Article Summary

Keeps promises science-backed hair loss treatments, but do the claims hold up? This deep-dive review breaks down what Keeps actually offers, the real science behind finasteride and minoxidil, and where the evidence either supports their marketing or falls short. If you’re considering Keeps (or already using it), this article separates hype from hard data so you can make an informed decision.

Full Article

Men are becoming increasingly skeptical about hair loss solutions due to the flooding of the market with pseudoscience-backed products that aren’t effective. Keeps is a telehealth brand offering hair loss and sexual health products. According to their website, their main focus is providing customers with access to proven, science-backed hair loss treatments produced using FDA-approved ingredients. They have strong claims about the effectiveness of their products, but what does the research actually say?

This article will explore the products Keeps offers, the science behind their hair loss treatments, whether their claims and recommendations align with current research, and safety considerations associated with their products. 

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Key Takeaways

• The science mostly supports the core treatments offered by Keeps – both finasteride and minoxidil reliably slow hair loss and promote regrowth for many men.
• Keeps fail to provide personalization – fixed doses, limited options, and a lack of escalation routes increase the risk of side effects or stalled progress.
• Formulations may carry avoidable risks – high-dose topicals and unclear ingredient transparency raise concerns about systemic exposure and skin irritation.

What Causes Male Pattern Hair Loss?

Androgenic alopecia (AGA) is the medical name of male pattern hair loss. It involves the progressive shrinking of the hair follicle, a process that is induced by androgen sensitivity.^[1]Ho, C.H., Sood, T., Zito, P.M., (2024), Androgenetic Alopecia. Available at: https://www.ncbi.nlm.nih.gov/books/NBK430924/ (Accessed: 07 January 2026) 

Dihydrotestosterone (DHT) is the key androgen driving follicular miniaturization and AGA. The 5-alpha reductase (5AR) enzyme binds to free testosterone and converts it into DHT. The DHT then binds to cells via androgen receptors and influences the behaviour of the cell, ultimately resulting in follicle miniaturization.

What Does Keeps Offer?

Keeps offers a range of treatments for hair loss, with a focus on minoxidil and finasteride. In addition to these, they offer various other products, including shampoos, a styling product, and supplements. Their Rx offerings include reliable, clinically-proven products delivered in multiple formats, such as sprays, gels, and pills.

We will investigate their product range, exploring what their catalog offers, whether the science backs their claims, and if Keeps is really the best option

Keeps Finasteride (1mg Oral)

Formulations

Keeps offers Finasteride as an oral drug; they do not offer topical finasteride without it being in combination with minoxidil. The oral drug offered contains 1 mg finasteride.

What is Finasteride?

Finasteride is a drug originally created to treat benign prostate hyperplasia and now commonly used to treat AGA. It is a prescription drug that has been approved by the FDA for oral use, and is commonly also prescribed off-label for topical use.

How Does Finasteride Work?

Finasteride selectively inhibits 5AR, the enzyme that converts testosterone to DHT. As DHT is the primary driver of AGA, blocking its production interrupts the hormonal processes causing pattern hair loss. As such, finasteride helps to maintain existing hair and induce hair regrowth.

Clinical trials have demonstrated that finasteride treatment decreased levels of DHT in the scalp by 64-60%.^[2]Drake, L., Hordinsky, M., Fiedler, V., Swinehart, J., Unger, W.P., Cotterill, P.C., Thiboutot, D.M., Lowe, N., Jacobson, C., Whiting, D., Stieglitz, S., Kraus, S.J., Griffin, E.I., Weiss, D., … Continue reading Finasteride also contributes to anti-cell death effects, in addition to promoting pathways that are important in hair follicle maintenance.

