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If you have an anal fissure, the goal is simple: calm the sharp pain and the itching long enough for the tissue to heal. A cream that numbs the area lets you sit, walk, and use the bathroom without bracing for that tearing sting. But not every cream is built to touch a fissure. Some are water-based lidocaine numbing creams. Some add phenylephrine to shrink swollen tissue. Some are suppositories that melt inside for deep, long-lasting relief. The wrong pick can sting, stain, or do nothing at all. This guide walks through five creams and suppositories built for exactly this problem, and what each one actually does best.
This guide is built by comparing the manufacturers’ published specifications and the patterns across verified customer reviews, so you get each pick’s real strengths and trade-offs instead of marketing spin.
The key is matching the formula to your symptom — sharp pain, itching, or bleeding — so we ranked the best cream for anal fissures by what works for each case.
Top Picks
How To Choose The Best Cream for Anal Fissures
A fissure cream has to do two jobs at once: stop the pain signal, and let the torn tissue rest long enough to close. Most products do one of those well and the other poorly. Before you buy, check three things: what the active numbing ingredient is, how fast it works, and whether it will irritate skin that is already raw.
Lidocaine vs. Phenylephrine — what each one does
Lidocaine is a numbing agent — it blocks the nerve signal so you feel less. A 5% lidocaine cream is the highest strength you can buy without a prescription, and it starts numbing in 3-5 minutes. Phenylephrine is different: it is a vasoconstrictor, meaning it narrows blood vessels to reduce swelling and shrink tissue. Some formulas combine both. If your main problem is sharp pain, lidocaine is the key. If your problem is a swollen, bulging lump, phenylephrine is the one doing the shrinking.
Cream vs. ointment vs. suppository
A cream is water-based, absorbs fast, and is easy to wipe away — good for external irritation and itching. An ointment is thicker and oil-based, so it sits on the skin longer and shields it from friction with every step. A suppository is inserted and melts inside, which is why it reaches internal fissures a cream cannot touch. If your fissure is inside the anal canal, no cream will actually make contact — a suppository is the only option that reaches it.
Skin irritation and staining — the hidden deal-breakers
Raw, cracked skin reacts to almost everything. Parabens, heavy scents, and thick petroleum bases can sting on contact. Look for water-based, oil-free, odor-free formulas if you tend to react. If you go the suppository route, know that turmeric-based ones can leave yellow residue on underwear and sheets — manageable, but worth knowing before you buy.
Side-by-Side Comparison
| Model | Best For | Active Ingredient | Format | Target Use | Amazon |
|---|---|---|---|---|---|
| AneCream5 5% Lidocaine Numbing Cream★ Best Overall | Fast numbing for sharp pain | 5% Lidocaine | Topical cream | External pain, itching, burning | Amazon |
| LMNOOP Hemorrhoid Treatment OintmentBest Soothe-First Formula | Soothing internal and external relief | Natural herbal (aloe vera), no lidocaine | Ointment | Fissures, hemorrhoids, perianal wounds | Amazon |
| Doctor Butler’s Hemorrhoid & Fissure Ointment | All-around fissure and hemorrhoid relief | Lidocaine + Phenylephrine | Ointment | Fissures, hemorrhoids, swelling, burning | Amazon |
| Healing Bottoms Anal Fissure Suppository | Internal fissures and bleeding | Natural curcumin & turmeric extract | Suppository (16ct) | Internal fissures, bleeding, deep discomfort | Amazon |
| DERMATOOL Advanced Hemorrhoid Cream | Swelling plus pain, multi-symptom | 5% Lidocaine + Phenylephrine + Witch Hazel | Topical cream | Swelling, pain, bleeding, itching, burning | Amazon |
Detailed Reviews
1. AneCream5 5% Lidocaine Numbing Cream
Our pick — over 4★ from 400+ verified ratings; the strongest balance of quality and price.
The numbing cream that quiets the nerve first and lets the tissue rest second
The most important number here is the 5% lidocaine — the highest strength of this numbing ingredient you can buy without a prescription. That matters because a fissure is essentially a tear across nerve-rich tissue. Numb it, and you stop flinching every time you sit down. AneCream5 starts working in 3-5 minutes, peaks in 20-25 minutes, and holds for about an hour from that peak. For a fissure, that timing is the whole point: apply before a bowel movement or before bed, and the worst part of your day gets easier.
How it feels matters as much as how it numbs. The formula is oil-free, odor-free, and non-greasy — a water-based cream that wipes away clean rather than leaving that heavy petroleum film from thicker ointments. And unlike some numbing products that sting on application, this one earns its reputation for going on without irritation. As one owner put it, “It works, and it does not irritate my skin.” The child-proof lid is a small but genuinely useful detail if you keep it in a bathroom drawer and have curious little ones around.
