I did everything you were supposed to do. I found a saddle that worked, I found shorts that worked, I trialed different creams/lubricants, I had my bike fit to me... I have never had saddle sores before but I got them at TransPortugal. I think the difference was that I was off road and the bumping and jarring led to friction blisters over my sit bones.While the reasons why are important, what I want to share here is what to do once you have them.
First of all, stock up on hydrocolloid dressings. These aren't obvious at the pharmacy but you can often find them as a blister care dressing like these that I used. This is actually a nice summary on why hydrocolloids work and how to use them.
But beware, although these dressings are meant to be left in place for multiple days, that's not going to work on a multi-day stage race. You'll have to change them everyday and you'll have to tape them in place to make sure they don't move. Here are your step by step instructions:
1) Clean the wound and the area you expect to tape well with alcohol. You have to get rid of any skin oil or lotions or the tape and dressing won't stay in place.
2) Apply the dressing to the saddle sore.
3) Tape the dressing in place using Kinesiotape. Cut the tape to the desired length and use scissors to round out the corners. Stand on one leg with the opposite foot (the side to be taped) on a chair simulating the position your leg will be in at the top of the pedal stroke. Rip off about 1 inch of the backing on the kinesiotape and apply it without any stress or tension on the tape. Rub it in place to get a good contact point, then tension the tape along it's length as you apply it to the skin, covering the dressing and holding it in place. Leave about 1 inch at the end to be applied to the skin without tension.
4) Grease up with your preferred skin lube over any other friction areas like at the edges of the chamois and seams. I like A&D Lotion, it's cheap and it works.
5) Put on your favorite riding shorts.
6) Put on a second pair of riding shorts. Then go out and ride again.
This routine got me through about another 700 km of mostly off-road riding and my saddle sores were actually healing, not getting worse. Trust me, this works.