Clinical Effectiveness

Multiple clinical trials have demonstrated the effectiveness of finasteride in improving hair growth. Long-term trials have shown its ability to enhance hair growth and reduce further hair loss across 1-year, 2-year, and 5-year clinical trials. These trials have demonstrated that approximately 65% of men show increased hair counts after 5 years of use.^[3]Finasteride Male Pattern Hair Loss Study Group. (2002). Long-Term (5-Year) Multinational Experience With Finasteride 1 mg in the Treatment of Men With Androgenetic Alopecia. Eur J Dermatol. 12:38-49. … Continue reading,^[4]Shapiro, J., Kaufman, K.D. (2003). Use of Finasteride in the Treatment of Men With Androgenetic Alopecia (Male Pattern Hair Loss). J Investig Dermatol Symp Proc. 8(1):20-23. Available at: … Continue reading

Are There Any Side Effects?

Finasteride works by altering certain hormones; as such, it can cause side effects throughout the body. These include altered libido, erectile dysfunction, breast enlargement, or mood alterations. 

In controlled clinical trials, side effects are uncommon. A meta-analysis (a study where data from multiple independent studies are analyzed) of 15 clinical trials found that only 5.31% of users experienced sexual side effects when taking 1 mg finasteride, whereas these were seen in 3.05% of those taking a sugar pill.^[5]Lee, S., Lee, Y.B., Choe, S.J., Lee, W.S. (2019). Adverse Sexual Effects of Treatment with Finasteride or Dutasteride for Male Androgenetic Alopecia: A Systematic Review and Meta-Analysis. Acta … Continue reading

Although rare, these side effects can seriously impact the lives of those experiencing them, and it is for this reason that finasteride is a prescription-only product that requires medical supervision.

Does the Science Support Keeps’ Claims?

Claim 1: Blocks the production of DHT

Conclusion: True

Finasteride has demonstrated its ability to reduce DHT in multiple clinical trials, in one study showing a 69.4% decrease in DHT in the scalp (although at a higher dose of 5 mg/day).^[6]Drake, L., Hordinsky, M., Fiedler, V., et al., (1999). The Effects of Finasteride on Scalp Skin and Serum Androgen Levels in Men with Androgenetic Alopecia. Journal of the American Academy of … Continue reading

Claim 2: Works on a receding hairline and for overall hair thinning

Conclusion: Partially true

While finasteride does work on a receding hairline, it does not exclusively act there.^[7]Leyden, J., Dunlap, F., Miller, B. (1999). Finasteride in the Treatment of Men with Frontal Male Pattern Hair Loss. Journal of the American Academy of Dermatology. 40(6). 930–937. Available at: … Continue reading Finasteride acts on all androgen-sensitive scalp areas – the frontal, mid-scalp, and vertex – with some evidence that the vertex (crown) may respond more robustly in some men.^[8]Olsen, E.A., Whiting, D.A., Savin, R. (2012). Global Photographic Assessment of Men Aged 18 to 60 Years with Male Pattern Hair Loss Receiving Finasteride 1 mg or Placebo. Journal of the American … Continue reading

Finasteride is effective at improving overall scalp hair thinning.

Claim 3: 90% effective at treating hair loss

Conclusion: Oversimplification

High-quality, randomized controlled trials (the optimal method of testing claims) do not support a 90% effectiveness rate. These trials have demonstrated significant improvements in those taking finasteride compared to those taking the placebo (sugar pill), but do not report 90% effectiveness.

The 90% figure probably arises from observational trials where men already taking finasteride are assessed. In one trial, 87.1% of men taking finasteride showed some degree of improvement (great, moderate, or slight), and in another 85.7% of men were judged as improved after 5 years of finasteride.^[9]Sato, A., Takeda, A. (2011). Evaluation of Efficacy and Safety of Finasteride 1 mg in 3177 Japanese Men with Androgenetic Alopecia. Journal of Dermatology. 39(1). 27–32. Available at: … Continue reading,^[10]Shin, J., Chung, E., Kim, M., Kim, T., Kim, W., Huh, C. (2018). Evaluation of Long-Term Efficacy of Finasteride in Korean Men with Androgenetic Alopecia Using the Basic and Specific Classification … Continue reading These studies do not include control groups and may be subject to selection and assessment biases.

