisal,” *Journal of the American Academy of Dermatology*, 2004
- FDA drug database, finasteride and minoxidil approved labeling
- Hims, Keeps, Happy Head public pricing and product pages (verified 2025)
