What maintenance therapies do you most commonly recommend for patients with improving genital lichen sclerosis?

Betamethasone dipropionate with clotrimazole cream is my treatment of choice to provide a sufficiently potent corticosteroid while mitigating the risk of secondary Candida infections. Adjust the frequency of application from daily to once weekly to every other week for severe symptoms vs maintenance...

Betamethasone ointment weekly can maintain many patients. I like 10-12 weeks of daily use when it’s hot. 15 grams can last a whole 6-12 months and low risk medication. I used to use tacrolimus but now have moved away from that.