Claim 4: Results within 4-6 months of consistent use

Conclusion: Partially true

Improved hair growth is consistently seen in controlled clinical trials within 6 months of taking the product. While emerging effects may be seen after 4 months, the evidence points to results being most evident at the 6-month timepoint.^[11]Van Neste, D., Fuh, V., Sanchez-Pedreno, P. (2000). Finasteride Increases Anagen Hair in Men with Androgenetic Alopecia. British Journal of Dermatology. 143(4). 804–810. Available at: … Continue reading

Keeps Minoxidil Solution (5%)

Formulations

Minoxidil exists in oral and topical forms. The oral form requires a prescription, whereas the topical form can be purchased over the counter.

What is Minoxidil?

Minoxidil was originally developed as an oral drug to treat high blood pressure. However, a side effect of this product was noted to be increased hair growth. As a result, the FDA approved topical minoxidil for male pattern hair loss in 1988.^[12]Suchonwanit, P., Thammarucha, S., Leerunyakul, K. (2019). Minoxidil and Its Use in Hair Disorders: A Review. Drug Design, Development and Therapy. 13. 2777–2786. Available at: … Continue reading

How Does Minoxidil Work?

Minoxidil is thought to stimulate hair growth through a combination of biological mechanisms:

• Local Vasodilation: Minoxidil causes vasodilation, enhancing blood circulation around the hair follicles and delivering more oxygen and nutrients to the follicular environment, creating enhanced conditions for hair growth.^[13]Patel, P., Nessel, T.A., Kumar, D.D. (2023). Minoxidil. StatPearls. Available at: http://www.ncbi.nlm.nih.gov/books/NBK482378/ (Accessed: 04 February 2026)
• Anagen Induction and Telogen Shortening: Minoxidil can induce the anagen phase (growth) and shorten the telogen phase (resting).^[14]Van Neste, D. (2020). Placebo-Controlled Dose-Effect Studies with Topical Minoxidil 2% or 5% in Male-Patterned Hair Loss Treated with Oral Finasteride Employing an Analytical and Exhaustive Study … Continue reading By influencing resting hair follicles to re-enter the growth phase, minoxidil treatment causes increased hair density and thickness.
• Prostaglandin Modulation: Minoxidil is thought to increase the production of prostaglandin E2 (PGE2), promoting hair growth, potentially through providing cytoprotective effects and modulating inflammation within the surrounding follicle environment.^[15]Michelet, J.F., Commo, S., Billoni, N., Mahé, Y.F., Bernard, B.A. (1997). Activation of Cytoprotective Prostaglandin Synthase-1 by Minoxidil as a Possible Explanation for Its Hair Growth-Stimulating … Continue reading

Clinical Effectiveness

The effectiveness of minoxidil can be split into response rates (proportion of men for whom minoxidil works) and regrowth rates.

Response rates

Surveys and clinical studies demonstrate that approximately 60% of men show a response to minoxidil (the slowing, stopping, or reversal of hair loss) within 3-6 months of beginning treatment.^[16]Asilian, A., Farmani, A., Saber, M. (2023). Clinical Efficacy and Safety of Low-Dose Oral Minoxidil Versus Topical Solution in the Improvement of Androgenetic Alopecia: A Randomized Controlled Trial. … Continue reading However, increasing the treatment time up to over 12 months does not show continued improvements. Instead, response rates drop to approximately 30%.^[17]Rietschel, R.L., Duncan, S.H. (1987). Safety and Efficacy of Topical Minoxidil in the Management of Androgenetic Alopecia. Journal of the American Academy of Dermatology. 16(3). 677–685. Available … Continue reading

After the 12-month mark, the rate of discontinuation is approximately 90%, with “low effect” as the leading reason given for stopping.^[18]Shadi, Z. (2023). Compliance to Topical Minoxidil and Reasons for Discontinuation among Patients with Androgenetic Alopecia. Dermatology and Therapy (Heidelberg). 13(5). 1157–1169. Available at: … Continue reading