What owners keep coming back for
- Starts numbing in 3-5 minutes — fast enough to apply before a bowel movement
- Oil-free, odor-free, non-greasy water-based formula wipes clean without a residue film
- Highest over-the-counter strength of lidocaine at 5%
- Child-proof lid for safe bathroom storage
Where it falls short
- The tube is small for the strength you get — a real tube-versus-value question for repeat users
- Numbness peaks around 20-25 minutes and starts fading an hour after that — not a set-and-forget formula
Reach for this if: your chief symptom is sharp, stinging pain right around the anal opening and you want fast numbing before a bathroom trip or bedtime.
Look elsewhere if: your fissure is deep inside the anal canal — a topical cream will not reach it, and a suppository like the Healing Bottoms pick is the better call.
2. LMNOOP Hemorrhoid Treatment Ointment
An herbal-based ointment for anyone who wants to avoid lidocaine and go gentler from the start
Here is the formula that stands apart from the numbing-heavy picks: no lidocaine, no phenylephrine. Instead, LMNOOP builds its relief on natural herbal ingredients, with aloe vera extract doing the soothing work on the skin. That makes it a strong fit if you have reacted badly to numbing agents before, or if your fissure symptoms lean toward burning and irritation rather than sharp pain. It is described as easy to absorb and quick to act on pain, bleeding, burning, itching, and swelling from both hemorrhoids and fissures.
The trade-off is smell. This one carries a distinct minty scent — some buyers like the cooling tingle it produces, others find it too strong for something meant for such sensitive skin. It is also noticeably light in weight and small in size, so if you are a heavy user you may go through it faster than you expect.
The honest catch: the scent is the most polarizing thing about this formula. If you are sensitive to strong smells or share a bathroom, apply it before bed so the tingle eases while you sleep rather than during the workday.
Where it shines: for anyone who wants an aloe-based, non-medicated approach to fissure and hemorrhoid discomfort, this is the gentlest-feeling option that still gets the job done.
Worth trying if: you have not had luck with lidocaine creams or want a soothing, herbal relief option while your fissure recovers.
Go a different route if: you need prescription-strength numbing for sharp pain or want a quick-absorbing formula without any scent — the AneCream5 above is the better fit for that.
3. Doctor Butler’s Hemorrhoid & Fissure Ointment with Lidocaine
The two-in-one formula that numbs the pain and shrinks the swelling in the same application
What sets Doctor Butler’s apart is the ingredient pairing. It uses lidocaine to numb the sharp fissure pain — the same job as the AneCream5 — and pairs it with maximum-strength phenylephrine to reduce swelling. That combination covers two problems at once, which is why buyers who have tried weaker formulas keep coming back to it. The formula is paraben-free and blends aloe vera extract, ginseng extract, and horse chestnut to help shield the skin while it heals.
The size comparison is worth naming: at 1.6 ounces this tube runs slightly heavier than the LMNOOP ointment. That is a real difference if you want the tube to last through a full fissure recovery. It is also made in the USA under quality controls and carries a cruelty-free standard through a Leaping Bunny partnership — two details that matter if you prefer to know where your topical products are manufactured.
The one honest caveat is speed. A couple of users report the numbing fades faster than they expected, and some find that a single application soothes but does not fully heal the fissure on its own. Think of this as a reliever, not a cure — best paired with a healing-support formula and consistent application three times a day.
Why people who try it tend to keep it
- Combines lidocaine numbing with phenylephrine swelling reduction in one application
- Paraben-free with aloe vera, ginseng, and horse chestnut for skin protection
- Made in the USA under quality controls, with Leaping Bunny cruelty-free standards
What to weigh before buying
- Relief may fade faster than expected for some users — this is not a long-lasting numbing formula
- Designed for symptom relief, not a standalone cure for a deep or chronic fissure
Best if you want one tube that does two jobs: numbing sharp pain and shrinking swollen tissue together, with a paraben-free formula.
skip it if: your chief complaint is a deep internal fissure — this ointment sits on the surface, so a suppository is what reaches the inside.
4. Healing Bottoms Anal Fissure Suppository (16ct)
A melt-in suppository that reaches the inside — where no cream can actually go
Here is the one pick that solves a problem the other four cannot. A cream only touches the outside. If your fissure is inside the anal canal, a topical formula is not reaching it at all. That is where a suppository comes in. This one is made with curcumin and turmeric extract — natural ingredients described as useful for soothing rectal discomfort and bleeding tied to fissures, hemorrhoids, constipation, and diarrhea. It is a 16-count box built for a full treatment run.
The freeze-first routine is the key to using it well. Warmer suppositories get soft and awkward; chilled ones slide in more smoothly and feel cooler on insertion, which matters when the area is already tender. The results many buyers report are the strongest case for this format: several describe a chronic fissure that finally eased after creams and salves had failed.
The honest trade-off is cleanup. Turmeric is a bright yellow compound, and these suppositories are known to leave yellow residue on underwear and sheets if you don’t use a liner or gloves. They are also messy to handle at room temperature, and inserting one is not always easy for everyone. Neither of those is a reason to avoid it — it is just the cost of using a melting suppository, and it is manageable with a little planning.
