Best Topical Finasteride

Since they hit the scene, finasteride and minoxidil have formed the cornerstone of men's hair loss treatments. Better known by their brand names Propecia and Rogaine, these two drugs have proven effective on their own and even more so as a one-two punch to combat global thinning.1

Unfortunately, oral finasteride has some significant potential drawbacks, most notably sexual and depressive side effects.2 To avoid these, topical formulations of finasteride have recently evolved and can match or even outperform oral treatment.

Our team wanted to know if these treatments were worth your time, so we got our hands on the top contenders in the space and tested them all. If you’re in a particular hurry, check out our summary of recommendations below.

At Innerbody Research, we extensively vet each and every product or service we review, including the topical finasteride you'll find here. Our process involves significant interaction with the companies to report on the customer experience, from ordering the products to trying them ourselves.

As we conducted this hands-on research, our testing team pored over hundreds of scholarly articles about hair loss and the various treatments aimed at it. This review was thoroughly vetted for accuracy by Dr. Scott Bukoski, a dermatologist and member of our Medical Review Board.

We’ve spent thousands of hours over the past half-decade researching and testing hair loss treatment plans and the customer service of telemedical companies offering them. We'll continue to monitor the hair loss landscape to keep this article current.

Over the past two decades, Innerbody Research has helped tens of millions of readers make more informed decisions involving staying healthy and living healthier lifestyles.

We’ve narrowed down what was already a focused field to the top four companies offering topical finasteride. Here’s a quick breakdown of what you can get from each. (Note: ketoconazole is abbreviated as KCZ.)

As you can see, there are some similarities among them, but key distinctions like medication format, ingredient mix, and cost make for a complex comparison.

In the chart above, you may notice that these companies each take a different approach to providing you with topical finasteride. Differences in ingredient choice and concentration inform an important evaluation criterion: effectiveness. We also scrutinized safety, cost, and convenience to help clarify which options would be the right choice for you.

Let’s take a closer look at what the criteria we employed reveal about our top contenders.

Effectiveness

Winner: Hims Hair Hybrids

While all of the products in this guide contain finasteride at a similar concentration, the addition of other ingredients and their concentrations can tip the efficacy scales in favor of one or the other (as can the potential to include other effective treatments from a single company).

To that end, it’s important to note that all commercially available topical finasteride products are compounded with topical minoxidil. You can get topical minoxidil on its own, but you can only buy topical finasteride mixed with topical minoxidil. Dr. Bukoski says, “Part of this [combination] is likely because the most robust studies have shown that topical finasteride and topical minoxidil combined are more effective than when they are used individually.”39

The standard minoxidil concentration for men is 5%. However, most topical finasteride treatments include slightly higher concentrations. Topical minoxidil does not require a prescription on its own, but topical finasteride does, even when it’s mixed with topical minoxidil or other non-prescription treatments. Here’s a quick look at the drugs included in the top choices in our guide (and note that ketoconazole is abbreviated as KCZ):

At first glance, the 8% minoxidil concentration in Happy Head’s Aqueous Solution may seem superior to Hims 6% or 7%, but there’s an interesting quirk to consider here. Topical solutions like minoxidil can cause scalp irritation, which, if intense enough, can ultimately increase shedding and possibly damage follicles at a rate greater than they can regrow hair and repair follicles.

That potential for irritation means that “stronger” doesn’t always equate to “more effective” in this category. One study comparing a 5% concentration to a 10% concentration saw undeniable superiority in the 5% concentration.3 Its scientists attributed the decrease in efficacy at 10% to increased scalp irritation. That’s not enough to convince us that a 6% or 7% concentration would be too aggressive to outperform 5%, but this may come down to the individual.

Roman could certainly be considered a runner-up in this category, as there is some evidence that retinoids can increase the efficacy of topical minoxidil.4 But there is also evidence supporting ketoconazole in both hair thinning and anti-dandruff applications, leading us to conclude that Hims’ specific ingredient combination may offer the best results.5 However, there haven’t been any head-to-head clinical studies comparing these additional ingredients’ roles in treating hair loss.