Regrowth rate

Multiple clinical trials have been carried out to assess the effects of minoxidil on hair growth, with the majority demonstrating measurable regrowth after 4-12 months of use.^[19]Olsen, E.A., Whiting, D., Bergfeld, W. (2007). A Multicenter, Randomized, Placebo-Controlled, Double-Blind Clinical Trial of a Novel Formulation of 5% Minoxidil Topical Foam Versus Placebo in the … Continue reading,^[20]Hasanzadeh, H., Nasrollahi, S.A., Halavati, N., Saberi, M., Firooz, A. (2016). Efficacy and Safety of 5% Minoxidil Topical Foam in Male Pattern Hair Loss Treatment and Patient Satisfaction. Acta … Continue reading^[21]Van Neste, D. (2020). Placebo-Controlled Dose-Effect Studies with Topical Minoxidil 2% or 5% in Male-Patterned Hair Loss Treated with Oral Finasteride Employing an Analytical and Exhaustive Study … Continue reading The exact level of regrowth varies; however, estimates of regrowth are approximately 50-70% over 12 months. Few trials carry out assessments beyond 12 months. Those assessing longer-term effects see reduced regrowth after 12 months.^[22]Olsen, E.A., DeLong, E.R., Weiner, M.S. (1987). Long-Term Follow-Up of Men with Male Pattern Baldness Treated with Topical Minoxidil. Journal of the American Academy of Dermatology. 16(3). 688–695. … Continue reading

Does the Science Support Keeps’ Claims?

Claim 1: Increases new hair growth in men with AGA

Conclusion: True

Minoxidil has been shown in multiple clinical trials to have a positive effect on hair growth.

Claim 2: Works at the crown and middle of the head

Conclusion: Partially true

Evidence from clinical trials has not shown that minoxidil only or primarily works at the crown or middle of the head. This misconception arose due to early important trials specifically focusing on these areas, such as a 2002 trial that recruited men with a blading spot on their crown.^[23]Olsen, E.A., Dunlap, F.E., Funicella, T. (2002). A Randomized Clinical Trial of 5% Topical Minoxidil Versus 2% Topical Minoxidil and Placebo in the Treatment of Androgenetic Alopecia in Men. Journal … Continue reading

More recent trials have demonstrated the effectiveness of minoxidil across the scalp, with no significant differences in effects seen between the frontotemporal and vertex areas.^[24]Kanti, V., Hillmann, K., Kottner, J., Stroux, A., Canfield, D., Blume-Peytavi, U. (2016). Effect of Minoxidil Topical Foam on Frontotemporal and Vertex Androgenetic Alopecia in Men: A 104-Week … Continue reading

Claim 3: Increases hair growth by up to 35%

Conclusion: A reasonable estimate

While hair growth has been readily identified in minoxidil clinical trials, the exact percentage increase varies widely between different men and depending on how long they have been taking minoxidil. Overall, it is a reasonable estimate, but not a guaranteed outcome for all individuals.

Keeps Minoxidil Foam (5%)

The Keeps Minoxidil Foam claims to offer the same benefits as the Minoxidil Solution. It could be assumed that the exact ingredients forming the products are not the same; however, no readily accessible list of ingredients is provided on the website.

Keeps Minoxidil+ Spray

The Minoxidil+ Spray contains additional ingredients aimed at improving minoxidil’s efficacy and supporting hair growth.

Formulation

The Minoxidil+ Spray consists of 5% minoxidil, 0.01% tretinoin, 0.2% caffeine, and 0.1% melatonin.

Clinical Effectiveness

0.01% Tretinoin

Tretinoin (also known as retinoic acid) has been used as a hair loss treatment on its own and in combination with other hair loss drugs, such as minoxidil. While the clinical results for tretinoin on its own are limited, the combination of tretinoin and minoxidil has shown more positive results. 

