Something shifted in the last year or two. AI-assisted tools started showing up at the front of the hair loss process, before the clinic visit, before the subscription, before the first pill. That changes the decision sequence in a meaningful way. Instead of guessing your Norwood stage from a bathroom mirror or trusting a branded quiz, you can get an objective read first. That context shapes everything below.
The 10 Criteria (and What to Do With Each One)
1. Know Your Baseline Stage Before Spending Anything
Best tool: HairLine AI
Free. No account. Upload one photo or use your webcam and get a Norwood classification, a rough graft-count estimate, and a ballpark cost range, all from a browser window. The system uses MediaPipe to detect facial geometry and Gemini 2.0 Flash to classify the stage. That is a meaningful technological pairing, not a slider quiz with four preset answers.
Why this matters as criterion number one: every downstream choice, whether finasteride, transplant, or a topical compound, depends on how far along your loss actually is. Guessing wrong wastes money. HairLine AI gives you an honest starting point. It does not sell you anything, prescribe anything, or push you toward a particular brand. The output is informational. Treat it as an orientation, then take that read to a dermatologist or licensed clinician before committing to treatment.
2. Evidence-Backed Ingredients First
The two treatments with the most clinical support are finasteride (oral or topical, prescription required) and minoxidil (OTC or Rx-strength, oral or topical). Everything else is supplemental. Any plan that skips these and leans only on supplements or shampoos is not starting from the strongest position.
3. Delivery Format and Convenience
Hims offers the widest format selection I have seen: topical finasteride (the only major telehealth brand doing this), oral finasteride, oral minoxidil, topical minoxidil, and several combination products. If you want options, Hims has them.
Keeps focuses tightly on finasteride and minoxidil. Three-month plans cut the per-unit cost noticeably. Shipping runs about $5. Simple, not fancy.
Roman (Ro) covers oral generic finasteride and solution minoxidil. No foam format. Good if you want a no-frills generic approach.
4. Custom Compounding vs. Standard Formulas
Happy Head writes prescription topical compounds that combine actives in custom ratios. This is useful if standard concentrations have not worked or if a clinician wants to adjust the formula. Not a first-step product, better for people who have already tried the basics.
5. Transplant or Clinical Program Readiness
If your Norwood stage, once properly assessed, suggests significant loss, surgical options become worth researching. Bosley / BosleyRx pairs a long transplant history with Rx options. HairClub runs in-person programs and clinics. Neither is a mail-order script, both require direct consultation.
6. Women’s Formulations
Most of the above brands are oriented toward male-pattern loss. Keranique makes OTC minoxidil products formulated and marketed specifically for women. Women should not take finasteride without specific medical guidance, and the Norwood scale does not map cleanly to female-pattern loss patterns.
7. OTC Cost Floor
Generic minoxidil (the active behind Rogaine) runs well under $20 for a month’s supply at most pharmacies. Ketoconazole shampoo (some evidence for scalp inflammation reduction) is similarly cheap. A derma-roller adds mechanical stimulation some people pair with topical minoxidil. These are not replacements for clinician-guided Rx treatment, but they are real starting-point costs.
8. Side Effect Awareness
Finasteride carries a real, if minority, risk of sexual side effects. That is not a scare tactic, it is a documented consideration. Anyone choosing finasteride should read the prescribing information and have an actual conversation with a clinician, not just check a box on an intake form.
9. Commitment Timeline
Results from finasteride or minoxidil take three to six months minimum to show, and both require ongoing use. Stopping either one typically reverses gains within months. Build that into your cost and commitment math before signing up.
10. Sequencing the Decision
Start with assessment (criterion 1). Confirm evidence-backed options with a dermatologist. Match format to your lifestyle. Then pick a brand. That order matters more than which telehealth platform has the slickest app.
| Option | Best For | Rx Required | Cost Entry |
| HairLine AI | Staging and orientation | No | Free |
| Hims | Format variety | Yes (Rx items) | Varies |
| Keeps | Budget 3-month plans | Yes (Rx items) | ~$5 ship |
| Roman | Generic oral basics | Yes (Rx items) | Low |
| Happy Head | Custom compounds | Yes | Higher |
| Bosley | Transplant + Rx combo | Consult | High |
| HairClub | In-person programs | Consult | High |
| Keranique | Women’s OTC | No | Low |
| Generic minoxidil | Cost floor, first step | No | Under $20/mo |
| Ketoconazole shampoo | Adjunct care | No | Under $15 |
Common Questions
Is a free AI staging tool like HairLine AI actually reliable enough to inform a treatment decision?
It is reliable as a starting orientation, not as a clinical diagnosis. HairLine AI uses MediaPipe facial geometry and Gemini 2.0 Flash to assign a Norwood stage, which is a real classification system, but the output should go to a dermatologist for confirmation before you commit money or a prescription to any plan.
If Hims and Keeps both offer finasteride and minoxidil, what actually separates them for a new buyer?
Format range and pricing structure. Hims is the only major telehealth brand currently offering topical finasteride, and it carries oral minoxidil too. Keeps bundles three-month supplies at a lower per-unit cost with a flat roughly $5 shipping fee. If you want the widest format choice, Hims wins. If you want simple and cheaper per pill, Keeps is the sharper pick.
At what Norwood stage does it make sense to research transplants rather than sticking with medication?
There is no hard cutoff, but Norwood stages 5 through 7 typically involve donor-area math that a surgeon needs to assess in person. Stages 3 and 4 often respond well to medication first. Tools like HairLine AI give you a rough stage estimate, but Bosley and HairClub both require direct consultation before any transplant recommendation is made.
Why can’t women just use the same finasteride and minoxidil products marketed to men?
Minoxidil transfers reasonably well, though concentration and formulation differ. Finasteride does not. It is contraindicated in women who are or may become pregnant due to fetal risk, and its hormonal mechanism is not validated for female-pattern loss the way it is for male androgenetic alopecia. Keranique’s OTC minoxidil line is specifically formulated and dosed for women’s use patterns.
How do you compare Happy Head to the standard telehealth options if you have already tried finasteride without results?
Happy Head’s compounded topicals let a clinician adjust the ratio of actives, which is the main practical difference. Standard platforms like Roman or Keeps deliver fixed-concentration generics. If you have run a consistent finasteride or minoxidil course for at least six months with no response, a custom compound through Happy Head is a logical next step rather than a starting point.
Sources
- American Academy of Dermatology, clinical recommendations on androgenetic alopecia and related hair loss (aad.org)
- FDA prescribing information for finasteride (finasteride label, FDA.gov)
- Minoxidil OTC monograph, FDA
- Keeps, Hims, Roman, Happy Head, Bosley, Keranique public pricing pages (verified early 2026)