Cost

Winner: Hims Hair Hybrids

While some variables can tilt the scales in another company’s favor, the base price for a straightforward topical finasteride spray from Hims is the lowest in its class. You could pay as little as $35/month for it (billed and shipped every 150 days). The downside is that you might have to pay more if you don't have as much money to spend all at once and need to opt for monthly billing, or if you want to get a stronger or more complex formula. And Hims charges a $5 processing fee on all orders.

If you want to avoid all of that decision-making and price confusion, Roman would be your next best bet, thanks to a decidedly simple system that offers one well-made topical finasteride product at one price and one shipping schedule: $50/month, billed quarterly. However, Hims still has Roman’s option beat by nearly $15/month with 150-day billing, and that savings will add up to a lot over time.

Safety

Winner: Keeps Topical Finasteride and Minoxidil Foam

Higher concentrations of topical ingredients like finasteride and minoxidil are more likely to cause adverse reactions than lower concentrations. But active ingredients aren’t the only culprits when it comes to hair loss medication and scalp irritation.

Many topical hair loss serums use propylene glycol as part of the carrier solution, but propylene glycol has been shown to cause the kind of irritation we’ve seen in numerous topical treatment studies.6 That’s why some companies have developed formulas that use alternatives to propylene glycol, though that can increase their cost.

Hims and Keeps both offer minoxidil as a foam, rather than a serum, which is how they skirt around the need for propylene glycol. But Hims uses propylene glycol in all of its Hair Hybrid products, including every option for topical finasteride. Roman’s 3-in-1 spray also contains it. And Hims is the only one of the products in our guide to add a fragrance to its topical finasteride, which may also increase irritation.

Only Keeps and Happy Head offer topical finasteride formulations that don’t include propylene glycol. Happy Head’s options are its aqueous solution and liposomal gel, both of which are among the company’s priciest offerings and contain 8% minoxidil concentrations. That added minoxidil might cause unnecessary irritation for some who would find success with a 5% or 6% solution from another company instead.3

Meanwhile, neither of Keep’s topical finasteride products contain propylene glycol, and both offer lower doses than competitors, with a 5% minoxidil concentration and a 0.25% finasteride concentration. Those numbers and the exclusion of propylene glycol in the company’s topical finasteride foam may yield the lowest risk of scalp irritation.

Convenience

Winner: Roman 3-in-1 Topical Spray

Topical hair loss treatments can be messy, with minoxidil often demanding twice-daily applications and placing restrictions on sleeping and showering afterward. Fortunately, most (but not all) topical finasteride products only require one application per day. Also, while we've typically had pleasant experiences dealing with these companies in testing, there are some issues certain companies have that others seem to avoid.

On the application side, whether you prefer a serum with a dropper cap, a spray bottle, or a pump-action gel or foam will largely be up to you. But we've tried all of these delivery mechanisms, and the spray bottle is our preferred choice. That eliminates Happy Head and Keeps from the running in this category. Happy Head also requires two applications daily, and Keeps' foam is the worst-smelling product of the bunch, in our opinion.

Between Hims and Roman, the companies' respective sprays are very similar in application. Both require only once-daily application at four sprays each. Hims is a little more prescriptive about where you point those sprays, but that can change from user to user based on the pattern of your hair loss.

So, we turn to the companies themselves for added convenience measures. Here, Roman emerges on top. Its billing cycles are simplified, and its pricing is obvious from the get-go. Hims tends to advertise its lowest possible prices — those you could only get with the most basic product delivered at the most extended billing schedule. Though many men would want to go that route in the end, you won't be able to tell what other formulas or schedules would cost you until checkout.

Roman shines in this category thanks to its directness and transparency combined with the convenient spray application.

Finasteride is a 5-alpha reductase inhibitor, which means that it can dramatically reduce the rate at which the enzyme 5-alpha reductase converts testosterone into dihydrotestosterone (DHT).7 The oral form is traditionally used to combat the symptoms of benign prostatic hyperplasia (BPH), for which its dose was 5mg daily.8

The drug’s potential to stop hair loss and even regrow hair was soon recognized. Not long after finasteride was approved for use in BPH patients, its prescription for hair loss under the brand name Propecia became extremely common. But how does a drug designed to address a prostate issue work to stop hair loss?