Tretinoin is thought to increase responsiveness to minoxidil by increasing the activity of the enzyme that converts minoxidil in the body into its active form.^[25]Sharma, A., Goren, A., Dhurat, R. (2019). Tretinoin Enhances Minoxidil Response in Androgenetic Alopecia Patients by Upregulating Follicular Sulfotransferase Enzymes. Dermatologic Therapy. 32(3). … Continue reading Clinical trials have shown that the once-daily application of a combination of 5% minoxidil and 0.01% tretinoin is as effective (and safe) as twice-daily application of 5% minoxidil alone.^[26]Shin, H.S., Won, C.H., Lee, S.H., Kwon, O.S., Kim, K.H., Eun, H.C. (2007). Efficacy of 5% Minoxidil Versus Combined 5% Minoxidil and 0.01% Tretinoin for Male Pattern Hair Loss. American Journal of … Continue reading See our article for a more in-depth look at tretinoin.

0.2% Caffeine

Caffeine has been suggested as a hair loss therapy; however, the evidence supporting its use may be flawed. It is thought that caffeine may act via several mechanisms, including prolonging the anagen (growth) phase of the hair cycle, encouraging the growth of new hair fibres, promoting blood flow, and inhibiting cell death. See our article assessing the effectiveness of topical caffeine for more information.

The clinical studies supporting the use of topical caffeine (including in conjunction with minoxidil) are generally positive. However, analysis of these studies shows major flaws, including a failure to measure hair count and reliance on patient self-satisfaction surveys.^[27]Dressler, C., Blumeyer, A., Rosumeck, S., Arayesh, A., Nast, A. (2017). Efficacy of Topical Caffeine in Male Androgenetic Alopecia. Journal der Deutschen Dermatologischen Gesellschaft. 15(7). … Continue reading

Therefore, while there is accumulating evidence that caffeine may help to reduce hair shedding, there is limited evidence showing that it slows hair loss.

0.1% Melatonin

Melatonin has also been suggested to have an effect on hair loss, potentially through reducing androgen levels, although this mechanism is purely hypothetical at this stage.

While the mechanisms for melatonin’s impact on hair loss are unknown, a few clinical studies have shown that it appears to have a positive effect on hair growth and reducing hair loss.^[28]Fischer, T.W., Burmeister, G., Schmidt, H.W., Elsner, P. (2004). Melatonin Increases Anagen Hair Rate in Women with Androgenetic Alopecia or Diffuse Alopecia: Results of a Pilot Randomized Controlled … Continue reading^[29]Fischer, T.W., Trüeb, R.M., Hänggi, G., Innocenti, M., Elsner, P. (2012). Topical Melatonin for Treatment of Androgenetic Alopecia. International Journal of Trichology. 4(4). 236–245. Available … Continue reading Although it should be noted that many of these studies were small and they often lacked a control group.

Does the Science Support Keeps’ Claims?

Claim 1: Topical minoxidil improves blood flow to hair follicles to boost hair regrowth by up to 35%

Conclusion: Partially true

As discussed above, minoxidil is thought to work by improving blood flow to the hair follicles. The figure of 35% is a reasonable estimate of hair regrowth; however, this varies widely and is not a guaranteed outcome for all individuals

Claim 2: Tretinoin gently exfoliates to enhance minoxidil’s efficacy, making for easy once-daily application

Conclusion: Partially true

While tretinoin has been shown to enhance minoxidil’s efficacy to enable once-daily instead of twice-daily application, this has nothing to do with exfoliation.

Claim 3: Caffeine supports thicker, healthier hair growth and makes thinning hair look thicker

Conclusion: Partially true

While there is evidence supporting the potential for caffeine to improve hair growth and reduce hair loss, no clinical trials show that caffeine supports thicker hair.

Claim 4: Melatonin helps increase hair growth on the scalp

Conclusion: True

Studies have demonstrated that melatonin increases hair growth and reduces hair loss.

