How to get finasteride: online, in person, and what it costs

Finasteride is not available over the counter. It's a prescription medication, so you'll need a healthcare provider to prescribe it.

The process is usually straightforward, though. Here's how to get finasteride, what it costs, and what else to know before starting treatment.

Getting a finasteride prescription generally doesn't require imaging or a complicated workup. In most cases, a healthcare provider can assess your hair loss through a conversation about your symptoms and a visual examination of your scalp — or even through photos, if you're doing the visit remotely.

Your provider will typically want to know:

• Where you're noticing thinning (crown, hairline, or both)

• Whether hair loss runs in your family

• How long the changes have been going on

• Any medications and/or supplements you’re currently taking

From there, it's usually a simple path to get a finasteride prescription, depending on what's most convenient for you.

In some cases, your provider may order basic blood work (such as thyroid or iron levels) to rule out other causes of hair loss, but this isn’t always necessary, especially if your hair loss follows a typical male pattern.

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Use a telehealth platform 

If you'd rather skip the waiting room, telehealth platforms like Ro help you get a finasteride prescription online (if eligible). You'll complete a medical evaluation, and if finasteride is appropriate, a licensed healthcare provider can send a prescription with medication shipped to your door.

Whichever route you choose, finasteride prescriptions can generally be refilled without a brand-new consultation each time. Your provider may want to check in periodically to see how treatment is going, but you typically won't need a full appointment for every refill.

See your primary care provider

If you already have a regular healthcare provider, getting a finasteride prescription through them can also be a convenient route. During your in-person appointment, your provider will likely ask about your symptoms — e.g. thinning hair, a receding hairline, or increased shedding — and review your medical history and any medications you're currently taking. If they determine that male pattern baldness is the likely cause of your strand struggles, they may write a prescription right then and there.

Visit a dermatologist

A dermatologist specializes in conditions that affect the skin, hair, and nails, so they're well-equipped to evaluate hair loss. This route can be especially helpful if your hair loss doesn't follow a typical male pattern baldness pattern. 

A dermatologist can rule out other causes, such as alopecia areata or telogen effluvium, and prescribe finasteride if appropriate.

Finasteride (Propecia) is a prescription medication that’s approved by the US Food and Drug Administration (FDA) to treat androgenic alopecia (male pattern baldness) and benign prostatic hyperplasia, or BPH (an enlarged prostate). It was first approved by the FDA in 1992 for BPH and in 1997 for male pattern hair loss and has been a go-to treatment for both conditions since. 

Oral finasteride is available as 1 mg and 5 mg tablets, and each strength is typically used for a different condition. The 1 mg dose is usually prescribed for hair loss and is available as a generic or under the brand name Propecia. The 5 mg dose is typically used to treat BPH and is available as a generic or under the brand name Proscar.

You can also find finasteride in topical products, such as Ro Mane Spray. While these products are generally produced by compounding pharmacies, they — just like oral finasteride — require a prescription from a licensed healthcare provider. Unlike the oral form, however, topical finasteride treatments are not FDA-approved. 

Finasteride is a type II 5-alpha-reductase inhibitor, meaning it works by blocking a specific enzyme that converts testosterone into dihydrotestosterone (DHT). DHT is known to shrink hair follicles and accelerate hair loss. So, reducing levels of the hormone can help slow that process and encourage regrowth. 

In one study, 66% of patients treated with finasteride showed an increase in visible hair growth at 24 months. 

Finasteride can slow hair follicle shrinkage and even reverse it in follicles that are still actively growing. But once a follicle has been dormant for too long, it may not respond to treatment. Starting earlier generally leads to better results.

Finasteride only works while you're taking it. If you stop, DHT levels return to normal, and hair loss typically resumes within 12 months. For most people, that means finasteride is a long-term commitment rather than a short course of treatment.

Most people tolerate finasteride well when taken as prescribed and instructed. But like any medication that affects hormone levels, finasteride can cause side effects. That's one of the reasons you need a prescription for the treatment and aren’t able to just pick it up over the counter. 

