Choosing between Keeps and Strut for hair loss treatment means deciding between budget-friendly FDA-approved generics and premium custom compound formulations. Keeps offers the industry's lowest-cost access to FDA-approved medications at $39/month for finasteride + minoxidil combination, backed by decades of published clinical data (in the PROPECIA trials described in the FDA label, 66% of treated men showed increased hair growth at 2 years versus 7% on placebo; individual results vary). Strut provides compound formulations at $119-139/month including topical finasteride, high-concentration minoxidil, and multi-ingredient proprietary combinations with medical optimization. This evidence-based comparison examines the 205-257% cost difference ($4,800-6,000 over 5 years), clinical effectiveness, FDA-approval distinctions, and value propositions to help you choose between proven affordability and premium personalization. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Overview: Budget Hair Loss Specialist vs Custom Formulation Platform
Keeps launched in 2017 as a hair loss-focused telehealth platform offering the most affordable access to FDA-approved finasteride and minoxidil medications. The company specializes exclusively in male pattern baldness treatment, providing generic finasteride at $20/month and combination finasteride + minoxidil packages at $39/month. Keeps operates in all 50 states with board-certified physicians conducting streamlined online consultations. The platform emphasizes simplicity, low pricing, and convenient subscription delivery of proven hair loss medications without extras or premium services.
Strut entered the market in 2020 with a different positioning: compound formulations for hair loss at premium pricing. Rather than offering standard FDA-approved generics, Strut partners with licensed 503A compounding pharmacies to create custom-strength medications, proprietary combination treatments, and specialty delivery systems. Their hair loss treatments start at $99/month for topical finasteride formulations and run up to $139/month for multi-ingredient custom compounds. Strut targets patients willing to pay premium prices for personalization and formulations unavailable as FDA-approved products. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
The fundamental difference lies in standardization versus customization and budget versus premium positioning. Keeps provides the absolute lowest-cost access to FDA-approved medications (finasteride 1mg, minoxidil 5%) that have decades of clinical data. Strut offers custom-blended compound formulations at 154-257% higher costs, trading FDA-approved simplicity for customization flexibility. The FDA-approved drugs are the same molecules whichever platform ships them, while compounded formulas lack large-scale efficacy data. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Both platforms employ board-certified physicians with medical licensure and prescribing privileges. Both comply with HIPAA regulations and ship medications from licensed U.S. pharmacies. However, Keeps physicians prescribe only FDA-approved generics following established protocols, while Strut physicians create prescriptions for compounded formulations based on individual patient characteristics and preferences.
For patients deciding between these platforms, the choice centers on value optimization versus personalization preference. Men seeking the most cost-effective access to FDA-approved hair loss medications find Keeps delivers excellent value. Those wanting custom formulations, higher-strength compounds, or specialty combinations prefer Strut's approach despite significantly higher costs.
Pricing Comparison: Budget Leader vs Premium Compounds
Keeps operates as the industry's low-cost leader for hair loss treatment. Finasteride-only plans cost $20/month ($240 annually) for 90-day supplies of finasteride 1mg daily tablets. Combination plans with finasteride + minoxidil cost $39/month ($468 annually), while adding thickening shampoo increases costs to $49/month. These prices include medications, quarterly medical consultations, and free shipping. Keeps charges no consultation fees, no membership fees, and no hidden costs - the monthly subscription covers everything.
Strut charges premium pricing reflecting custom compound positioning. Topical finasteride formulations (finasteride delivered directly to scalp in topical solution) cost $99/month ($1,188 annually). Custom-strength minoxidil formulations (7-15% concentration versus standard 5%) run $99-119/month. Multi-ingredient combination topicals blending finasteride + minoxidil + tretinoin + biotin cost $119-139/month ($1,428-1,668 annually). Initial consultations cost $49 versus free evaluations through Keeps. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Cost differences over time become substantial. For standard combination treatment (finasteride + minoxidil), Keeps charges $39/month ($468 annually, $2,340 over 5 years). Strut's custom topical combinations cost $119-139/month ($1,428-1,668 annually, $7,140-8,340 over 5 years). This represents a $4,800-6,000 premium over 5 years - 205-257% more expensive for Strut's custom compounds versus Keeps' FDA-approved generics.