How finasteride can stop hair loss

To be clear, finasteride is not a suitable treatment for all types of hair loss. It’s particularly well-suited to treating androgenetic alopecia, also known as male or female pattern baldness. Fortunately, androgenetic alopecia is the most common cause of hair loss.10

Androgenetic alopecia has “androgen” right there in the name, and finasteride is known as an anti-androgen. Its activity blunts a specific process in the life cycle of testosterone in the body. Normally, your body would convert a certain amount of testosterone into DHT, which is a critical component of sexual development in men.9 But while some DHT is necessary for sexual development, too much can cause prostate issues and hair loss over time.

When circulating DHT makes its way to the scalp, excessive amounts of it can cause damage to hair follicles, leading to their dormancy and eventual death.10 Finasteride’s ability to reduce the rate at which your body produces DHT helps to ensure that your healthy follicles stay healthy and that dormant follicles have a chance to come back online.

The big drawback to oral finasteride is that it decreases DHT throughout the body, not just on the scalp. And given DHT’s role in male sexual health, that systemic reduction is likely why finasteride has seen numerous sexual side effects in its studies.11 It’s important to note that the 5mg dose used in treating BPH has seen much higher rates of sexual side effects than the 1mg dose used in hair loss cases, but those hair loss cases still see 2-3% of users suffer significant sexual side effects.12

“A major concern in the medical community is reported risk of persistent sexual dysfunction in the setting of oral finasteride use,” Dr. Bukoski confirms. That persistence Dr. Bukoski is referencing is a particularly harrowing risk, as some men find their sexual side effects can last for years, even after they’ve stopped taking the oral finasteride.43

These side effects can include:

• Loss of libido
• Erectile dysfunction
• Ejaculatory dysfunction
• Fertility issues

There are also noteworthy depressive side effects associated with oral finasteride at the 1mg dose.13

But topical finasteride doesn’t enter the bloodstream in any meaningful way. One study found plasma concentrations to be more than 100 times lower with topical finasteride compared to oral.14 Importantly, the efficacy between the two treatment modes appears to be similar. That means topical finasteride can offer the benefits of its oral version without the risk of sexual or depressive side effects.

Most men with androgenetic alopecia make good candidates for topical finasteride treatment. The drug has been shown to stop hair loss and regrow hair in such patients.14

Topical finasteride may be a particularly smart treatment for anyone interested in finasteride but wary of its potential sexual side effects. It’s also a nice choice for men who’ve tried oral finasteride and experienced unpleasant side effects alongside noted efficacy. Topical applications can offer similar efficacy without those same adverse effects.

Who might want to look elsewhere?

Finasteride has been shown to be successful in female patients. However, it should be avoided by female patients who are pregnant or considering a future pregnancy.15 It’s also likely unsuitable for anyone who’s had a negative reaction to topical minoxidil, as commercially available topical finasteride products all contain full topical minoxidil doses.

You’ll also want to consider an alternative if your hair loss isn’t the result of androgenetic alopecia. Some other underlying causes of hair loss include hypothyroidism, decreased vitamin D, stress, and anemia.40 If present, it’s important to first treat these conditions and see how much of a person’s hair loss may be attributed to hormonal changes afterwards.

So, we can see that topical finasteride offers some big safety benefits compared to oral finasteride, but does that make it safe enough for you? Well, even with the threat of sexual and depressive side effects removed from the equation, new potential side effects can crop up, though most of them are different forms of scalp irritation.14

At the moment, commercially available topical finasteride is always sold in a compounded mixture that also includes minoxidil. So, any topical side effects associated with minoxidil — burning, itching, scaling — are risks with topical finasteride treatment, as well.27

In many cases, these side effects may be as likely the result of an inactive ingredient — such as propylene glycol — as they are a result of the medications themselves.6 So, anyone with an even remotely sensitive scalp might want to start with a topical finasteride that doesn't include propylene glycol. We gave Keeps the win for safety in our above evaluation criteria, as neither of its topical finasteride products uses propylene glycol, and its active ingredient concentrations are slightly lower (though again, this by no means confers a definitively lower risk based on any available clinical data).

What treatments can you combine with topical finasteride?

