The men's hair loss telehealth market exploded after 2017 when a wave of DTC brands started selling what is essentially the same generic finasteride and minoxidil the rest of the world has used since the 1990s. The active drugs are commodity. What varies is price, formulation sophistication, consultation quality, and whether they lock you into a subscription you can't easily exit.
I've evaluated the five most relevant services for men seeking the minoxidil + finasteride stack (or variants). Plus Sesame Care, which isn't a hair-subscription service but is the best option if you want a one-time dermatology consult without signing up for anything recurring.
The Services
Care Bare Rx — Best Overall
Care Bare Rx is a physician-supervised telehealth platform covering men's hair loss along with other men's wellness categories. What sets it apart: the consultation is substantive (actually asks about family history, current health, and treatment history, not just checkbox gating), the formulations are customizable, and the pricing is transparent without the "hidden fee on month 2" pattern some competitors use.
Their standard hair loss program combines oral finasteride with either topical minoxidil or a custom topical (minox + finasteride + azelaic acid). Pricing is comparable to Hims but the quality of the consultation and follow-up is better.
Pros: Licensed MDs, transparent pricing, flexible formulation options, strong patient support.
Cons: Less brand recognition than Hims. Less aggressive marketing, which some people read as less polish.
Best for: Guys who want a serious, customizable program without Hims-level branding markup.
Care Bare Rx: Full Hair Loss Program
Free online consultation with a licensed MD. Customizable protocols (oral fin + topical minox, compounded formulations, or both). Discreet delivery. Our top pick in 2026 for the stack because they handle onboarding and follow-up better than the big-brand alternatives.
Start Free Consult →Strut Health — Best for Plateaued Stack Users
Strut Health is a physician-owned compounding pharmacy. The key differentiator: they're one of very few US telehealth services that offers dutasteride off-label for hair loss. Dutasteride inhibits both type I and type II 5-alpha-reductase (vs finasteride's type II only), reducing serum DHT by ~90% vs finasteride's ~70%.
If you've been on finasteride for 12+ months and plateaued — meaning you've stopped gaining and maybe started losing slowly — dutasteride is the logical next step. Strut makes it accessible in the US without requiring a specialty consult.
They also offer custom compounded topicals at a range of strengths that the big brands don't carry.
Pros: Dutasteride availability, custom compounding, physician-owned (they actually practice, not just prescribe).
Cons: Higher prices than basic services. More intensive consult process (which is appropriate given what they prescribe).
Best for: Guys 12+ months into standard stack who want to escalate. Also good for anyone who wants custom topical formulations.
Strut Health: Dutasteride + Custom Topicals
One of the only US telehealth services offering dutasteride for hair loss. Also compounds custom topical formulations (higher minox percentages, combined fin+minox, azelaic acid options). Physician-owned, so the consults are substantive.
Shop Strut Hair Loss →Hims — Best UX, Premium Pricing
Hims is the biggest brand in the space by a wide margin. They've built a polished app experience, strong subscription management, and reliable delivery. The formulations are solid: 1mg oral finasteride, 5% topical minoxidil, and various combo products including their "Hair Power Pack" and chewable oral minoxidil.
What you're paying for: the brand, the polish, the confidence that the logistics won't fail. What you're not getting: differentiated formulations. Everything Hims offers can be obtained generically elsewhere for less.
Pros: Best-in-class UX, reliable subscription management, good customer support.
Cons: 30–50% price premium vs generic alternatives. No true custom compounding. Aggressive upsell of ancillary products.
Best for: Guys who prioritize convenience and brand trust over cost, or who find generics intimidating.
Keeps — Best Budget Option
Keeps was originally built as "Hims for cheap" and largely still is. Their oral finasteride runs $25–$30/month and their topical minoxidil is $11–$15/month — the lowest prices in legitimate US telehealth.
The trade-off is a thinner product catalog (no dutasteride, limited compounding, no oral minoxidil in all states) and a less polished experience. For a bread-and-butter "I just want generic fin + minox" protocol, Keeps works fine.
Pros: Lowest prices in mainstream telehealth. Simple, no-frills experience.
Cons: Limited formulation options. No advanced treatments (dutasteride, custom compounds).
Best for: Budget-conscious guys starting the basic stack who don't need advanced options.
Happy Head — Best Compounded Topicals
Happy Head specializes in custom-compounded topical formulations at strengths you can't get over the counter. Their flagship product combines 8% minoxidil (vs the standard 5%), topical finasteride, and often retinoic acid or azelaic acid in a liposomal vehicle for enhanced absorption.
If your scalp tolerates the formulation well, Happy Head's custom topicals outperform standard 5% minoxidil in real-world use. The catch: custom compounding means higher prices and sometimes scalp irritation from the concentration or inactive ingredients.
