If you’re male and over 25, you’ve likely seen a ton of ads for hair loss subscription products lately. There’s a war raging between the likes of Hims (aka ForHims.com), Roman (aka getRomans.com), and Keeps (keeps.com), all fighting to be your trusted hair loss prevention supplier. While these companies (and their heated, VC-fueled rivalry) are new, the supplements they promote to maintain your glorious man-mane have been around for a long time. So, do they work? Can they really help you keep a full head of hair into your late 50’s and 60’s like George Clooney? Yes. Kind of. It depends who you ask. Let’s get to the bottom of the hair loss supplement efficacy question once and for all.
But first, a primer on men’s hair loss treatments.
While the idea of scrambling to secure every last fiber to one’s scalp may seem funny, I assure you hair loss is no laughing matter to most grown men. With two-thirds of American males experiencing “appreciable hair loss” by age 35, and 85% noticing full-blown “thinning” by age 50, it’s an extremely pervasive source of insecurity and stress. As a result, Hims, Keeps, and Roman are vying for their share of a massive market. Here’s an overview of what these three brands offer when it comes to hair loss treatment, and how exactly they work to keep your precious locks flowing. If you’re already familiar with what Roman, Hims, and Keeps have to offer, skip to the end for our take on if they actually work.
Hims vs. Roman vs. Keeps: Hair Loss Treatment Comparison
After a brief questionnaire and phone consultation with a licensed doctor, Hims, Roman, and Keeps will recommend a personal hair loss treatment plan. All three typically offer the same general remedy: a 1mg daily finasteride regiment. Hims and Keeps also offer Minoxodil — the generic version of Rogaine, a topical treatment. Finally, Hims also recommends a daily biotin vitamin (in gummy bear form) for good measure, but this is more to guard against diet deficiencies, rather than inevitable hereditary balding. Here’s a quick price comparison and more details on how each treatment works to stem hair loss:
Sometimes referred to as “fin” in online forums or more commonly by the brand names it’s been sold under previously (“Propecia” or “Proscar”), finasteride for hair loss is typically prescribed in a 1mg pill taken daily. Originally designed to treat enlarged prostates, finasteride is sold over the counter (i.e. it does require a prescription from a real doctor) and is the core ingredient of the hair loss prevention cocktail recommended by all three of the new subscription services: Hims, Roman, and Keeps.
How does finasteride work for hair loss prevention?
Finasteride works by blocking DHT (dihydrotestosterone), a hormone derived from testosterone that is known to shrink hair follicles and cause male pattern baldness (androgenetic alopecia).
While some patients have reported experiencing partial regrowth for a brief period immediately after starting treatment, finasteride is generally intended to maintain one’s current head of hair, not promote regrowth after it’s already fallen out.
Hair follicles begin shrinking again the minute you stop taking finasteride, and thus patients often report hair loss immediately after stopping. Thus continued use of finasteride is required to maintain results.
Do studies show that Finasteride works for hair loss?
In one clinical study from 1998 involving ~1500 balding men over two years, 1 mg/d of finasteride slowed the progression of hair loss and increased hair growth in the balding vertex (i.e. the crown area most commonly associated with male pattern hair loss). Meanwhile, the control group experienced progressive hair loss. Efficacy was evaluated by scalp hair counts, patient and investigator assessments, and review of photographs by an expert panel.
A similar study from 1999 demonstrated an equally significant increase in the hair count in the frontal scalp of finasteride-treated patients (i.e. the hair line neat the forehead region, not just below the crown).
What are the *potential* side effects of finasteride?
Loss of lebido and sexual dysfuntion.There is a fair amount of research on finasteride and sexually adverse effects including loss of lebido, erectile dysfunction, and reduced sperm count/motility. While incredibly terrifying — especially for men looking to keep their hair in the first place to prolong a healthy sex life — studies has shown that these adverse effects occur at low rates between 2.1% to 3.8%. Among sexual side effects: erectile dysfunction (ED) is the most common, followed by ejaculatory dysfunction, then the loss of libido. All of that said, the only causal relation between finasteride and sexual adverse effects is decreased ejaculatory volume because of predominant action of DHT on prostate. Men trying to conceive may want to take a hiatus from finasteride as a result.
Breast cancer. There have also been studies linking high doses of daily finasteride (5mg+/day) to increased risk of breast cancer. Doctors (including those at Hims, Roman, and Keeps) typically don’t prescribe more than 1mg/day, so this is less concerning if you stick to the standard dose. Just remember that when it comes to finasteride, taking more than prescribed does NOT increase its effectiveness for hair loss prevention.
Overall. While studies haven’t conclusively exonerated finasteride from the threat of devastating side effects, the persistence of sexual side effects after long-term finasteride use appears to be rare. There is a relatively high incidence of sexual dysfunction in the general population overall, and it has yet to be determined whether finasteride has any true causal relationship. Also, little data is available concerning the medical and psychological work-up of these patients to exclude other potential causative factors.
Now that you have a sense of finasteride and what it has to offer, let’s turn the spotlight on Minodoxil, the popular topical treatment that Hims, Keeps, and Roman typically recommend as a compliment.
