Best Topical Finasteride: Does It Work for Hair Loss?

Before online telemedicine, Topical Fin was only available through dermatologists and custom compounding pharmacies. Today the price of topical finasteride online ranges between $40 – $100 per month. Here’s the breakdown for each brand we’ve reviewed:

• $40 – $50: Hims ($50 per month) and Keeps ($40 per month) are the most affordable, each offering a combined 2-in-1 finasteride + minoxidil topical treatment that’s likely to do the trick for most guys.
• $60: For a bit more oopmh, Strut ($59 per month) offers a custom compound that includes finasteride, minoxidil and a third active ingredient: tretinoin.
• $80-$100: for less price-sensitive users, Happy Head ($79 per month) offers a more highly concentrated custom compounded topical, while XYON ($100 per month) offers a patented SiloxysSystem gel that allows topical finasteride to be released more slowly onto your scalp for maximum absorption. In clinical trials, it’s shown some really promising results, and thus the results may justify the higher price tag.

Topical Finasteride is not FDA approved, unlike the oral formulation of this hair loss medicine. That being said, specialized men’s pharmacies like Hims, Keeps,  Strut Health and Happy Head do offer online physician visits where you can get an “off label” prescription for the topical version of this hair loss medicine, then have it shipped regularly straight to your home.

Yes. Even though it’s an off label medicine, you still need a prescription from a licensed doctor. Thankfully, the companies we review in this article can get you an online physician’s visit right from your couch, where a legitimate doctor can determine if you are a good candidate for this hair loss drug.

According to our research (and one of our editors experience using Topical Finasteride), the best brands in the US are:

• Hims
• Keeps
• Happy Head
• XYON
• Strut

Canadians can find topical finasteride online via XYON,  Jack Health or OnMen, while those in the UK can get it prescribe through Sons or Numan.

Application of the drug is going to depend on the formulation – with a dropper, you apply the recommended dose, typically twice a day. With a spray formulation, you apply directly to the parts of your scalp where you are experiencing hair loss, usually twice a day. After application for either formulation you likely have to massage the medicine into your skin (and then carefully wash your hands). 

Based on my personal experience, and the clinical trials we referenced, topical finasteride is similar in effect to oral fin, and significantly improves hair density compared to a placebo. Additionally, as it is applied to the skin instead of being “eaten,” overall DHT concentrations in the body are lower, which may lead to fewer side effects.

Overall, it comes down to personal preference – which application method can you stick to diligently? For us, we slightly prefer topical finasteride over oral because of the lower risk.

Finasteride is not the only medicine dermatologists have been prescribing for hair loss. As we mentioned, Minoxidil is FDA approved for topical use as well. Research shows that combining the two can improve the odds of successfully fighting hair loss, and is currently the best, scientifically known, way to prevent hair loss. So why not try combining them into a solution that you can apply directly to your scalp? 

Companies like Keeps, Hims, and Happy Head offer 2-in-1 (finasteride + minoxidil — i.e. Finoxidil) topicals that are reasonably priced and likely to work better for hair loss than just finasteride alone.

Strut’s topical Finasteride comes mixed with Minoxidil, an FDA approved topical hair loss medicine, and Tretinoin, a vitamin A derivative that might help promote hair growth. The medicine starts at $59 per month, but may cost more depending on your formulation. 

Happy Head’s hair loss meds cost $79 per month, with shipping included. Since you need a prescription, you’ll have to complete their online doctor’s consultation, which is free. So all in, you’ll be spending $79 a month for the 60 ML bottle of Fin/ Minoxidil/ Retinoic Acid. 

Strut’s topical hair loss product contains the two FDA approved hair loss medicines, Finasteride and Minoxidil, plus a vitamin-like compound, Tretinoin. The Finasteride, Minoxidil and Tretinoin concentrations in Strut’s formulations vary. That’s because they use a compounding pharmacy to mix different concentrations depending on what the physician recommends.

Unlike Hims or Happy Head, Strut’s medicine can be delivered in a gel formula, which you’ll apply directly to your scalp. If you prefer a dropper-like application, that’s available too. The choice is yours.

As we mentioned in our Happy Head review, Strut contains a third active ingredient, Tretinoin. To quickly recap, the Tretinoin in Strut’s compound may help promote blood flow to your follicles, making them healthier. However, this is prescribed off-label, it’s not technically approved by the FDA to treat baldness, but studies show it can help prepare your follicles for absorption of finasteride and minoxidil, the real stars of the show.

Something totally unique to Strut is that they can also prescribe Dutasteride for hair loss – either alone, or in combination with topical Finasteride. Dutasteride is a drug prescribed off label for hair loss – it works somewhat similarly to Fin in that it reduces DHT, which can help your follicles stay healthier. Strut’s Dutasteride either comes as a separate topical formulation, or packaged with biotin into a capsule you can swallow. Again, it’s up to you!   Some studies show that Dutasteride is more effective at blocking DHT than finasteride, bit it’s a less popular solution because it hasn’t been FDA approved specifically to treat hair loss, and thus may have a higher instance of side effects (specifically the scary sexual ones).

