@julievansickle @sue225 and others…
For what it’s worth this is what I have been doing successfully for Lichen Sclerosis. Has taken years, but this is the perfect cocktail for me. Everyone is different, so your regimen may vary. Confer with your doctor(s). I am focused here on the vulvovaginal region, but may pertain to other areas.

Lichen Sclerosis: Betamethasone did not work for me. Successfully using Clobetasol (Temovate). Per Mayo Clinic, every day initially (or if outbreak) until under control (1-2 weeks?), then 3x/week ongoing. That’s what works for me. Topical steroid ointment.

Cracks/fissures/tears/bleeding: For me, a tear or fissure triggers the lichen sclerosis and results in fusing/scarring. Per my dermatologist, I am successfully using Mupiricin (Bactroban). Daily until fissure(s) under control, then just as needed and often after sex. Couldn’t be having sex without it. Heals a fissure quickly before the lichen sclerosis kicks in. Antibiotic ointment.

Yeast: Per my doctor Mayo Clinic, #1 cause of fissures is yeast. Mayo prescribed one Diflucan (Fluconazole) tablet the first of every month to keep the yeast at bay. Seems to help.

Daily Moisturizer: Various, but I use a thin application of Aquaphor or Vaseline daily.

Lubricant for sex: Coconut oil externally. ‘Luvena Vaginal Moisturizer & Lubricant’ internally, if needed. Can get Luvena over the counter or online. Mayo Clinic advised some studies show Luvena (or similar product) internally 3x/week can keep inner tissues healthier as we age. (Ensure product is natural… does not contain sulfates, parabens, etc)

Estrogen: If needed for post menopause. Not directly related to Lichen sclerosis, but does complicate the issue. I was previously using the eString, which I absolutely loved. Insert vaginally and change every three months. However, I’ve discontinued due to breast cancer. Now cancer-free, may resume since cancer was triple negative for hormones. So far, I’ve been doing OK without it. However, It’s not uncommon to need a little of some form of estrogen. Confer with your doctor.

Realize this is a lot to consider and sometimes it can be a downer. However, relief from discomfort and being able to be intimate with my life partner is paramount. We pamper our faces, our hair, our nails, shave our legs, etc… I simply integrate it into my routine and move on. Sometimes I slip up, but then I just get back to it.

Hang in there! Hope this helps someone. Blessings to all. Grateful to be alive.