Hair loss

Roman is a telemedicine company that provides a discreet, convenient, and affordable way for you to receive hair loss treatment from a doctor or nurse practitioner—all without leaving the couch. Minoxidil (generic Rogaine) is available for purchase directly from the website as an over-the-counter (OTC) product. If you are interested in prescription treatment, it starts with an online visit. The online visit will ask you about your symptoms, your medical history, and other basic information. You’ll also be asked to upload a photo of your ID to verify your identity. Once you have done all of this, a doctor or nurse practitioner will review everything, determine if you’re a candidate for hair loss treatment through telemedicine, and craft a personalized treatment plan for you.

There is one prescription-strength medication for hair loss available on the Roman platform: finasteride (generic Propecia) (see important safety information). This medication helps patients maintain the hair they have or possibly even regrow some hair they have lost. Finasteride can be used for a receding hairline as well as hair loss at the crown.

In addition to finasteride, minoxidil (generic Rogaine) is an over-the-counter treatment for hair loss that you can purchase directly from the website without going through an online visit. Minoxidil can be used for hair loss at the crown. The specific form of minoxidil offered by Roman is minoxidil topical solution at the 5% strength.

In some cases, your doctor or nurse practitioner may recommend using finasteride and minoxidil together.

Hair loss treatment can work to preserve hair and possibly even regrow hair. In one study, finasteride (see important safety information) was effective at stopping hair loss in 83% of men (compared to 28% for the placebo group). In one European study, men treated with finasteride over a five-year period experienced “a 93% decrease relative to placebo in the 5-year likelihood of developing further hair loss.”

Finasteride regrows hair less well, but it does provide a benefit for some men. In one study, the authors found that the chances of mild to moderate visible regrowth were 61% on the vertex after 2 years. The chances of mild to moderate visible regrowth on the frontal area were 37% after 1 year.

Finasteride (see important safety information) and minoxidil typically take three to four months of daily use to start seeing visible changes. It can take up to a year to see the maximum results. As long as you don’t experience side effects, it’s best to continue the medication for one full year before deciding on whether the medication is doing all it can for you. Like all medications, finasteride and minoxidil will work differently for different people. To sustain benefits, you have to continue using hair loss medication. If you stop, your hair loss may return.

Just as no drug works on everyone, no drug is 100% safe, and finasteride (see important safety information) is no exception. In clinical trials, some men experienced sexual dysfunction due to finasteride. This included a decrease in sexual desire (libido), a decrease in semen volume, or erectile dysfunction (ED). These side effects were noted in 3.8% of men taking finasteride and in 2.1% of men taking a placebo.

In addition, finasteride can lower serum prostate-specific antigen (PSA) levels and may increase the risk of high-grade prostate cancers. If you are being screened for prostate cancer, you should let your healthcare provider know that you are taking finasteride. Also, as finasteride enters the system, it may cause shedding of fine hairs before it stops or reverses hair loss. Do not be concerned—this part is expected.

The most common side effects associated with minoxidil are local skin irritation. Systemic side effects are rare as only a very small percentage of the medication gets absorbed.

Yes. During your online visit, we’ll ask you to take and upload a few photos. This helps your doctor or nurse practitioner determine the appropriate treatment option.

Your online visit is free.

Services, products, and medications offered through Roman are not covered by insurance.

If prescribed, the cost of treatment depends on the type of medication and the number of doses you receive. Finasteride (see important safety information) plans are $0.67 per day, minoxidil plans are $0.53 per day, and, when ordered together, the combination is $1.17 per day (when you select a quarterly plan). Prices at your local pharmacy may vary.

You’re only charged for the medication after a doctor or nurse practitioner has approved a personalized treatment plan.