Hims Hair (Finasteride + Minoxidil)vsKeeps

Hims Hair targets male-pattern baldness two ways at once. Finasteride blocks the enzyme 5-alpha-reductase, which converts testosterone into DHT, the hormone that shrinks genetically susceptible scalp follicles; lowering scalp DHT slows that miniaturization. Minoxidil works on a different pathway, widening blood vessels and prolonging the follicle's active growth (anagen) phase to reactivate dormant follicles and thicken existing hairs. Used together as a daily scalp spray, they aim to slow loss (finasteride) while stimulating regrowth (minoxidil).

Keeps itself is a telehealth service, not a drug; an online clinician reviews your intake and prescribes generic medications shipped to your door. The actual hair regrowth comes from two well-studied ingredients. Finasteride is an oral Type II 5-alpha-reductase inhibitor that lowers scalp DHT, the hormone that miniaturizes genetically susceptible follicles, thereby slowing loss and allowing some regrowth. Minoxidil is a topical vasodilator thought to prolong the follicle's growth (anagen) phase and increase blood flow to follicles, helping produce thicker hair; its exact mechanism in hair growth is still not fully understood. Keeps also offers a compounded once-daily topical finasteride/minoxidil gel and foam (0.25% finasteride, 5% minoxidil), ketoconazole 2% shampoo, and may offer dutasteride for some patients.

The active ingredients are individually well-validated. In the pivotal oral finasteride 1mg trials cited on the Propecia FDA label, 48% of men had increased hair count at 12 months versus 7% on placebo; in 5-year data, 48% showed increased growth, 42% had no further loss, and about 10% continued losing. For topical minoxidil, a 393-man, 48-week randomized trial found 5% minoxidil produced roughly 45% more regrowth than 2% minoxidil by target-area hair counts. Combining a 5-alpha-reductase inhibitor with minoxidil generally outperforms either alone. Important caveat: Hims' specific compounded 0.3% topical finasteride / 6% minoxidil spray has not been studied in large dedicated FDA trials, so its exact regrowth numbers are inferred from the individual drugs, not proven for this product.

The medications Keeps prescribes have strong evidence; Keeps has not published its own large clinical trials. In a multinational study of men with male pattern hair loss, oral finasteride 1 mg daily produced durable hair-count improvement over five years while placebo users progressively lost hair (p<0.001 for all endpoints; PubMed 11809594). Earlier pivotal trials showed roughly two-thirds of finasteride users had visible improvement versus continued loss on placebo. For minoxidil, a 48-week randomized trial in 393 men found 5% topical minoxidil significantly superior to 2% and placebo in non-vellus hair count, and a separate 16-week foam trial in 352 men showed significant hair-count gains versus placebo (P<.0001). Smaller studies suggest combining finasteride and minoxidil may outperform either alone. Benefits require continuous use; stopping reverses gains within months.

Local effects are most common: scalp itching, dryness, flaking, redness, or irritation from the alcohol/minoxidil base, plus possible unwanted facial hair if the product migrates. Minoxidil can cause a temporary early shed in the first weeks. Finasteride's known risks include decreased libido, erectile dysfunction, and ejaculation disorders (roughly 1-2% in oral trials, modestly above placebo). Serious or rarer concerns on the FDA finasteride label include depression, suicidal ideation, gynecomastia, and sexual side effects that can persist after stopping (sometimes called post-finasteride syndrome). Critically, in April 2025 the FDA alerted clinicians and consumers about compounded topical finasteride after reports of erectile dysfunction, anxiety, suicidal ideation, brain fog, depression, fatigue, insomnia, decreased libido, and testicular pain, many of which continued after discontinuation; topical use lowers but does not eliminate systemic absorption. Minoxidil can rarely cause dizziness or rapid heartbeat. Stop and seek care for chest pain, swelling, fainting, or mood changes.

Minoxidil's common side effects are local: scalp itching, dryness, flaking, or irritation, plus possible temporary "shedding" in the first weeks. Unwanted facial or body hair can occur if it spreads beyond the scalp. Finasteride's notable risks are sexual: in Merck's Phase III trials about 1.3-1.8% of men reported decreased libido, erectile dysfunction, or ejaculation problems (versus roughly 0.7-1.3% on placebo), usually reversible after stopping. A debated but reported condition, "post-finasteride syndrome," describes sexual or mood symptoms persisting after discontinuation. The FDA-approved finasteride 1 mg (Propecia) label lists depression and, since an August 2022 update, suicidal ideation and behavior among postmarketing adverse reactions. Finasteride also lowers PSA, and the label notes a possible increased risk of high-grade prostate cancer. Seek medical care for mood changes, persistent sexual dysfunction, breast lumps or tenderness, or signs of an allergic reaction.

As of 2026, the Hims topical finasteride + minoxidil spray starts around $35/month, with the lowest per-month price when billed and shipped on a longer (for example, multi-month) cycle. For comparison, Hims oral finasteride runs about $22/month and standalone minoxidil about $15/month. There may also be a low-cost or one-time medical consultation fee. These are cash-pay telehealth/compounded products, so insurance typically does not cover them; generic oral finasteride filled at a pharmacy with a prescription can sometimes be cheaper (often around $10-25/month with discount cards) for those who do not need the topical convenience.

As of 2026, Keeps positions itself as budget-friendly: individual plans often start around $10-25 per month (minoxidil at the low end, generic finasteride roughly $17-25), with combination and compounded multi-ingredient formulas costing more, plus a roughly $5 shipping fee per order. Longer 6- or 12-month commitments usually lower the per-month price, and the online consultation is typically free or low-cost. Insurance generally does not cover cosmetic hair-loss treatment. Because these are generics, it's worth comparing: a GoodRx coupon for generic finasteride or minoxidil at a local pharmacy can sometimes match or beat subscription pricing, though you'd manage the prescription and refills yourself. Keeps' parent company agreed to be acquired in late 2025, so verify current prices on the Keeps website before subscribing.

Designed for adult men (typically 18+) with mild-to-moderate male-pattern hair loss, especially at the crown/vertex and frontal areas; earlier treatment generally protects more hair. It requires a telehealth medical evaluation before a clinician decides whether to prescribe it. Finasteride is not approved for and should not be used by women, and it must never be handled by anyone who is or may become pregnant because of the risk of birth defects in a male fetus. Avoid if you have a finasteride or minoxidil allergy; men planning to conceive, with a history of depression, or with liver or cardiovascular concerns should discuss the risks with a clinician first.

Keeps is designed for adult men (18+) with hereditary male pattern hair loss (androgenetic alopecia), and works best on early-to-moderate thinning at the crown and hairline rather than long-established bald areas. Finasteride is FDA-indicated for men only and is contraindicated in women who are or may become pregnant, who should not handle crushed or broken tablets, because it can cause genital abnormalities in a male fetus. Men with a history of depression or mood disorders, men planning to father children, or those with prostate-cancer concerns should discuss finasteride carefully with a clinician, since it lowers PSA levels (affecting prostate-cancer screening) and its label notes that 5-alpha-reductase inhibitors may increase the risk of high-grade prostate cancer. Men who want to avoid hormonal side effects entirely can use minoxidil alone.