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Ro 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 to determine if you're a candidate for hair loss treatment through telemedicine and decide which treatments are (or are not) safe and appropriate for you. Hair loss treatments available through Roman are oral finasteride, oral minoxidil, and topical minoxidil.

There are two prescription-strength hair loss medications available through Roman: oral finasteride and oral minoxidil.

Oral finasteride is an FDA-approved prescription hair loss treatment, while oral minoxidil is considered an off-label prescription for hair loss. This means oral minoxidil is not FDA-approved for that particular use, but a provider can still prescribe it if they deem it safe and appropriate for the patient.

Oral minoxidil may be preferred by men who do not want to risk the known slight chance of sexual side effects from taking finasteride. Oral minoxidil and oral finasteride have different mechanisms of action to tackle hair loss. Your provider will recommend a treatment based on your medical history, lifestyle, and any particular treatment preferences or side effect aversions you may have.

Scientists aren't entirely sure how minoxidil works, but it is thought that it helps increase blood flow to the hair follicle. This helps more nutrients to get to the follicle, which can support hair growth.

Minoxidil comes in two forms: oral medication and topical solution.

Topical minoxidil is an FDA-approved hair loss treatment that does not require a prescription whereas oral minoxidil is considered an off-label prescription for hair loss and does require a prescription. “Off-label” means it’s not FDA-approved for that particular use, but can still be prescribed at the provider’s discretion.

Topical and oral minoxidil contain the same active ingredient. While there have not been clinical studies comparing their efficacy, there appear to be some benefits of using an oral treatment method vs. a topical treatment method, such as more precise dosing and better treatment adherence & consistency.

Male pattern baldness (also called androgenetic alopecia) is a common form of hair loss. It is typically associated with a receding hairline and hair loss at the crown (top) of the head. Not all men experience male pattern baldness but some men are genetically susceptible.

Male pattern baldness occurs when hair follicles undergo a process called follicular miniaturization. This is when the longer, darker hairs that once grew on the scalp get replaced by thinner, shorter, less pigmented hairs. This process occurs as a result of a hormone called dihydrotestosterone (DHT), which is derived from testosterone. Early on, it's possible to stop or even reverse this hair loss. However, at a certain point, the hair follicle also loses attachment to the small muscles in the skin (called the arrector pili muscles). When this happens, hair loss is permanent.

Finasteride 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.