Topical Finasteride and Minoxidil Gel

Formulation

Keeps offers this two-in-one prescription topical treatment consisting of 0.25% finasteride and 5% minoxidil.

Clinical Effectiveness

Finasteride and minoxidil function through two separate mechanisms. As such, their combination offers users the opportunity to attack hair loss from two different angles.

Multiple clinical trials have demonstrated the efficacy of combining finasteride with minoxidil, showing that the combined therapy is more effective than minoxidil or finasteride alone.^[30]Suchonwanit, P., Srisuwanwattana, P., Chalermroj, N., Khunkhet, S. (2018). A Randomized, Double-Blind Controlled Study of the Efficacy and Safety of Topical Solution of 0.25% Finasteride Admixed with … Continue reading,^[31]Rossi, A., Caro, G. (2023). Efficacy of the Association of Topical Minoxidil and Topical Finasteride Compared to Their Use in Monotherapy in Men with Androgenetic Alopecia: A Prospective, Randomized, … Continue reading^[32]Bharadwaj, A.V., Mendiratta, V., Rehan, H.S., Tripathi, S. (2023). Comparative Efficacy of Topical Finasteride (0.25%) in Combination with Minoxidil (5%) Against 5% Minoxidil or 0.25% Finasteride … Continue reading, with a meta-analysis also backing up these findings.^[33]Li, Y., Huang, Q., Zhou, Z., Zhang, Y. (2025). Comparing Minoxidil-Finasteride Mixed Solution with Minoxidil Solution Alone for Male Androgenetic Alopecia: A Systematic Review and Meta-Analysis of … Continue reading

Does the Science Support Keeps’ Claims?

Claim 1: Finasteride stops hair loss by blocking the production of DHT, the hormone responsible for male pattern baldness

Conclusion: True

Studies have shown that the topical application of finasteride also successfully lowers DHT levels in the scalp.^[35]Lee, S.W., Juhasz, M., Mobasher, P., Ekelem, C., Mesinkovska, N.A. (2018). A Systematic Review of Topical Finasteride in the Treatment of Androgenetic Alopecia in Men and Women. Journal of Drugs in … Continue reading

Claim 2: Minoxidil increases blood flow to hair follicles to stimulate hair regrowth

Conclusion: True

Minoxidil has been shown in multiple clinical trials to have a positive effect on hair growth.

Keeps Daily Hair Defense Supplement

Formulation

The Daily Hair Defense Supplement contains saw palmetto, vitamins A, B6, B12, C, D, calcium, selenium, zinc, and biotin.

Clinical Effectiveness

Saw Palmetto

Saw palmetto is a popular hair growth supplement as it does not require a prescription to obtain. But is it actually effective? 

Early studies demonstrated positive results, showing that 60% of men taking 200 mg of saw palmetto experienced some degree of hair regrowth compared to 11% in the control group, although the researchers agreed that more work needed to be done given the small size of the trial.^[36]Prager, N., Bickett, K., French, N., Marcovici, G. (2002). A Randomized, Double-Blind, Placebo-Controlled Trial to Determine the Effectiveness of Botanically Derived Inhibitors of 5-Alpha-Reductase … Continue reading

Saw palmetto is able to reduce DHT, although not to the same degree as finasteride, resulting in reduced effectiveness at inducing hair growth compared to finasteride.^[37]Rossi, A., Mari, E., Scarnò, M. (2012). Comparative Effectiveness of Finasteride vs Serenoa Repens in Male Androgenetic Alopecia: A Two-Year Study. International Journal of Immunopathology and … Continue reading However, hair growth was still seen on saw palmetto supplementation, indicating its potential for use in a supplement.