The pricing premium for Strut buys several differentiators: topical finasteride delivery systems reducing systemic absorption, higher-concentration minoxidil (potentially more effective but also more irritating), multi-ingredient proprietary combinations, and formulation adjustments based on individual response. Whether these justify 205-257% higher costs depends on whether standard FDA-approved medications work adequately or you need compounded formulations.
Neither platform accepts insurance for hair loss treatment, as insurers classify male pattern baldness as cosmetic rather than medical. Both accept HSA/FSA funds for tax-advantaged payment. According to
IRS Publication 502, prescription medications including hair loss treatments qualify for HSA/FSA reimbursement. However, the $4,800-6,000 Strut premium over 5 years represents significant discretionary spending even with tax benefits.
Treatment Options: FDA-Approved Standards vs Custom Compounds
Keeps provides FDA-approved generic medications in standard formulations. Finasteride comes as 1mg daily oral tablets (generic Propecia) that block DHT (dihydrotestosterone), the hormone primarily responsible for male pattern baldness. In the PROPECIA (finasteride 1mg) trials described in the FDA label, an expert panel reviewing photographs found increased hair growth in 66% of treated men after 2 years, versus 7% on placebo; individual results vary. Minoxidil comes as 5% topical solution (generic Rogaine) applied twice daily.
These are the only two medications with FDA approval and strong clinical trial data for male pattern baldness. Keeps' approach provides the lowest-cost access to medications with documented efficacy, established safety profiles, and decades of real-world use in millions of men. All medications are bioequivalent to brand-name Propecia and Rogaine per
FDA bioequivalence standards, delivering active ingredients at essentially identical rates.
Strut takes a fundamentally different approach through compounded formulations unavailable as FDA-approved products. Topical finasteride formulations deliver finasteride directly to the scalp in solution form rather than oral tablets, theoretically reducing systemic absorption and sexual side effects while maintaining scalp DHT suppression. Research on topical finasteride effectiveness remains limited compared to decades of oral data, with small studies showing promise but lacking large-scale clinical trials. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Strut also compounds custom-strength minoxidil up to 15% concentration, versus the FDA-approved 5%. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality. Stronger concentrations are associated with more scalp irritation, itching, and contact dermatitis, and have not been compared with 5% in large trials. Their proprietary multi-ingredient combinations blend finasteride + minoxidil + tretinoin (retinoid that may enhance absorption) + biotin (B vitamin with limited hair growth evidence) + dutasteride (more potent DHT blocker) in single topical formulations tailored to individual responses.
According to
FDA guidance on compounding, compounded medications can provide valuable customization for patients with specific needs but haven't undergone FDA approval processes with large-scale safety and efficacy testing. Strut's compounds use pharmaceutical-grade ingredients from licensed 503A pharmacies, but individual formulations lack the extensive clinical validation of Keeps' FDA-approved generics. For risk-averse patients prioritizing proven treatments, Keeps provides more predictable outcomes; for those wanting customization, Strut offers alternatives.
Consultation Process: Speed vs Depth
Keeps runs quick online medical evaluations built for efficiency and simplicity. The questionnaire takes approximately 5-10 minutes and asks basic questions about hair loss pattern, family history, current medications, and treatment goals. Licensed physicians review submissions within 24 hours, approve standardized treatment protocols (finasteride 1mg daily, minoxidil 5% twice daily), and ship medications within 2-3 days. The entire process from initial evaluation to medication arrival typically completes in under one week.
This efficiency-focused model eliminates unnecessary complexity. For men with straightforward male pattern baldness seeking FDA-approved medications, this approach provides fast, affordable access without lengthy consultations or personalization discussions. Follow-up consultations occur quarterly through brief online questionnaires checking effectiveness and side effects, with option to adjust between finasteride-only, minoxidil-only, or combination plans.
