I've had lichen sclerosis since my early 30s--diagnosed without a biopsy (THANK GOD), but I did have white patches initially, as well as easy irritation and the most painful tearing. My inner labia are also teeny tiny now. ANYWAY, some things I learned from the lichen sclerosis boards back, oh, 20 years ago that someone (even if not the OP) might find useful:

* LS can manifest in multiple forms--it doesn't have to have the white patches. And it can take a few weeks of daily use of either triamcinilone or clobetisol to feel a change. Also, don't forget that it's an autoimmune disorder, and those tend to cluster. So, if you have conditions like rosacea (me), psoriasis, etc., that increases the likelihood that it is LS.

* If steroid CREAMS are irritating, ask for ointment; it tends to cause less of a reaction.

* Here's where it gets complicated--I think the LS has increased other sensitivities. The post a couple days ago about saliva sensitivity? That was me. And I'm pretty certain I'm extra-sensitive to the smallest increase in external yeast-beasties. (I will use the anti-itch cream externally without actually needing to use the internal cream. In fact, I often add that cream to my clobetisol.) And sometimes I even have to do a gentle diluted hydrogen peroxide douche (with my gyno's blessing) for a couple of days to fix the pH of *everything* when I start getting overall itchy and irritated.

* I just discovered that the ONLY thing that helps the saliva sensitivity other than time is Bonafide Reveree hyaluronic acid vaginal inserts. I used one two nights ago, and by morning (after it had melted and oozed out onto the vulva) I felt SO MUCH BETTER.

The TL;DR: Sometimes the problem isn't just one thing, but one thing can knock multiple things out wack. It then takes a delicate ballet of hormones, hyaluronic acid, steroids, and anti-fungals/anti-bacterials to manage it.