As we discussed above, topical finasteride is sold compounded alongside topical minoxidil, so any finasteride you apply to your scalp will also have a full minoxidil dose in it. Research confirms the relative safety of this combination, as well.17

In Happy Head’s catalog, you’ll see oral and topical versions of these two medications combined with other drugs. These include retinoic acid, latanoprost, and dutasteride. Hims also offers a combination of finasteride and ketoconazole.

Given the similarities in their efficacy, there isn’t much reason to add something like oral finasteride to a topical finasteride regimen. You could consider the addition of hair loss-related supplements to your regimen alongside your finasteride treatment; however, the clinical data on other hair loss supplementation is sparse, and the more medications you add to the mix, the higher risk of side effects. Regardless, you’ll want to talk to your doctor before mixing any drugs together.

Best overall, best budget pick, best combination treatment, and best-smelling

Hims offers a wide range of health services, with hair loss and erectile dysfunction occupying the center of its business. Hims offered oral finasteride for years, along with topical minoxidil, but it was the first major telemedicine provider to offer a topical finasteride spray. That spray is the foundation of its new line of topical treatments sold under its Hair Hybrids banner.

Hair Hybrid medications are essentially custom-compounded topical and oral medications formulated by your consulting physician within certain dose options. There are three topical finasteride products in Hims’ Hair Hybrids catalog, including the company’s first topical finasteride formula.

As we noted above, topical finasteride products are sold compounded with topical minoxidil, and the concentration of minoxidil in these products from Hims will either be 6% or 7%, depending on the results of your intake consultation. Men who haven’t tried topical hair loss treatments in the past will likely start with 6% minoxidil in their topical finasteride, as there wouldn’t be a good reason to increase the dose without finding out whether 6% would be sufficient to see results.

The topical finasteride concentration is the same across all products: 0.3%. That’s as high or higher than Hims’ competition.

Here’s a quick look at what Hims charges for its Hair Hybrid Topical Finasteride Sprays and Serum:

As you can see, Hims only offers two billing cycles for its topical Hair Hybrids, and neither of them is month-to-month. While this may seem frustrating, it’s worth noting that Happy Head is the only company in this guide to offer a subscription with one-month billing.

Using Hims topical finasteride

Hims topical finasteride serum resembles minoxidil serums we’ve used through the years, though it’s worth noting that it only requires a once-daily application rather than the typical twice-daily minoxidil regimen. Hair Hybrids sprays are the same, only requiring you to use them once per day.

Compared to Roman's spray, Hims seems to put out just a little more material per spritz. Once the spray is out of the bottle, its consistency is nearly identical to the serum, as is its smell. In our opinion, Hims makes the best-smelling topical finasteride in the business. Others have chemical or medicinal smells, though Roman's spray has nearly no smell to it. Hims topical finasteride has a minty essence that's not too sharp. Our testers universally preferred it to all the other topical finasteride products we tried.

But Dr. Bukoski notes, “Whenever we have people with sensitive skin, we recommend finding fragrance free products.” Added fragrance — no matter how pleasing — may not be best for men with sensitive scalps.

Best for sensitive scalps

Keeps’ primary focus for most of its existence has been hair loss. The company has recently waded into the deep waters of sexual wellness, with ED medication, STI testing, and herpes medication entering its lineup. But its hair loss treatments have also continued to evolve. Since our last time reviewing the company’s catalog, it’s added a topical finasteride foam to complement its gel offering.

That foam catapulted Keeps to the top of our consideration for sensitive scalps. The biggest difference is that Keeps formulates the foam with propanediol in place of propylene glycol, but it also adds ingredients designed to help soothe the scalp that may decrease the risk of skin irritation.

There’s a delicate balance between effectively treating hair loss with topicals and causing too much irritation from those very treatments. That kind of irritation can actually lead to increased follicle damage and shedding, undermining your efforts entirely. This is the suspected issue behind the decrease in efficacy seen with 10% minoxidil solutions, compared to the more common 5%.3

Keeps foam and gel topical finasteride provide a 5% minoxidil concentration and a 0.25% finasteride concentration. That technically makes this the weakest product in our guide, but those concentrations are also in line with what we’ve seen in successful studies of either component in isolation.14 Furthermore, direct comparison studies of the other companies’ concentrations have not been done, so there is no guarantee that higher concentration will yield higher results in those other products. And the addition of aloe and green tea extract may provide additional soothing and antiinflammatory support if these lower numbers still cause a reaction on your scalp.18 19

That said, it’s still worth considering the slightly stronger formulations from others if you know you have particularly robust skin, as Hims and Roman offer stronger formulas with better smells and additional active ingredients.