The staining reality: yellow turmeric marks are the most-cited downside. Use gloves, wear a liner on nights you use one, and keep the box in the freezer between uses — problem mostly solved.
Where it wins: internal fissures and bleeding that no external cream has reached, with a natural curcumin-and-turmeric formula rather than a numbing agent.
Reach for this if: you have an internal fissure or ongoing bleeding that external creams have not touched, and you want a natural-ingredient option that gets inside.
Think twice if: stains on fabric or a freezer-and-gloves routine sound like more trouble than they are worth — a surface-only cream may be easier for a purely external problem.
5. DERMATOOL Advanced Hemorrhoid Cream
Four active ingredients in one tube — the kitchen-sink approach for stubborn fissure symptoms
Of the five picks, this is the most ingredient-dense. DERMATOOL packs four active ingredients into one formula: 5% lidocaine for numbing, phenylephrine for shrinking and reducing swelling, and witch hazel for its soothing and astringent action on the skin. Aloe, Vitamin E, and horse chestnut round out the base. That combination targets pain, swelling, bleeding, itching, and burning at once — which is a benefit if you cannot pinpoint which symptom bothers you most and want one tube that covers all of them.
The feel is a strong selling point. Reviewers describe it as non-greasy, smell-free, and free of the heavy petroleum feel that thick pharmacy ointments tend to leave behind. Several note it outperforming the familiar name brands they had been using — a formula that actually absorbs and does not turn every application into a slick cleanup job.
One practical catch: the tube can be stiff to dispense, and getting the thick cream out takes a bit of patience. It is a minor irritation, not a functional problem, but worth knowing if you have limited hand strength.
Why it stands out: four active ingredients means one application addresses pain, swelling, bleeding, itching, and burning in a single step — no layering products.
The small friction point: the formula is thick enough that the tube dispenses slowly. Squeeze from the bottom and be patient.
Pick this one if: you want a single cream that handles every symptom at once — pain, swelling, bleeding, itching, and burning — in a lidocaine-numbing, phenylephrine-shrinking package.
pass on it if: you prefer the standard pharmacy consistency or want the fastest, easiest flow from the tube — the Doctor Butler’s or AneCream5 formats dispense more freely.
Know the Specs
Lidocaine Percentage
The percentage of lidocaine tells you how much numbing power you are getting. 5% is the maximum strength available without a prescription. More lidocaine means faster, deeper numbing — which is helpful if sharp pain is your main complaint, but can feel too intense for some people. If you have reacted poorly to numbing creams before, look for a lidocaine-free option like an herbal or aloe-based formula.
Onset and Duration
Onset is how long it takes to start working; duration is how long the effect lasts. A fast onset — like 3-5 minutes — matters most if you need relief before a bathroom trip or right at bedtime. Duration tells you how often you will need to reapply. Faster-acting formulas tend to wear off sooner; slower ones often hold longer.
Format and Formula Type
Creams are water-based and wipe clean; ointments are oil-based and sit longer for a protective barrier; suppositories melt inside and are the only format that reaches an internal fissure. The right format depends on where your fissure is. A cream for a surface problem, a suppository for an internal one — no product works on a spot it cannot physically reach.
Natural vs. Medicated Ingredients
Medicated formulas use lidocaine, phenylephrine, or both. Natural formulas use plant extracts — aloe vera, turmeric, curcumin, witch hazel, horse chestnut. Medicated options typically numb and shrink faster; natural options tend to be gentler and are a fit if you want to avoid numbing agents. Neither is better — they solve different problems for different skin types and symptoms.
Common Questions
How fast does a 5% lidocaine cream start numbing a fissure?
Can a hemorrhoid cream help an anal fissure?
Is a suppository better than a cream for a fissure?
Does turmeric in a suppository stain underwear and sheets?
Can I use a fissure cream while pregnant or breastfeeding?
Why do some fissure creams sting on application?
Does a fissure cream actually heal the tear or just cover the pain?
Can I use lidocaine cream on the same day as a suppository?
How do I store a melting suppository so it goes in easily?
What is the difference between phenylephrine and lidocaine in a fissure cream?
The Bottom Line
The best cream for anal fissures depends on what your fissure is actually doing. If sharp pain is the worst part, the AneCream5 5% Lidocaine Numbing Cream is the pick — it numbs in minutes, goes on without irritation, and wipes clean with no greasy film. If swelling and pain hit together, the Doctor Butler’s Hemorrhoid & Fissure Ointment pairs lidocaine with phenylephrine so one tube does both jobs. And if your fissure is internal or you are dealing with bleeding, the Healing Bottoms Anal Fissure Suppository is the only format on this list that actually reaches the inside — freeze it first and plan for a little cleanup.
How we choose
We do not accept paid placement. Every pick is matched to a real buyer and a real use-case; we do not hands-on test units.
Sources
Specifications: manufacturer listings and product documentation. Review insights: verified customer reviews, as of October 2026. Pricing: not shown on this page (it changes often); check the current price via the retailer link.
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