Strut requires more detailed consultations reflecting their approach. Initial evaluations include extended questionnaires about hair loss severity (Norwood scale), previous treatment attempts, side effects experienced with standard medications, scalp sensitivity, lifestyle factors, and specific customization preferences. Physicians review responses and often conduct follow-up discussions about formulation options: topical versus oral finasteride, minoxidil concentration selection (5%, 7%, 10%, 15%), multi-ingredient combinations, and treatment expectations. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
The personalization extends to ongoing formulation optimization. If you report scalp irritation from 10% minoxidil, Strut adjusts to 7% concentration. If you experienced sexual side effects from oral finasteride, they compound topical formulations with reduced systemic absorption. If hair growth plateaus after 6 months, a provider may add tretinoin or dutasteride to the formula. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Follow-up care differs significantly. Keeps conducts brief quarterly reviews through standardized questionnaires, while Strut provides ongoing formulation refinement with monthly check-ins during initial treatment and quarterly optimization consultations. For patients wanting intensive medical partnerships and iterative treatment refinement, Strut justifies premium pricing. For those seeking simple, FDA-approved medications without complexity, Keeps delivers better value.
Medication Quality: FDA-Approved Generics vs Compounded Formulations
Keeps sources all medications from licensed U.S. pharmacies and FDA-approved manufacturers. Their finasteride tablets are FDA-approved generics bioequivalent to brand-name Propecia, meaning they deliver finasteride at the same rate and extent. Minoxidil solutions are FDA-approved generics bioequivalent to Rogaine. According to
FDA bioequivalence standards, generics must demonstrate 80-125% bioavailability within statistical confidence - functionally identical to brand medications.
These FDA-approved generics have undergone rigorous testing including bioequivalence studies, manufacturing quality standards, Good Manufacturing Practices (GMP) compliance, and post-market surveillance. Keeps' medications are the same products dispensed by CVS, Walgreens, and retail pharmacies nationwide - proven, regulated, and extensively validated. All pharmacies maintain state licensing and federal regulatory compliance with routine inspections.
Strut partners with licensed 503A compounding pharmacies that prepare customized formulations based on individual prescriptions. These pharmacies follow USP <795> (Pharmaceutical Compounding - Nonsterile Preparations) quality standards including beyond-use dating, ingredient sourcing verification, preparation protocols, and quality testing. However, individual compounded formulations don't undergo FDA approval - they're created based on physician prescriptions and pharmacy expertise rather than formal drug approval processes.
According to
FDA compounding regulations, compounded medications "have not been evaluated by FDA for safety or effectiveness" unlike FDA-approved drugs. Strut's compounds use pharmaceutical-grade ingredients (USP or NF grade finasteride, minoxidil) from licensed suppliers, but the specific combinations and formulations (finasteride + minoxidil + tretinoin + biotin topicals, high-concentration minoxidil) haven't undergone clinical trials establishing safety and efficacy profiles like Keeps' FDA-approved products. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Safety and predictability considerations favor FDA-approved generics for most patients. Keeps' medications have decades of safety data from millions of men, well-established side effect profiles (sexual dysfunction in 1-3%, scalp irritation with minoxidil), and predictable efficacy outcomes. Strut's compounds offer customization but with less established safety data, particularly for high-concentration formulations and multi-ingredient combinations. Keeps stays inside the FDA-approved products; Strut offers compounded alternatives with provider oversight. Which one fits you is a conversation for a licensed provider.
Results and Effectiveness: Clinical Outcomes Comparison
In the PROPECIA (finasteride 1mg) trials described in the FDA label, an expert panel found increased hair growth in 66% of treated men after 2 years versus 7% on placebo, and at 5 years 48% showed increased growth with 42% rated as no further visible progression. Individual results vary. These outcomes apply to Keeps' FDA-approved generics, which are bioequivalent to the medications used in clinical trials.
Strut's topical finasteride formulations show promise in limited research but lack the extensive clinical validation of oral finasteride. Small studies suggest topical finasteride may reduce scalp DHT with lower systemic absorption, potentially maintaining efficacy while minimizing sexual side effects. However, comparative effectiveness data remains limited. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
High-concentration minoxidil (10-15%) may provide greater hair growth than standard 5% formulations, but also increases side effect rates. Some research suggests higher-strength minoxidil may improve hair density more than 5% solutions, but with significantly higher rates of scalp irritation, contact dermatitis, pruritus, and facial hypertrichosis (unwanted hair growth on forehead, cheeks). The incremental benefit must be weighed against increased side effects and 154-257% higher costs.