Minodoxil is the active ingredient in Rogaine and many other topical treatments that can be purchased sans prescription. Unlike finasteride which is only prescribed to men, Minodoxil can be used to promote hair growth for women as well. A major shortcoming of Minodoxil, however, is that most need to use it for 4+ months before seeing any benefit, and then continuously henceforth to maintain growth.
How exactly does Minodoxil work for hair loss prevention?
Belonging to a class of drugs called vasodilators, Minodoxil is widely used as a way to promote hair growth. While the exact mechanism of action remains unclear, many believe that it increases blood flow to hair follicles, increasing follicular size and hair shaft diameter in the region where applied.
Do studies show that Minodoxil works for hair loss?
One study that led to Minodoxil’s FDA approval in 1987, 40% of men exhibited moderate to dense hair growth in the vertex of their scalp. Another of almost 1000 men showed that 62% reported a reduction in hair loss after using it.
Apparently higher concentrations lead to better results. That’s according to at least one study that found that 5% minodoxil treatment stimulated more hair growth than did a 2% solution among men with androgenetic alopecia (male pattern baldness).
Like finasteride, regular use is required to see results indefinitely. One study found that cessation of topical Minoxidil treatment resulted in reduction of hair weight and number count after 28 weeks, with levels similar to placebo group.
What are the *potential* side effects of Minodoxil?
Being a topical treatment, the most common side effect of minoxidil is minor skin irritation at or near the application site. This is typically not caused by the minoxidil itself, but rather as a result of minoxidil products containing propylene glycol, and alcohol.
There is a long list of other potential side effects (acne, facial swelling / hair growth, dizziness, headache, etc.), but they are exceedingly rare. Minoxidil is seen as one of the safest hair loss treatments on the market today.
Hims vs. Roman vs. Keeps: The Verdict
While there are many small differences between the male hair loss products and subscriptions offered by Hims, Roman, and Keeps, let’s just focus on finasteride and minodoxil for now, and assume no difference in potency. Just different packaging, slightly different price tags, and potentially different user experiences. Does a hair loss subscription to Hims vs. Roman vs. Keeps save you enough hair to justify $20-$40/month?
Yes. And here’s why.
History: Although not without their skeptics, finasteride and minodoxil appear to have prevented hair loss for millions of men. Roman, Keeps, and Hims are merely selling the same chemical compounds that helped balding men maintain their hairlines for decades. A few studies I linked to earlier in the article attempted to quantify how finasteride and minodoxil have helped stave off male pattern baldness (androgenetic alopecia). Admittedly direct impact is murky and hotly debated, but there’s a large body of evidence and a growing community of users in support.
Personal Anecdote: My own experience taking Propecia (finesteride) for the last ten years seems worth mentioning. I’m actually convinced it’s helped me keep most of my hair. I have more or less the same amount today as when I first started treatment in high school. And on occasions when I’ve paused my prescription, I’ve noticed thinning almost immediately. When Hims first launched in 2017, I signed up and was sold on the experience. No more trips to the pharmacy. No more calls to the doctor. All for the same price as I had been paying. When I discovered both Roman and Keeps, I signed up for free trials to test them out as well. Today I remain a loyal Roman customer, mostly because it’s the cheapest of the three when you buy in bulk. I only use finasteride though, none of the other treatments. Why not minoxidil? I’ve tried it, but quickly realized I’m part of the 60% of men who see no results.
What others say: Ok, so my story is just my experience. But if you scan the deeper recesses of the interwebs, there’s a wealth of user feedback on these products from real men with real hair loss problems. While their tone varies, most tales corroborate my own positive experience, and the general consensus seems to be pretty pro hair loss subscriptions. Here are a few cherry-picked responses:
While there seems to be consensus that finasteride and minoxidil work as hair loss prevention supplements for most men, they unfortunately don’t help regrow hair if you’re already bald. (Sorry about that.) They also both stop working the moment you pause treatment, so if you’re unable to follow a strict daily routine, you are unlikely to see any results. In the case of minoxidil, note that you likely won’t notice results for the first 6 months of diligent application. There have been cases of adverse sexual effects linked to steady finasteride use, but they typically occur in 2-3% of users, and no causal relationship has been established.
These are some basic caveats so you can adjust your expectations accordingly. I hope this post helps you compare roman vs. hims vs. keeps! To help you further decide if they offer solutions that could work for you, you might have to give each a shot.
If you’re looking for a place to start, I’d recommend Hims. With beautiful branding and a great user experience, it’s the perfect way to ease into hair loss treatment. Read our full Hims review, or click the image below to give it a shot for just 5 bucks month.
If you’re a seasoned finasteride user looking for convenience and low price, go with Roman. They take customer discretion seriously, always your sending meds in nondescript packaging. Plus you gotta love their discounts for buying in bulk. Click the image below to give Roman a closer look:
If you love supporting an underdog, give Keeps a shot. They emerged onto the scene last, but that doesn’t mean they won’t end up on top one day. Read our full Keeps Review.
One final thought: if you’re hesitant to get started or skeptical, there’s nothing wrong with embracing your baldness. You’ll be in good company 🙂