Vitamins A, B6, B12, C, and D

There is little to no convincing clinical evidence that supplementation with Vitamins A, B6, B12, C, and D has any effect on hair growth, although they may have positive effects in cases where people have a severe deficiency.^[38]Cheung, E.J., Sink, J.R., English, J.C. (2016). Vitamin and Mineral Deficiencies in Patients With Telogen Effluvium: A Retrospective Cross-Sectional Study. Journal of Drugs in Dermatology. 15(10). … Continue reading

Calcium

No strong clinical trials have shown any role of calcium in hair growth.^[39]Almohanna, H.M., Ahmed, A.A., Tsatalis, J.P., Tosti, A. (2018). The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatology and Therapy (Heidelberg). 9(1). 51–70. Available at: … Continue reading

Selenium

Both severe selenium deficiency and too much selenium can cause hair loss. A clinical trial in chemotherapy patients receiving a selenium supplement showed reduced hair loss, but no successful clinical trials have been carried out in healthy people.^[40]Almohanna, H.M., Ahmed, A.A., Tsatalis, J.P., Tosti, A. (2018). The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatology and Therapy (Heidelberg). 9(1). 51–70. Available at: … Continue reading

Biotin

Biotin deficiencies also cause hair loss; however, no high-quality clinical trials have demonstrated any effectiveness as a hair supplement.^[41]Yelich, A., Jenkins, H., Holt, S., Miller, R. (2024). Biotin for Hair Loss: Teasing Out the Evidence. Journal of Clinical and Aesthetic Dermatology. 17(8). 56–61. Available at: … Continue reading

Does the Science Support Keeps’ Claims?

Claim 1: The key ingredient, saw palmetto, stabilizes hair loss and promotes healthy hair growth

Conclusion: True

Saw palmetto is thought to support hair growth and reduce hair loss, although not as successfully as finasteride.

Claim 2: Vitamins A, B6, B12, C, D, Calcium, Selenium, Zinc, and Biotin support overall health, immune function, and vitality

Conclusion: True

These vitamins and minerals do not have any significant effects on hair growth, but may contribute to improved overall health by reducing the risk of deficiency.

The Problems with Keeps’ Approach

A One-Size-Fits-All-Model

Keeps fails to provide any personalization in their offerings. Although they offer a range of products, these are all at fixed concentrations – 5% for minoxidil, 1 mg for oral finasteride, and 0.25% topical finasteride (only available when combined with minoxidil).

As such, they fail to provide tiered dose progression or the ability to switch to a lower dose or a topical dose (in finasteride’s case) if side effects present themselves. In addition, individuals can react very differently to these hair loss treatments, and so a dose that works well for one person may give another side effects or may not work at all.

Finasteride has been shown to be near maximally effective at several doses, meaning that a dose reduction may decrease side effects while still retaining positive hair growth effects. However, this option is not available with Keeps.

If finasteride is having no effect, medical professionals may recommend treatment escalation. This is often achieved using dutasteride, which has been shown to better reduce DHT compared to finasteride and can lead lead to better regrowth.^[42]Harcha, W. G., Barboza Martínez, J., Tsai, T.-F., Katsuoka, K., Kawashima, M., Tsuboi, R., Barnes, A., Ferron-Brady, G., & Chetty, D. (2014). A randomized, active- and placebo-controlled study … Continue reading This option is also not available with Keeps, limiting the opportunity for effective hair growth.

Failure to provide a flexible, personalizable model limits the ability of users to seek alternatives, leading either to perseverance with potentially harmful treatments or to their stopping the use of treatments altogether.

Mega-Dosed Topicals

While the minoxidil dose (5%) is well within normal recommendations, the sole offer for topical finasteride (0.25%) is high. 

Topicals are often advertised as the low-risk option, where application to the scalp prevents the effects that occur to the body as a whole (as could occur with oral dosing). Unfortunately, this is false.

