Last Updated: May 21, 2020
If you’re one of the many men noticing hair loss, the good news is that there are some scientifically backed, FDA-approved treatments available.
The treatments do not offer any magical fixes, but if your hair loss is due to male pattern baldness, they can help you stop hair loss, preserving the hair you still have and even regrowing hair you thought was gone for good, as long as the follicles haven’t died.
Keeps is a subscription-based alternative for hair loss treatment and prevention. They offer a narrow catalogue and buy generic medication directly from a domestic lab, and this allows them to offer significantly cheaper treatments. They’re not out to replace your family doctor, just to provide you with a stress-free, affordable and discreet way to protect the hair on your head.
So is Keeps right for you? We’ve tested their service and products, so read on to find out!
- Convenience – The consultation and entire process are online and medications will be delivered straight to your home.
- Quality – Medical staff are board-certified and registered to practice.
- A physician reviews every consultation to ensure it follows medical guidelines, and they follow up with their patients before a refill.
- Affordable – The total cost is less than half than the cost of buying at a traditional pharmacy.
- The first consultation and the first month of medication are free if you purchase a three-month subscription.
- Prompt and efficient – The entire process (from sign-up to the moment the medication reaches your home) usually takes a week or less.
- Treatment plans are proven effective only for male pattern baldness (androgenic alopecia).
- No live video call consultations, although you can request to speak to your doctor by phone.
- Medical consultations are not available at all states, but their medication subscription option is, as long as you get a prescription somewhere else.
- They do not work with insurance companies and are not eligible for HSA/FSA withdrawals.
- Medications are only available through an auto-renewed three-month subscription. There is also an additional $3 delivery fee on each shipment.
How close is a cure for baldness?
Larry David was once asked what he was most proud of in life. “That’s easy,” the creator of Seinfeld and Curb Your Enthusiasm replied, “it would be the way I’ve adjusted to baldness.”
He reasoned that in a world where 75% of women say they wouldn’t date bald, the bald man who forswears hair plugs, periwigs, toupees, sombreros, simply has to try harder.
“We have to dress a little better, make a little more money and have a little more charm just to compete. And we do. Have a conversation with a bald man sometime. Go ahead. Do yourself a favour.
Tell me you don’t walk away impressed.”
Have a conversation with a bald man sometime. Go ahead. Do yourself a favour. Tell me you don’t walk away impressed
David made this claim back in 2000. But fast-forward a few years and his enhanced compensation strategy begins to look a little quaint.
Androgenetic alopecia, or male pattern baldness, afflicts about half of all men aged 50 and they can’t all reinvent the sitcom. And significant advances in the £3bn hair regrowth industry mean that they have other, seemingly easier, options.
The man who is “ideally bald” (to use Vladimir Nabokov’s description of his comic hero, Pnin) may soon become a rare sight.
Hair transplant surgery – which works by painstakingly moving grafts of hair (typically two to four follicles at a time) from the back of the head to the temples and crown, the first parts to drop – is becoming mainstream.
Wayne Rooney was frank about his 48-hour, £30,000 follicular unit extraction at Harley Street Hair Clinic in 2011, and is widely credited with changing attitudes towards the procedure. Actor James Nesbitt had one as he feared he’d lose out on roles as a bald man.
“It was something I struggled with,” he said, “and that was probably the vanity in me.”
There are pharmaceutical solutions, too. Finasteride (often referred to by its brand name, Propecia) and Minoxidil (aka Regaine/Rogaine) are both available via online prescription in the UK. They stop hair falling out as opposed to making it grow back again, though some report more lustrous locks after three months or so. Donald Trump is the world’s most famous Propecia user.
“Never go bald,” he once counselled. “The worst thing a man can do is go bald.” He’s not wrong. The anti-bald dating prejudice that David lamented extends to politics. Only five US presidents have ever been bald. As laughable as Trump’s follicular arrangements are, chances are that if nature had taken its course, a bald Trump wouldn’t have got to the White House.
Careful what you wish for.
‘The worst thing a man can do is go bald’ said Donald Trump, the world’s most famous Propecia user. Photograph: Jim Watson/AFP/Getty Images
The Holy Grail remains a drug that will promote regrowth, but this might not be so far away. Earlier this year, Manchester University announced that an osteoporosis drug had been found to have “dramatic results” promoting hair growth when applied to tissue samples in pre-clinical trials.