For standard male pattern baldness, Keeps' FDA-approved generics deliver predictable, proven outcomes at the lowest cost. The 66% figure comes from the PROPECIA trials described in the FDA label, measured against 7% on placebo at 2 years; individual results vary. Strut's custom formulations may benefit specific patient subgroups - men who experienced sexual side effects from oral finasteride, those with severe hair loss requiring maximal treatment intensity, or patients who didn't respond adequately to standard doses. But for typical patients, standard FDA-approved treatments provide excellent results without justifying 205-257% cost premiums.
Long-term effectiveness requires continuous medication use for both platforms. Hair loss prevention depends on ongoing DHT suppression (finasteride) and follicle stimulation (minoxidil). Discontinuing treatment leads to gradual loss of maintained and regrown hair over 6-12 months. Both Keeps and Strut emphasize that hair loss treatment is indefinite rather than curative, requiring sustained medication use and subscription continuation. Success depends more on patient adherence and individual genetic response than platform choice.
How We Compared Keeps vs Strut
Our Comparison Methodology
This comparison analyzes treatment protocols, pricing structures, medication sourcing, and clinical evidence from both platforms.
Regulatory Framework: FDA bioequivalence standards (FDA Generic Facts) and FDA compounding regulations (FDA Compounding Q&A).
Pricing Analysis: Pricing reflects the rates last recorded in our provider database; providers change prices frequently, so confirm current pricing directly at checkout. Long-term calculations show 5-year total costs accounting for subscription fees and initial consultations.
Service Verification: Platform capabilities, physician credentialing, compounding pharmacy partnerships, and medication sourcing evaluated through detailed review of service offerings and regulatory documentation.
Our analysis is our own editorial work. Most of the providers compared here pay ManyTreatments a commission when you buy through a link on this page. Nobody pays us for a placement, a rating, or a listing, and we are not going to add that commissions have never influenced anything, because that is a claim about our own conduct we cannot show you evidence for. Our goal is to provide evidence-based comparison helping men choose between budget-friendly FDA-approved medications and premium custom formulations based on clinical needs, side effect experiences, and financial priorities.
Final Verdict: Keeps vs Strut
Final Verdict: Budget FDA-Approved vs Premium Custom Compounds
Choose Keeps if you:
- Want the lowest-cost hair loss treatment ($39/month vs Strut's $119-139/month)
- Have standard male pattern baldness without previous treatment complications
- Value FDA-approved medications with decades of safety and efficacy data
- Prioritize outcomes documented in the FDA label (66% of treated men showed increased hair growth at 2 years versus 7% on placebo; individual results vary)
- Want simple, streamlined treatment without personalization complexity
- Seek to minimize long-term costs ($2,340 vs $7,140-8,340 over 5 years)
Choose Strut if you:
- Experienced sexual side effects from oral finasteride and want topical formulations
- Need higher-concentration minoxidil (10-15%) beyond FDA-approved 5%
- Didn't respond adequately to standard finasteride + minoxidil combinations
- Want multi-ingredient proprietary formulations and optimization
- Value intensive medical consultations with ongoing formulation refinement
- Can justify 205-257% cost premium ($4,800-6,000 more over 5 years) for customization
The optimal choice for most men:
For standard male pattern baldness without previous treatment complications, Keeps provides exceptional value: FDA-approved finasteride + minoxidil at $39/month ($2,340 over 5 years) backed by decades of published clinical evidence (66% of treated men showed increased hair growth at 2 years versus 7% on placebo in the PROPECIA trials; individual results vary). The $4,800-6,000 savings versus Strut represents enormous cost efficiency for equivalent standard treatment.
For men with specific complications - sexual side effects from oral finasteride requiring topical alternatives, inadequate response to standard concentrations requiring customization, or scalp sensitivities needing formulation adjustments - Strut's compounds justify premium pricing through clinical necessity rather than preference.
Strategic recommendation: Start with Keeps' affordable FDA-approved medications to establish baseline treatment response. If standard finasteride and minoxidil work well for you, you save thousands. If you experience side effects or inadequate response, escalate to Strut for custom formulations. This tiered approach optimizes value while maintaining access to personalization when medically justified. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Frequently Asked Questions
Which platform offers better value for hair loss treatment?