Pros: Highest concentrations, most sophisticated topical formulations, good derm network.
Cons: Premium pricing ($60–$90/month just for topical). Not available in all states. Some guys react to the vehicle.
Best for: Guys who've used standard 5% minoxidil for 6+ months and want to escalate to a stronger, customized topical.
Sesame Care — Best Non-Subscription Option
Sesame is not a hair-specific subscription service — it's a direct-to-doctor marketplace where you book a one-time consult with a licensed MD or dermatologist at a flat rate (usually $25–$75). The doctor can prescribe finasteride, minoxidil, or other treatments that you then fill at any pharmacy (yours, Costco, GoodRx-discounted generics).
This is the cheapest long-term route if you're comfortable managing your own refills. You pay for one consult, get the prescription, and then use the cheapest pharmacy you can find (Costco generic finasteride is often $10/month with a Costco membership).
Pros: No subscription lock-in. Full pharmacy freedom. Cheapest long-term for disciplined users.
Cons: You manage the refills, the pharmacy hunt, and the annual re-prescriptions. Not hand-holding.
Best for: Guys who want pharmacy freedom and don't need the telehealth-delivery UX.
Sesame Care: One-Time Dermatology Consult
Skip the subscription. Book a flat-rate consult with a licensed dermatologist, get a finasteride/minoxidil prescription, fill it at any pharmacy you want. Best long-term cost if you're willing to manage refills yourself.
Find a Provider →Head-to-Head Comparison
| Feature | Care Bare | Strut | Hims | Keeps | Happy Head |
|---|---|---|---|---|---|
| Oral finasteride | ~$24/mo | ~$25/mo | ~$22/mo | ~$27/mo | ~$24/mo |
| Topical minoxidil 5% | ~$15/mo | ~$18/mo | ~$15/mo | ~$11/mo | Custom only |
| Dutasteride | No | Yes | No | No | No |
| Oral minoxidil | Yes | Yes | Yes (chew) | Yes | Yes |
| Custom compounding | Yes | Yes | Limited | Limited | Yes (strongest) |
| Topical finasteride | Yes | Yes | Yes (spray) | Yes (gel) | Yes |
| Consult fee | Free | Free | Free | Free | Free |
Prices are approximate and change frequently. Always verify on the service's site before committing.
The Third-Leg Question
None of these services prominently sells the third leg of the traditional stack: ketoconazole shampoo. You don't need a prescription for it anyway — Nizoral 1% is OTC. Grab it separately.
Nizoral A-D Anti-Dandruff Shampoo (1% Ketoconazole)
The OTC version works regardless of which telehealth service you use. Adds modest anti-DHT activity at the scalp level, helps with seborrheic dermatitis (which co-occurs with hair loss in ~40% of men). Use 2–3x per week, leave on scalp for 3–5 minutes before rinsing.
Decision Framework
Starting fresh, budget-conscious:
→ Keeps or Care Bare Rx. Both get you the basic stack at reasonable prices. Keeps is cheaper; Care Bare has better consult quality.
Starting fresh, want the best experience:
→ Care Bare Rx or Hims. Care Bare if you want substance; Hims if you want brand polish.
12+ months in, plateaued, want to escalate:
→ Strut Health for dutasteride or Happy Head for high-concentration custom topicals.
Want pharmacy freedom, can manage refills:
→ Sesame Care + Costco pharmacy for the cheapest long-term option.
Don't care about UX, just want cheapest:
→ Sesame consult + generic pharmacy fill. Probably $15–$25/month all-in after the initial consult.
Red Flags Across All Services
Regardless of which service you pick, watch for:
- Subscription traps. Most services ship automatically on a recurring basis. Check cancellation policies before signing up. Easy-to-cancel subscriptions are a feature, not a given.
- Upsell during consult. Some services push you toward more expensive compounded products when a generic would work equally well. The consult should be about your situation, not their margin.
- Vague "personalization" claims. "Custom formula" sometimes means "we added a vitamin to generic minoxidil." Ask what's actually in the compound and at what concentrations.
- Missing licensed MD. All legitimate US hair loss telehealth requires a licensed physician to prescribe. If the service's consult is a chatbot with no doctor review, that's a regulatory red flag and probably a legal one.
The Bottom Line
The active drugs are commodity. What you're really buying with a telehealth service is the consult quality, the formulation options, the logistics, and the brand. In 2026, my pick for most men new to the stack is Care Bare Rx — best balance of consult quality, formulation flexibility, and price. If you've been on the stack for a year and want to escalate, Strut for dutasteride is the best next move.
Whichever you pick, commit for at least 12 months before evaluating results. Take baseline photos. Don't quit during the shed.
Related reading: The stack protocol explained →