The resultant frenzy left the PhD student responsible, Dr Nathan Hawkshaw, a little dazed. “Every other week, something comes out about hair loss and it doesn’t generate as much media coverage as what I experienced,” he grumbles.
He’s in this for the science – there aren’t many fields where you get to mess around with real human tissue – but such is the distress caused by hair loss and such is the potential customer base that interest is always high.
“It all started with a particular drug, Cyclosporine A, which is an immunosuppressant,” Hawkshaw explains.
“It’s typically given to transplant patients to stop them rejecting new organs post-surgery and it’s been observed that it enhances hair growth.
But the thing is, you don’t really want to give this to patients normally because you don’t want to suppress their immune system. So, I used that drug to treat human hair follicles in the lab to try and identify how it actually worked.”
Widow’s peak: Wayne Rooney before his £30,000 follicular unit extraction. Photograph: Darren Staples/Reuters
It wasn’t quite the “accident” it was portrayed to be. He worked out that the drug targeted a protein called SFRP1, which affects follicle growth. He looked into the literature and discovered there was a pre-existing osteoporosis drug, WAY-316606, designed to target this protein with much more precision.
So he applied that to leftover slabs of scalp donated by hair transplant clinics. “We usually do experiments for over a week. We put the hair follicles in a dish and this drug enhanced hair shaft elongation within two days. But it also kept the hairs healthier. When you look at them, they’re larger, thicker hair follicles.
So, it’s quite promising.”
Hawkshaw is no longer working on the project, but the Italian pharmaceutical company, Giuliani, hopes to take his findings through to clinical trials. An American start-up, RiverTown Therapeutics, is exploring a similar avenue with a drug known as RT1640. And it’s fair to say that whoever gets there first will make a lot of money.
“There are so many different groups going down different avenues to tackle this problem,” says Hawkshaw. “Some use stem cells, some use pharmacological drugs, as we did. There’s a lot of promise in these pre-clinical studies. But whether that extends to real life, we’re not sure yet.
” While it is essentially a cosmetic issue, that doesn’t mean it’s trivial. “It causes severe psychological distress,” he says bluntly. “It makes a big difference to a person’s perspective of life.” While he’s pretty lustrous at 28, he does worry about losing his own hair.
“It’s a human universal.”
Restoration man: Wayne Rooney after his treatment. Photograph: Jon Super/Rex/Shutterstock
Male patten baldness affects about 20% of men by the time they’re 20 and rises roughly in line with age: about 30% of men will experience significant hair loss by 30, 40% of men by 40, half of men aged 50, and so on. If you’ve retained your hair by middle-age, you’re one of the lucky ones.
I’m elated to say that I’m well thatched at 37, but the grey specks in my beard bother me enough to know that if I did lose my hair, I’d be dismayed. For some reason, there is something inherently conical, sorry comical, about baldness; some people can deal with that and indeed, emerge stronger and surer of themselves.
It’s fair to say Jason Statham wouldn’t have been a match for a prehistoric shark with his 1995 hair. But for others it’s just not so easy.
One friend who went bald in his early 20s said that even once he’d readjusted to his new look, the thing that saddened him was that this look would define him pretty much for ever.
Another, now in his 40s, found it dispiriting when his hair started falling out in his 20s – “the first sign that my youth was fading…” He decided against Minoxidil and Finasteride – “If I recall correctly, one of the side effects was impotence or diminished libido, which didn’t seem a good trade-off” – and found the idea of surgery “laughable”, so opted to shave it all off, finding some cheer in the new-found solidarity among his fellow balding friends. Still, he says, anti-bald prejudices are real.
“There’s the ‘I don’t date bald men’ line – hard to argue with, but still an injury to one’s pride.
” Then there are a surprising number of people who call out “baldie!” in the street, or equate a shaved head with homosexuality and/or neo-Nazism.
“I’ve had baldist/homophobic abuse in the street a couple of times and I’ve even been asked on the Tube: ‘Are you BNP, mate?’ When I expressed bewilderment at this, I was told: ‘It’s the hair, innit.’”
