How to Get a Finasteride Prescription: Telehealth vs. In-Person

Finasteride requires a valid prescription from a licensed US physician. You cannot legally buy it over-the-counter in the United States. This page explains your options for obtaining a prescription and what to expect from the evaluation process.

Your Three Main Options

1. Telehealth Platform (Fastest, Lowest Cost)

Telehealth platforms including Keeps, Hims, Roman (Ro), Forhims, and others offer online physician consultations and finasteride prescriptions. You complete a questionnaire, upload photos of your hair loss pattern, and a licensed physician reviews your case asynchronously (or via video). If appropriate, a finasteride prescription is sent to a pharmacy or dispensed directly.

Best for: Uncomplicated male AGA in otherwise healthy adult men who are confident in their diagnosis and want an efficient, affordable pathway. The bundled consultation + prescription + delivery model typically costs $15–$35/month.

Limitations: Photo-based assessment is less thorough than in-person trichoscopy. Telehealth physicians may not diagnose co-existing scalp conditions (seborrheic dermatitis, alopecia areata, tinea capitis) that can mimic or accompany AGA. Not appropriate if you have an atypical or uncertain hair loss pattern.

2. Primary Care Physician

Your primary care physician can prescribe finasteride for AGA. This is appropriate for most men without unusual features. The evaluation will include a clinical history, a brief scalp examination, and confirmation that AGA is the likely diagnosis. Most PCPs will also record a baseline PSA before prescribing, especially in men over 40.

3. Dermatologist (Recommended for Uncertain Diagnosis)

A dermatologist provides the most thorough evaluation, including trichoscopy (dermoscopic examination of the scalp), scalp biopsy if needed, and laboratory evaluation for other causes of hair loss (thyroid, iron, androgens). A dermatologist visit is most appropriate if:

• Your hair loss pattern is atypical or diffuse
• Hair loss started suddenly or is rapidly progressive
• You have scalp symptoms (itching, scaling, inflammation)
• You are not responding to finasteride after 12 months
• You are a woman considering off-label finasteride for FPHL

What to Discuss With Your Doctor

• Your hair loss history, timeline, and family history of AGA
• Current medications (particularly those affecting hormones or sexual function)
• Baseline sexual function (important for monitoring for changes)
• Any history of depression, anxiety, or mood disorders
• Prostate symptoms or family history of prostate cancer
• Plans for fathering children (relevant to finasteride’s semen effects)

Related: Finasteride cost guide | Dosage guide | Side effects guide