Here’s how pricing works for Keeps topical finasteride:

Initial orders from Keeps come with additional savings, with the gel costing $90 for the first three months and the foam costing $112.50. It’s unclear why the discount on the foam is less than the discount on the gel for initial orders.

Using Keeps topical finasteride

At this point, we’ve only performed hands-on testing on Keeps’ topical finasteride foam, and while our testers found the topical sprays to be their preferred delivery mechanism, the foam allows you to maneuver better through thicker hair and still get the medicine where it needs to go. If you still have thick hair around areas of loss, accurately targeting those areas with a spray can be a challenge.

However, Keeps’ foam was the worst-smelling topical finasteride we tested. It smells like a mixture of nail polish remover, burnt hair, and rubbing alcohol. We’d hoped the aloe and green tea might have positively influenced the smell, but this was not the case. Fortunately, the regimen only calls for one pump daily, so you only interact with it briefly.

Roman is closer to Hims than any other company in our guide in terms of catalog breadth. Both companies offer telehealth support for everything from hair loss and ED to skin care and weight loss. In many cases, Roman’s prices are a little higher than the rest of the field, but its topical finasteride spray is an exception.

In addition to the 6% minoxidil and 0.3% finasteride in this spray, Roman includes tretinoin, a derivative of vitamin A used in several medicinal and cosmetic applications. These include things like fighting acne or reversing the signs of photoaging. Some research suggests that combining tretinoin with minoxidil can enhance the latter ingredient’s effectiveness enough to negate the need for a second daily treatment.20 That’s a big benefit compared to the twice-daily minoxidil regimen, but Keep and Hims also offer topical finasteride treatments that only require a once-daily application, even without added retinol.

Topical tretinoin use can also lead to various reactions on its own, including redness, pain, itching, and inflammation.21 And its quarterly pricing is a little lower than the Hims alternative, even more so when you factor in Hims’ $5 processing fee. But Hims is still less expensive with 150-day billing.

Roman’s pricing for its topical finasteride spray is decidedly simple. For $150, you get a three-month supply. That works out to $50/month, and the model is subscription-only.

Using Roman’s topical finasteride spray

Roman’s topical finasteride spray was the first one of the group that we tested, and its smell — or lack thereof — threw us off at first. There’s a vague hint of alcohol or something medicinal, but you have to look hard for it. Ultimately, that might make this a better fit for anyone interested in topical finasteride but averse to minty smells like you find in the Hims alternative.

Excluding its odorlessness, Roman’s spray feels a lot like what you get from Hims, though our testers suspected the individual sprays from Roman were a bit thinner. Like Hims, Roman asks that you use the product once daily, applying up to four sprays where needed.

Happy Head has long occupied a particular niche in the hair loss space, offering some treatments at competitive prices but far more at prices well beyond what competitors charge. The upside to Happy Head is that its catalog features ingredients and combinations you usually can’t find anywhere else.

For example, among its topical formulations that contain finasteride, you can also get dutasteride or latanoprost as part of the mixture. Dutasteride is similar to finasteride, though some research directly comparing oral formulations indicates it may offer superior performance with a reduced side effect profile.22 And latanoprost is a prostaglandin analog that studies show can improve hair density after 24 weeks of application.23

Unfortunately, that latanoprost study employed a 0.1% concentration, whereas Happy Head’s products contain just 0.005% — a large reduction. We found one study using a 0.005% concentration, and the results were mixed. While hair density increased compared to control, the difference in hair loss area was insignificant.24

Happy Head also offers a simpler topical finasteride treatment, though it’s worth noting that its minoxidil concentration in most products is 8%, including in its basic topical finasteride. We typically see 5% and 6% in topical finasteride products, and 8% is much closer to the 10% we’ve seen underperform compared to 5% concentrations in studies.3 The theory is that the increased concentration causes increased irritation, which counteracts the good the minoxidil can do for follicles and the scalp. While the studies were not done using 8%, it is possible this may lead to a higher risk of scalp irritation and diminished returns.