Baldness is not caused by excess testosterone as is commonly thought; nor is it inherited from your maternal grandfather. It’s caused by sensitivity to testosterone: an enzyme converts testosterone into a substance called dihydrotestosterone – which then causes the follicle to shrink and fall out.
Male pattern baldness is inherited, but from both or either side of your genetic line. Why men go bald, we’re not sure – though there is a hypothesis that baldness was once a genetic advantage. People tend to associate baldness with virility and wisdom.
The bald hunter-gatherer would have been a natural choice for a chieftain back when life expectancies were shorter and bald heads rarer. In our age of appearances not so much. Of 17 male members of Cabinet, two are bald (Chris Grayling and Sajid Javid).
Studies correlate baldness with depression; the term “psycho-trichological” is used to describe the feelings of disfigurement, social avoidance and anxiety disorders that often arrive with premature baldness.
“I was 21 when I noticed my hair getting thinner,” says David Anderson, 45, who has had seven hair transplants.
He is now senior patient adviser at the Maitland Clinic in Liverpool, one of the country’s leading hair transplant clinics, where he raises awareness of the vulnerability of sufferers. “It was devastating. It completely consumed my existence. Now, I really regret that.
But time and again, I’m meeting patients going through the same anxieties. It’s an epidemic. A lot of people don’t understand how it can make you feel.”
Does Rogaine Work? On Thin Hair, Beards, Women, or Receding Hairline
If you’re losing your hair, you’ve probably already heard of minoxidil, or Rogaine.
This popular hair loss treatment is approved by the U.S. Food and Drug Administration. It’s available over the counter as a liquid or foam to treat male and female pattern baldness (also known as androgenetic alopecia).
Rogaine does work to some extent as evidenced by clinical studies, but only for certain types of baldness and only if you keep up with its application. But it won’t work for everyone. If it does work, you probably won’t grow back all of the hair you’ve lost, and it can take up to four months to see results. You’ll have to use Rogaine indefinitely to maintain any regrowth.
Read on to learn more about Rogaine’s effectiveness and to find out if you’re a good candidate.
Rogaine is considered a vasodilator. While the exact mechanism of action for minoxidil (the active ingredient) isn’t actually clear, it’s believed to work by partially enlarging hair follicles and elongating the growth phase of hair. With more follicles in the growth phase, you’ll see more hair coverage on your scalp.
Rogaine is applied to the scalp to help grow hair and prevent hair loss caused by male or female pattern baldness. This is the most common type of hair loss and runs in families.
Rogaine works best in people with hereditary hair loss at the vertex of the scalp (the area at the back of the head, just under the crown) or for women with general thinning of hair on the top of the scalp. Rogaine isn’t meant for a receding hairline or baldness at the front of your scalp.
Rogaine has been shown to be most effective in people under 40 years old and for those who start using it at the first signs of hair loss. It won’t help people who’ve already gone completely bald.
Don’t use Rogaine if any of the following apply:
- You don’t have a family history of hair loss.
- Your hair loss comes on suddenly and falls out in patches.
- You’re under the age of 18.
- Your scalp is red, itchy, infected, or painful to touch.
Ask an Expert: Is It Actually Possible to Regrow Hair?
Every guy is at risk of losing his hair, some more quickly than others. It sucks. The follicle itself shrivels up and is rendered incapable of regrowing anything. This type of hair loss is called androgenetic alopecia, often referred to as male pattern baldness.
(That's the permanent kind, not the temporary thing that happens sometimes due to stress.) This plays out in two ways: the thinning of each hair and the overall loss of density. But, in certain cases of alopecia, these losses are not truly “permanent.” At least, not right away.
Sometimes, it can be slowed down or delayed.
So there's hope! If you’ve been losing hair or if you think you’re at risk of hair loss of thinning, then read on for some possible fixes. The insight and advice comes from Dr. Francesco Fusco, MD of Wexler Dermatology in NYC. His main point? You've got to be proactive.
First of all, why is my hair falling out?
Fusco says that there’s something called miniaturization happening at the follicular level when a hair falls out. “Miniaturization refers to the slow shrinking of the hair follicle and the diminution of the hair within, until eventually the follicle no longer exists,” she says. “The remaining tiny hair falls out and nothing grows back.