In clinical trials of the 1 mg dose used for hair loss, sexual side effects were uncommon. Decreased sex drive, erectile dysfunction, and reduced ejaculate volume each occurred in fewer than 2% of men, and each resolved in most men who continued treatment. In rare cases, sexual side effects such as erectile dysfunction and decreased libido have been reported to persist after stopping the medication. 

Less common side effects reported after the drug's approval include depression, breast tenderness and enlargement, and skin rashes. There may also be an increased risk of high-grade prostate cancer associated with 5-alpha-reductase inhibitors, though this was observed at the 5 mg dose used for BPH, five times the 1 mg hair loss dose.

A healthcare provider can help weigh these risks against the benefits and make sure finasteride is a good fit for your specific situation. 

If you ever come across finasteride being sold without a prescription, avoid it. Selling prescription medications over the counter is illegal in the US, and there's no way to know whether an unregulated product is safe.

Disclaimer: Side effects can vary between individuals. If you have concerns about side effects, speak with your healthcare provider before stopping or adjusting your treatment.

The cost of finasteride depends on one key factor: whether you go brand-name or generic.

Brand-name Propecia (1 mg) typically costs approximately $160 per month for a 30-day supply without insurance, according to GoodRx. Generic finasteride is significantly cheaper, with an average retail price of around $47 per month. 

On Ro, finasteride starts at just $20 per month on a quarterly plan. This drops to $18 per month with a 6-month plan and $16 per month with a 12-month plan. 

Insurance typically does not cover finasteride when it's prescribed for hair loss. It may cover the 5 mg dose if prescribed for BPH, but for the 1 mg hair loss dose, you're likely paying out of pocket. Going with the generic version is the simplest way to keep costs down.

Finasteride can be effective on its own, but many people see even better results when they combine it with other treatments. Some of these are available over the counter, which means you can start using them right away, even before your finasteride prescription comes through.

Minoxidil (Rogaine)

Minoxidil is the most well-known over-the-counter treatment for hair loss. Originally developed as a blood pressure medication, researchers discovered that it also stimulated hair growth. It's been FDA-approved for male pattern baldness since 1988.

It works differently from finasteride: Rather than blocking DHT, minoxidil is thought to increase blood flow to hair follicles and extend the growth phase of hair. It's available as a foam or liquid solution that you apply directly to the scalp. 

Because finasteride and minoxidil target hair loss through different mechanisms, some research suggests that using them together may be more effective than using either one alone.

Topical finasteride combinations

If you'd rather not take a daily pill, topical finasteride may be worth considering. Ro's 3-in-1 topical spray*, for example, combines finasteride, minoxidil, and tretinoin into a single scalp treatment. 

This does still require a prescription, but it can simplify your routine by combining multiple active ingredients in one step.

*Compounded medication. Not FDA-approved.

Thickening shampoos and conditioners

Thickening shampoos and conditioners won't stop hair loss or regrow hair. But they can add volume and make thinning less noticeable while you wait for treatments like finasteride to take effect. 

Some contain ingredients like ketoconazole (which is prescribed for seborrheic dermatitis or dandruff) or saw palmetto, which may offer modest benefits for scalp health, though they're no substitute for clinically proven hair loss treatments.

Nutritional supplements

Deficiencies in certain vitamins, including vitamin D, vitamin B12 and other B vitamins, iron, and zinc can contribute to hair loss. If you have a diagnosed deficiency, supplements may help support healthier hair. 

But for most people eating a balanced diet and without deficiencies, supplements alone aren't likely to reverse male pattern baldness.

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Finasteride is one of the most studied and effective treatments for male pattern baldness, but it does require a prescription. Here's what to keep in mind:

• Generic finasteride is one of the more affordable prescription hair loss options. Telehealth platforms like Ro can handle the evaluation, prescription, and delivery.

• Combining finasteride with other treatments, such as minoxidil, may improve results. This is because they target hair loss through different mechanisms.

• Finasteride works best when started while follicles are still active. Earlier treatment generally leads to better outcomes.

• Finasteride is a long-term commitment. It only works while you're taking it, so if you stop, hair loss typically resumes within 12 months.

If you're noticing thinning or a receding hairline, a healthcare provider, such as one affiliated with Ro, can help you figure out how to get finasteride and whether it’s the right fit.