Perhaps to combat this, Happy Head includes additional active ingredients in even its most basic formulas, including hydrocortisone for dermatitis and inflammation and retinoic acid,25 which may also reduce inflammation and has been shown to boost the efficacy of minoxidil.26 20 You can also opt for either the aqueous solution or liposomal gel forms of Happy Head’s topical finasteride, as these are the only two topicals in the company’s lineup to exclude propylene glycol, a potential source of irritation.

All told, Happy Head has five topicals containing finasteride, and the mixtures that include less common ingredients are among its most expensive options. The company only offers monthly subscriptions for its topicals, with no extended billing cycles like you get from Hims, Roman, and Keeps, all of which can lower costs. You’ll get a discount on the first month of the first product you get from the company, but that’s it. Here’s how its pricing works out.

As you can see, the recurring monthly costs of these medications are significantly higher than those of competitors like Hims ($35) or Roman ($50). Considering that you’ll need to apply these topicals for however long you want to keep your hair, that cost difference will add up over the years. Even after one year, including that first-month discount, you’ll pay nearly $500 more for Happy Head’s basic topical finasteride than you would for Hims' simplest formula.

Using Happy Head’s topical finasteride

In addition to being the most expensive company in our guide, Happy Head also offers the least convenient application regimen. Most of its topicals are serums delivered by a traditional dropper. This can get messy rather fast. And Happy Head's topicals all require twice daily application, whereas every other topical finasteride we reviewed reduces that number to one daily application.

That twice-daily application is one of our biggest hangups with topical minoxidil. Suppose you work until 5 p.m., and it'll take you an hour or so to get home and run to the bathroom to apply your second dose of the day. These topical products demand a four-hour waiting period before you can shower or go to sleep (for fear of the substance spreading on your pillow). That means you're not getting to bed until 10 p.m. at the earliest.

It's also worth noting that Happy Head's topicals have the second least favorite smell in the eyes (noses?) of our testers. They smell like a less intense version of the Keeps foam, which was bad enough that our testers would not want to use the Keeps product regularly.

If some aspect of topical finasteride doesn't quite work for you — regimen, price, adverse effects — there are several other commercially available options that you could try instead. Some of them are just different versions of the same drugs or different drugs in the same class. But there are also other approaches to tackling hair loss that may fit better into your lifestyle. Let’s quickly explore your options.

Oral finasteride

The closest analog to topical finasteride is oral finasteride. Both act as 5-alpha reductase inhibitors and offer men effective treatment for hair loss.7 However, the side effect profile between the two is remarkably different. Until recently, oral finasteride was the best and only real place men could go if they wanted to treat their hair loss with a prescription pill.

All of the companies in this guide offer an oral finasteride prescription for the 1mg dose. But only Hims and Roman have a robust telemedical infrastructure that also happens to include ED medication. And Hims can go a step further by offering some depression support, as well. Keeps and Happy Head have also both begun offering ED medications, but their options are a bit more limited in terms of drug and dose flexibility.

Oral finasteride will probably become less popular soon; oral minoxidil has become a significant threat to oral finasteride's dominance, and we'll get into that a bit below.

Topical minoxidil by itself

If you took the finasteride out of any commercially available topical finasteride product, you’d be left with topical minoxidil. Better known by its original brand name, Rogaine, topical minoxidil has a good track record for efficacy with less concern of side effects.27 This is especially true when using a formula that doesn’t contain propylene glycol.

While finasteride’s mechanism of action is relatively well understood — both as a topical and oral medication — topical minoxidil remains something of a mystery. There is evidence that it increases blood flow to the scalp, which would improve follicle health by delivering more nutrients and oxygen to where hair strands begin.28

But there are undeniably other mechanisms at play here, including genetic signaling pathways, that make it hard to determine exactly what makes it successful.29

Keeps has the best prices for topical minoxidil, with costs as low as $8.50/month on a 12-month billing cycle. Competitors come close to this price, but not close enough.