Keeps offers dramatically better value for standard hair loss treatment, charging $39/month ($2,340 over 5 years) for FDA-approved finasteride + minoxidil combination versus Strut's $119-139/month ($7,140-8,340 over 5 years) for custom topical formulations. Both use the active ingredients finasteride and minoxidil, with Keeps offering the standard FDA-approved forms (in the PROPECIA trials described in the FDA label, 66% of treated men showed increased hair growth at 2 years versus 7% on placebo; individual results vary) at far lower cost. Unless you have specific medical reasons requiring custom formulations - previous side effects from oral finasteride, need for higher minoxidil concentrations, or inadequate response to standard treatment - Keeps delivers superior financial value. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
When does Strut's custom approach justify the higher cost?
Strut justifies premium pricing if: (1) You experienced sexual side effects from oral finasteride and want topical formulations with reduced systemic absorption, (2) Standard 5% minoxidil produced inadequate results and you want high-concentration formulations (10-15%), (3) You prefer multi-ingredient proprietary combinations not available as FDA-approved products, (4) You value ongoing formulation tweaks and monthly medical consultations. For most men with standard hair loss responding adequately to FDA-approved medications, the $4,800-6,000 premium over 5 years is difficult to justify based on clinical evidence alone. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Are Strut's custom compounds as effective as Keeps' FDA-approved medications?
FDA-approved oral finasteride and minoxidil 5% have decades of clinical data; in the PROPECIA trials described in the FDA label, 66% of treated men showed increased hair growth at 2 years versus 7% on placebo (individual results vary). Strut's topical finasteride shows promise in limited research but lacks large-scale clinical validation. Higher-concentration compounded minoxidil (10-15%) has not been compared with the FDA-approved 5% strength in large trials, and stronger concentrations are associated with more scalp irritation. For standard male pattern baldness, Keeps' FDA-approved approach provides more predictable, proven outcomes. Strut may benefit specific subgroups requiring customization, but most patients achieve excellent results with standard treatments at much lower cost. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Does topical finasteride from Strut cause fewer side effects than oral?
Topical finasteride theoretically reduces systemic absorption and sexual side effects while maintaining scalp DHT suppression. Limited research suggests lower side effect rates, but data remains preliminary. Oral finasteride causes sexual dysfunction in 1-3% of men according to large clinical trials. Topical formulations may reduce this to <1% based on small studies, but strong comparative data is lacking. If you previously experienced side effects from oral finasteride, topical formulations represent a reasonable alternative worth trying. However, for men without side effect history, FDA-approved oral finasteride provides proven effectiveness at much lower cost through Keeps.
Can I switch from Keeps to Strut if standard treatment doesn't work?
Yes, and this represents a rational escalation strategy. Starting with Keeps' affordable FDA-approved medications ($39/month) allows you to determine if standard treatment works adequately. In the PROPECIA trials described in the FDA label, 66% of treated men showed increased hair growth at 2 years versus 7% on placebo; individual results vary. If you respond well, you save $4,800-6,000 over 5 years versus starting with Strut. If standard treatment proves inadequate or causes side effects, you can upgrade to Strut for custom formulations, higher concentrations, or specialty combinations. This tiered approach optimizes costs while maintaining access to personalization if medically necessary. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Which platform provides better results for hair regrowth?
For standard male pattern baldness, results depend primarily on the medications (finasteride, minoxidil) and individual genetic response rather than the platform. Keeps dispenses the FDA-approved generics; in the PROPECIA (finasteride 1mg) trials described in the FDA label, 66% of treated men showed increased hair growth at 2 years versus 7% on placebo (individual results vary). Strut uses the active ingredients in different compounded delivery systems and concentrations, with limited comparative effectiveness data. Both platforms can produce excellent results for typical patients. The choice between them should be based on cost optimization ($39/month Keeps versus $119-139/month Strut), personalization needs, and FDA-approval preferences rather than inherent efficacy differences. Compounded medications are not FDA-approved and have not been reviewed by the FDA for safety, effectiveness, or quality.
Editorial Note: Researched and edited by our editorial team. AI tools assist with initial research and drafting; all content is fact-checked and edited by humans before publication. Learn more about our editorial standards