Treatment with a 0.25% solution of finasteride can reduce DHT in the serum (i.e., the blood) by 35%, even though it has only been applied to the scalp. While this is lower than occurs when oral finasteride is taken (55% reduction), it does show that there is still a risk of systemic (whole body) side effects, even if a topical solution is used.^[43]Piraccini, B. M., Blume-Peytavi, U., Scarci, F., Jansat, J. M., Falqués, M., Otero, R., Tamarit, M. L., et al. (2022). Efficacy and safety of topical finasteride spray solution for male androgenetic … Continue reading

This issue has been recognized by the FDA, who have recently issued a warning for topical finasteride, stating that “Absorption of finasteride through the skin into the bloodstream is expected, and the reports describe adverse events that are consistent with those reported in association with the approved oral finasteride products”.^[44]U.S. Food and Drug Administration. (n.d.). FDA alerts health care providers, compounders, and consumers about potential risks associated with compounded drugs. *FDA.* Available at: … Continue reading 

These warnings highlight the need for continuing follow-ups with experts so as to identify and rectify any side effects seen. While Keeps does offer access to the licensed medical provider for a free consultation to start with, ongoing consultations will cost the user each time, disincentivising them from getting in contact about any issue.

Lack of Available Ingredient Information

Keeps fails to provide a full list of product ingredients on their website, preventing potential users from checking for any sensitivities or for the presence of harmful ingredients often included in Rx topicals.

For example, topicals often contain propylene glycol to help with ingredient penetration; however, this can cause skin irritation in 7% of users, worsening hair growth.^[45]Patel, K., Palmer, A., & Nixon, R. (2023). Allergic contact dermatitis from propylene glycol: a case series from Australia. *Contact Dermatitis.* 89(2). 79–84. Available at: … Continue reading. In addition, to offset the irritation caused by propylene glycol, topicals may also contain corticosteroids due to their anti-inflammatory properties. Long-term corticosteroid use can result in various side effects, including hormonal changes, alterations to skin pigmentation, the creation of spider veins, and skin thinning.^[46]Aschoff, R., Schmitt, J., Knuschke, P., Koch, E., Bräutigam, M., Meurer, M. (2011). Evaluation of the Atrophogenic Potential of Hydrocortisone 1% Cream and Pimecrolimus 1% Cream in Uninvolved … Continue reading

A lack of transparency in Keeps’ ingredients doesn’t necessarily mean that they have included these harmful substances in their products, but we have no way of knowing for certain.

What Makes Ulo Different?

The issues seen in Keeps’ products are unfortunately seen frequently in the hair loss industry. A lack of personalization, mega-dosed topicals, limited escalation opportunities, and the potential inclusion of harmful ingredients are systemic issues and can limit the success of men looking to fight their hair loss.

Ulo was launched with a vision to rectify all of the bad practises currently employed by many haircare brands.

They offer flexible, personalized treatment options, not only offering different types of products (e.g., foam versus spray) but also offering topical versions of many of their products, a range of doses, ingredient-specific customization, and treatment escalation options. 

They refuse to use irritants or harmful substances, such as propylene glycol or corticosteroids, and instead have focused on altering their formulations to enable ample ingredient penetration without the irritation. While some of their ingredients have the potential to cause mild irritation (such as tretinoin), any users experiencing this have the opportunity to use the product with this ingredient removed by Ulo’s physician partners.

Finally, Ulo also offers ongoing physician involvement, providing personal support and the ability to contact a doctor at any time, dosing and ingredient adjustments based on individual experience, and offering expertise (based on clinical data) to guide expectations.

Final Remarks

Keeps offers multiple clinically-backed medications via a range of delivery methods, providing a broad and accessible entry point for hair loss treatments that are proven to work. These treatments have the potential to successfully slow hair loss and increase hair growth in many users.

However, a lack of personalization forces users into a set treatment pathway, which may not be best-suited for their needs, potentially resulting in ineffective treatments or harmful side effects. The inability to adjust doses to low-concentration formulations if side effects occur or to escalate treatment if effects plateau reduces the chances of successful outcomes and satisfied customers.

These issues are not unique to Keeps, but are also found in many other telehealth haircare brands. Ulo offers an alternative approach to the majority of the haircare industry, providing true personalization and care to produce optimal results.