Oral minoxidil

Topical minoxidil may have gone mainstream decades ago, but the medication was originally developed as an oral tablet to treat hypertension.30 A common side effect in early trials was hypertrichosis, or excess hair growth in sometimes unusual places. It makes sense that researchers at the time would have been curious about a topical alternative. The hypertrichosis oral minoxidil brought on was unpredictable. It may have spurred growth at the scalp, but it was equally likely to cause increased facial hair growth or patches to show up on the hands and other places.

For a time, it seemed like oral minoxidil would only be an option for men and women whose dermatologists were willing and informed enough to prescribe it off-label for hair loss. To this day, oral minoxidil is not FDA approved for hair loss, though it is approved for hypertension. And since the patent on minoxidil has expired, no pharmaceutical company will pour millions into research to get FDA approval for that specific use without any hope of a profit.

Fortunately, providers like Hims, Happy Head, and Roman offer oral minoxidil for hair loss through their compounding pharmacies.

The big difference between oral minoxidil for blood pressure and oral minoxidil for hair loss is the dose. The hair loss dose is much smaller, and its effects — while not exclusively confined to the scalp — are much more contained.31 It also appears that oral minoxidil is at least as effective as oral finasteride at stopping loss and creating new growth.32 It’s also nice that it can do this without the sexual or depressive side effects associated with finasteride.2

That doesn’t mean oral minoxidil is without its side effects, the most serious of which are cardiovascular. The most common side effects of oral minoxidil are lightheadedness, fluid retention, headaches, and a rapid heart rate.41 Often, these side effects can be managed by taking the medication at night or decreasing the dose. For this reason, the oral form of minoxidil is only available via prescription.

Supplements

No supplement will be as effective at stopping hair loss or regrowing hair as medicinal interventions will. Furthermore, none of the hair loss supplements often advertised have undergone the extensive testing the prescription-based treatments have with regards to efficacy and safety. That said, certain supplemental ingredients may bolster your overall hair loss efforts.

One of the most common ingredients you’ll see in both hair loss supplements and thickening shampoos and conditioners is saw palmetto. Some research suggests that oral saw palmetto can act as a natural 5-alpha reductase inhibitor, albeit with significantly less potency than something like finasteride.33 Topical saw palmetto formulations are available, as well.

Other supplemental ingredients target non-hormonal contributors to hair loss. For example, ashwagandha — an increasingly popular botanical supplement — boasts a lot of research supporting its anti-anxiety and stress-reducing effects.34 Stress can have a dramatic impact on hair loss, from being a direct cause to increasing the intensity of androgenetic alopecia or telogen effluvium, though the exact mechanism for why ashwagandha has shown positive results in some studies is unclear.16 42

You’ll also likely come across biotin if you research hair loss supplements, and Hims sells a gummy for hair loss that lists biotin as its sole active ingredient. Unfortunately, there isn’t convincing evidence that biotin supplementation makes a difference in hair loss unless you’re deficient in biotin or have a genetic condition that requires supplementation.35

Companies like Nutrafol and Happy Head produce complex hair loss supplements that are worth considering, but you might also want to speak with your doctor first and maybe get checked for certain nutritional deficiencies before purchasing one.

LLLT

So far, all of the alternatives we’ve discussed have either been oral or topical treatments of some kind, but there’s another popular approach that requires a bit more of an upfront investment and that can alleviate the need to take a pill or apply a topical liquid. The technology in question here is low-level laser therapy (LLLT), a form of photobiomodulation that uses finely tuned laser diodes to stimulate blood flow to the scalp.36

LLLT may have some additional, less well-understood mechanisms of action, not unlike minoxidil.37 In fact, its efficacy appears to be right around what you could expect from topical minoxidil.38 But instead of rubbing a serum into your scalp and waiting four hours until you could sleep, shower, or wear a hat, LLLT sessions typically take around 7-15 minutes. You’ll use the device either daily or every other day, depending on the brand.

We’re fans of LLLT as a monotherapy, but you can also combine it with topicals like topical finasteride or minoxidil, as well as the oral medications we’ve just detailed.

The biggest drawback for many is upfront cost, with some models costing north of $3,000. Fortunately, we’ve identified a few less expensive options that offer similar durability and efficacy as the pricier models, most notably the Kiierr MD 272 Premier.