” She says that this is often genetic and caused by a hormone called dihydrotestosterone (DHT), which is a byproduct of testosterone. DHT clings to the follicle and then slowly shrinks it. This most commonly happens at the temples, the crown, and the front of the head.
(This is also why you don’t see guys losing their hair around the sides and back.)
But it is possible to regrow that hair, right??
It depends. “If a follicle has closed, disappeared, scarred, or not generated a new hair in years, then a new hair wouldn’t be able to grow,” Fusco says. But if the follicle is still intact, yes, it is possible to regrow the hair—or to improve the health of the existing thinner hairs.
What can I do?
There are some common solutions and some uncommon ones:
Oral Medication: “In cases of androgenetic alopecia, finasteride is still the gold standard,” says Fusco. (Finasteride is the generic version of Propecia, which can be prescribed by your dermatologist and is also available via mail subscriptions.
) Fusco says that even younger men can slow or delay hair loss by starting a daily finasteride prescription. “This medication works by inhibiting an enzyme that leads to hair loss,” she notes.
“In clinical trials, 90 percent of the patients either gained hair or maintained their hair over a five-year period.”
Topical Medication: There are a few alternatives to finasteride, should it prove to be ineffective or if it starts causing side effects (some patients report losing their sex drive on the drug). One of these options is minoxidil (aka Rogaine).
It’s a topical product, available over the counter, that stimulates hair growth “by activating potassium channels in the follicle—this results in growth factors and prostaglandins that promote hair growth,” Fusco says. “This keeps the hairs in the growth cycle for a longer period of time.
” Your dermatologist may be able to prescribe minoxidil formulations of higher percentages, she adds. So, see your doctor to decide which route is best.
Herbal Supplements: “Saw palmetto is available over-the-counter and is an herb that has traditionally been used to treat men with prostate problems,” Fusco says.
“It is popular among men who do not want to take finasteride because it has been suggested that saw palmetto may block some of the receptor activity on the hair follicles which are stimulated in androgenetic alopecia.”
Could We See a New Dawn for Hair Loss Treatments?
There hasn’t been a new hair loss drug approved in twenty years. But, a number of European companies are hot on the case, and are getting tantalizingly close to the breakthrough that is hoped for by many patients.
With body dysmorphia magnified by the omnipresent digital world, psychiatrists have increasingly linked the onset of male and female pattern baldness to mental health conditions ranging from anxiety to even depression.
Over the past decade, cosmetic surgery has looked to ease the burden.
There is a scarcity of preventative treatments – the only drugs approved by regulators are Minoxidil and Propecia, both of which are only marginally effective at halting hair loss, and the former is the only treatment available to women. The value of the global hair transplant industry is therefore predicted to exceed €23B ($24.8B) by 2024.
However, hair transplants are no panacea as they can be costly and sometimes painful.
As a consequence, there is a huge market for any new product that can effectively halt pattern baldness in its tracks, and a series of European biotechs view this as an opportunity.
Buoyed by a number of research breakthroughs regarding the science behind hair growth, several biotechs have products in late-stage clinical trials, some of which may go on to become the first novel drug treatments for baldness in twenty years.
“The number of patients waiting for new treatment options is huge,” said Jan Alenfall, CEO of Follicum, a Swedish biotech whose lead candidate hair loss treatment is currently in phase II clinical trials.
“Transplantation is an invasive method and as such it is also associated with infections. In addition, many patients tend to require more than one transplant since the process of hair loss generally continues. Recently a lot of high-quality research from several academic groups has generated a lot of interest.”
Revisiting topical therapies
It was a research breakthrough that inspired Follicum’s development of its lead candidate drug.
While studying treatments for arteriosclerosis – a thickening and hardening of the walls of the arteries that often occurs in old age – scientists at Lund University, Sweden, discovered that a variant of the protein osteopontin — a naturally occurring molecule in our bodies — could increase hair growth in mice.
Subsequent studies found that this protein variant has a very specific target on hair follicle cells and can accelerate the hair cycle from resting to growth phases. This allows it to stimulate dormant hair follicles and encourage them to start producing cosmetically visible hairs again.