Strut’s Finasteride topical is different than the other formulations that we’ve reviewed, and you use it differently as well. One major advantage of Strut Health is that you only need to apply it once a day vs twice daily that’s recommended with Hims or Happy Head alternatives. 

To apply Strut’s Finasteride gel or solution

1. Start with dry hair and a “clean” scalp
2. Apply to your skin in the areas where you want to prevent hair loss
3. Wash any unintentional areas that the medicine accidentally touches, like your face
4. Wash your hands well
5. Let the gel thoroughly dry before going to bed
6. Wash it off in the morning (leave it in your hair for at least four hours)

Happy Head is an online telemedicine provider that offers a single product – a custom, compounded Finoxidil combo. Happy Head’s Minoxidil concentration is high – 8%. We’ve never seen Minoxidil at this high of a concentration, and haven’t seen evidence that increasing the medicine to this level will improve results, nor have we seen anything written about if it will cause more side effects.    It’s available at the Happy Head website, and can be shipped everywhere in the US except Alaska and Washington, D.C. We’ll briefly cover Happy Head’s offering here, but for a more in-depth analysis, read our full review of happy head for hair loss.

Unlike Hims’ topical, the Happy Head version contains an additional ingredient:  Retinoic Acid aka Retinol. It’s a similar ingredient to the Tretinoin that Strut often includes in their formulations discussed earlier, although there are a few differences between Retinol and Tretinoin that we won’t get into here.

It’s basically a form of Vitamin A, that can be used to promote the growth of skin cells and encourage collagen production. Many people use it to combat wrinkles and other skin issues that happen as you get older. Some dermatologists believe that it can increase blood flow to hair follicles, helping them be healthier. However, it can also irritate sensitive skin, and makes skin much more likely to become sunburned. So if you have a large bald spot and live in a sunny area, you’ll need to take extra precautions to avoid UV rays. 

How to apply Happy Head topical Finasteride

Happy Head’s topical Finasteride is a liquid that you apply using a dropper. This is a very different formulation than the Hims and Strut medicines, and has its own unique way of being put onto your head. 

Applying Happy Head is similar to how you’d apply Minoxidil or Rogaine to your scalp. Basically, you’ll:

1. Begin with your hair dry, not wet or damp 
2. Expose some of the skin on your scalp by pushing aside your hair
3. Use the dropper to take out 1 milliliter (1 ML) of the solution
4. Apply drops to your balding spots – remember to get it on your skin, since that’s where it needs to go to work it’s magic!
5. Rub it into your head
6. Let your it dry before doing your do 
7. Remember to wash your hands! You don’t want hair growing anywhere but your scalp… 

As I got my Happy Head prescription in the mail, their doctor emailed me and suggested that I also try using a 0.25mm dermaroller before I apply the medicine. I haven’t actually done that yet, but so far, applying their topical finasteride to my head has been exactly the same routine as applying Rogaine or standard old Minoxidil. 

Hims‘ topical Finasteride focuses on the two, FDA approved medicines to treat hair loss – Finasteride and Minoxidil, while Happy Head and Strut Health add additional ingredients that they claim will help combat baldness. Strut, for instance, says the Tretinoin they include in some formulations helps increase the percutaneous absorption, better allowing the finasteride + minoxidil to penetrate through the layers of dead skin, build up, and oils on the scalp so the active ingredients can reach the hair follicles more effectively.

Another key difference to note is application method. Hims spray has Minoxidil at a 6% concentration, which is not only higher than standard Rogaine, but is also easier to apply and less messy than Strut and Happy Head (in our opinion).

Whether you prefer a spray vs a gel or dropper applicator is probably more of a personal preference – there is no clinical evidence to suggest one application method is better than another. 

How to apply Hims Topical Finasteride

You apply the Hims’ spray twice a day, which is similar to how you’d use standard Minoxidil. We think it might take a day or so to get used to how to best apply the medicine if you haven’t used a spray scalp medicine before. 

Start with dry hair. Mentally divide up your scalp into four to six sections so you can focus on each You are aiming for the skin, not the hair, since the drugs need to penetrate your skin to get to the follicles to work their magic, so expose your scalp accordingly. Tilt your head back a little bit so nothing drips into your eyes Spray generously on the sections you previously visualized in / on your head. Wash your hands! It is possible that the medicine will cause hair to grow wherever it hits, so unless you want hairy hands, clean them with soap and water. Plus, you don’t want it getting on your dog, significant other, etc. Be extra careful if your partner is pregnant. Repeat this two times a day, more or less evenly spread apart Some doctors recommend that your evening application happen early enough so that by the time that you go to bed it’s totally dry to avoid getting the medicine on your pillow (and inadvertently onto your face later).

Hims is selling a real, compound drug that contains Finasteride and Minoxidil, the two drugs that have been shown to reduce hair loss and promote growth in around 90% of men. While the actual formulation, of the combined drugs that you apply to your scalp, hasn’t been rigorously studied, the clinical trials we reviewed above indicate that this formulation should have a high chance of working for most, otherwise healthy men. Visit Hims now to get a free doctor’s consultation and see if Topical Finasteride is right for you.