Keeps is an online service that combines telehealth with a monthly subscription plan focused on hair loss treatment for men.
Let’s take a look at what they offer and how their treatments compare with competitors.
Finasteride from Keeps
Finasteride is a 1-milligram pill that’s taken daily and is only available with a prescription. It’s the generic version of Propecia, and it contains the same amount of active ingredient as Propecia and Hims, another competitor.
The Federal Drug Administration (FDA) has approved finasteride for male pattern baldness. The active ingredient works to prevent a receding hairline, and it can reduce hair loss on the crown and vertex of your head.
Minoxidil from Keeps
Minoxidil is sold by Keeps as a solution that you apply to the scalp with a dropper or as a foam that you apply with your hands. Both contain 5 percent of the active ingredient, which is the same dosage as competitors like Hims, Rogaine, Target Hair Growth Treatment, and Walgreens Hair Regrowth Treatment.
Minoxidil is the generic version of Rogaine, and you don’t need a prescription to use it.
The FDA has approved minoxidil for male and female pattern baldness. It works best on the crown and vertex of the head.
Ketoconazole from Keeps
Keeps sells shampoo with 2 percent topical ketoconazole, which is a generic version of Nizoral. Ketoconazole is an antifungal medication, and it can be used off-label for hair loss.
Nizoral and Walgreens both sell shampoo with 1 percent ketoconazole.
How finasteride works
Finasteride blocks dihydrotestosterone (DHT), a hormone that causes male pattern baldness. Taking finasteride slows down hair loss, and in some people, it can even stop hair loss.
It takes up to 3 months of daily use to see effects from finasteride. If you stop taking it daily, the effects can reverse themselves within about a year.
How minoxidil works
Minoxidil works directly on your hair follicles to slow down hair loss and help regrow the hair at the crown of your head. Specifically, it has been shown to increase follicle size and the number of follicles, as well as increase blood flow to follicles to encourage growth.
It can take 3 to 4 months for the minoxidil solution to start working, or 2 to 4 months for the foam to start working. If you stop using minoxidil daily, regrown hair usually starts to fall out within 3 months.
How ketoconazole works
Only small studies of ketoconazole for hair loss have been done, but they show that treatment with ketoconazole shampoo seems to increase the number of hair follicles. It seems to take around 6 months to begin showing effects.
You can start with Keeps in two ways:
- If you know what you want, you can choose your plan: finasteride and minoxidil, finasteride only, or minoxidil only. You’ll then take a short online quiz so a doctor can double-check that you’ve selected the right plan.
- If you’re not sure, you can fill out a questionnaire that asks you about your hair loss, lifestyle, and medical history. It will also ask you for photos of your hair loss. A doctor will review your questionnaire and pictures and suggest a treatment plan for you.
For either method, you’ll also need to provide a copy of your driver’s license or other government-issued ID. Because you need a prescription to use Keeps, the ID is necessary so the doctor knows who you are before prescribing.
A doctor will review your information within 24 hours. In some states, you’ll need to have a phone call with a doctor before you get a prescription, but in others, the doctor can prescribe a treatment for you after just reviewing your information.
Keeps is a subscription service, so the products will automatically be sent to you every 3 months unless you cancel.
If you have questions or experience side effects once starting treatment, you can message a doctor through Keeps. You can speak with one of their doctors over the phone if you prefer, but Keeps will need to set up the call.
Your initial consultation with a doctor is free. After that first visit, you can message the doctor for free for 1 year.
Keeps also recommends an annual telehealth consultation, which costs $5.
Keeps is a subscription model, and you pay for 3 months at a time. Your options are:
- Finasteride and minoxidil foam: $78 for the first 3 months, then $120 every 3 months
- Finasteride and minoxidil solution: $70 for the first 3 months, then $105 every 3 months
- Finasteride only: $50 for the first 3 months, then $75 every 3 months
- Minoxidil foam only: $30 for the first 3 months, then $45 every 3 months
- Minoxidil solution only: $20 for the first 3 months, then $30 every 3 months
Ketoconazole is sold as an add-on to any treatment plan. It costs $30 for 3 months.
Pros of Keeps
- The subscription model helps some people stay consistent with their treatment, which is key for hair loss.
- Some people find going through Keeps to be more convenient than getting products from local pharmacies.
- You don’t need to go to in-person appointments to get your treatments.
- The initial consultation is free, even if you don’t have insurance.
Cons of Keeps
- In states where telemedicine isn’t available, using Keeps may add steps, as you’ll need a prescription from a separate doctor to get finasteride.
- Some hair loss may be caused by an underlying medical condition, which may not be caught or addressed through the Keeps model.
- You don’t get to choose your doctor.
- In-person visits with a doctor aren’t available through Keeps.
- Orders can’t be canceled or returned once processed. If you want to cancel, you need to make sure you do it at the right time or you’ll be charged.
Most negative reviews are about people being charged after they tried to cancel, or having other difficulties with canceling. Once a prescription is processed for a billing cycle, it can’t be returned or canceled. Keeps responded thoroughly to both negative and positive reviews.
Other reviews state that Keeps has prompt customer service. Reviews of the products themselves are generally positive across sites.
The Keeps website provides options to text, call, chat with, or email their customer service team.
The side effects of each medication are different.
Finasteride side effects
For finasteride, potential side effects include:
- decreased libido
- erectile dysfunction, which may be permanent
- decrease in ejaculate volume
- breast enlargement
- breast tenderness
- testicular pain
Experts point out that finasteride shouldn’t be used by anyone with a family history of prostate cancer.
About post-finasteride syndrome
Post-finasteride syndrome is a term used for a variety of possible serious side effects that researchers and clinicians have observed in people taking oral finasteride.
Symptoms may occur while taking finasteride and last after people stop using it. These include changes to sexual function, such as erectile dysfunction and low libido, as well as symptoms of depression and anxiety, or other physical sensations, like dizziness.
More research is needed on post-finasteride syndrome. Current research is focused on topical versions of this drug, which may be equally effective for hair loss treatment with fewer side effects.
Topical minoxidil side effects
Potential side effects of topical minoxidil include:
- unusual growth of facial and body hair
- scalp itching, dryness, or irritation
Some potential side effects are serious.
Check in with a doctor
Call your doctor if you experience any of the following while using minoxidil:
Topical ketoconazole side effects
Potential side effects of topical ketoconazole include:
- scalp irritation or dryness
- changes in hair texture
- blisters on your scalp
Ketoconazole can also cause serious side effects. Call your doctor if you have redness, pain, swelling, or tenderness where you applied the medication.
All types of treatment can cause an allergic reaction.
Check in with a doctor
Seek emergency medical attention if you experience any of the following right after using any product:
Although Keeps has doctors who can prescribe medication for you, it may be helpful to talk with an independent doctor, someone who knows your medical history, before using a subscription service for hair loss. They can help make sure your hair loss isn’t caused by an underlying issue.
Even if your doctor gives you a prescription, you can get your medication through Keeps, sometimes for less than what it costs at your local pharmacy.
However, the treatments that Keeps offers are available at any pharmacy. Finasteride requires a prescription, while minoxidil and ketoconazole don’t.
Ultimately, it’s important to learn what’s causing your hair loss, since it may or may not respond to the medications offered by Keeps and may need another type of treatment.
Keeps is one of many options for hair loss treatment, with some advantages. Their subscription model helps keep you consistent, while the telehealth it provides can be a good option if you don’t have a primary care physician or another way to access care.
If you’re not sure what’s right for you, talk with your doctor to help you decide.