What is your approach to managing patients with central centrifugal cicatricial alopecia (CCCA) who do not respond to ILK or doxycycline?   

ILK + doxy of course is the mainstay but when going beyond that these are my typical thoughts: HCQ can help if there is some lichenoid inflammation on path   Spiro+finasteride helps older women who likely also have some component of AGA   10% metformin in a lipoderm cream base has b...