Disclosure: Some links in this post are affiliate links. As an Amazon Associate I earn from qualifying purchases, at no extra cost to you. Learn more
Specs are compiled from manufacturer listings and verified buyer reviews and can change over time — please confirm the key details on the product page before buying.
An anal fissure is a small tear in the delicate lining of the anus, and it makes something as ordinary as a bowel movement feel like broken glass. If you are shopping for relief, the fastest way to get comfortable again is the right numbing and healing formula — not the biggest tube. This guide compares five treatments by what is actually in them, how they go on, and how quickly they earn their place in your medicine cabinet.
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.
Some of these are traditional creams, one is a suppository, and they all go after the same thing: quieting the pain, the itching, and the burning so your body can do its own healing. Here is how to read the labels and pick the best ointment for anal fissure.
Top Picks
How To Choose The Best Ointment for Anal Fissure
A fissure is a tear, not a bulge, so the ointment you reach for has to do two jobs at once. It needs to calm the raw nerve endings that make every trip to the bathroom miserable, and it needs to protect the torn skin so it can close. Which formula works best for you depends on the active ingredients and the texture.
Look at the active numbing agent first
The single fastest way to blunt fissure pain is an anesthetic, and lidocaine and pramoxine are the two you will see most. Lidocaine usually shows up in higher percentages for deeper numbing, while pramoxine is the active in maximum-strength over-the-counter creams. Either one dulls the sting so you can sit, walk, and use the bathroom without bracing yourself.
Cream, ointment, or suppository
An external cream or ointment is easy to apply with a finger or an applicator, and it works on the outer edge of the tear plus the surrounding skin. A suppository melts inside the anal canal, which is where an internal fissure sits, so a suppository can reach a spot a cream simply cannot. If your doctor tells you the tear is internal, that difference decides your choice.
Watch the added ingredients
After the numbing agent, scan for soothing add-ons like aloe, witch hazel, vitamin E, panthenol, and magnesium sulfate. Those are the ingredients that cool the area and calm inflammation. The flip side is sensitivity — some people react to heavy botanical blends, so a simple formula can be safer for delicate skin.
Side-by-Side Comparison
| Model | Best For | Format | Key Active | Size | Amazon |
|---|---|---|---|---|---|
| Preparation H Hemorrhoid Symptom Treatment Cream★ Best Overall | Everyday multi-symptom relief | Cream (2 tubes) | Pramoxine | 2 x 1.8 oz | Amazon |
| Hemorrhoid & Fissure Treatment Ointment Extra StrengthBest Value | Budget-friendly cooling relief | Ointment | Menthol | 1.41 ounces | Amazon |
| Fissure and Hemorrhoid Treatment with Lidocaine | Targeted numbing on a tear | Ointment | Lidocaine | 0.99 ounces | Amazon |
| Anal Fissure Suppository | Internal fissures and bleeding | Suppository (16ct) | Curcumin & turmeric extract | 3.17 ounces | Amazon |
| Advanced Hemorrhoid Cream 5% Lidocaine & Phenylephrine | Maximum-strength numbing plus shrinking | Cream | 5% Lidocaine & Phenylephrine | 1.5 ounces | Amazon |
Detailed Reviews
1. Preparation H Cream 2 x 1.8 oz
Our pick — over 4.5★ from 4,500+ verified ratings; the strongest balance of quality and price.
The dependable household name that gets you through the worst days without surprises.
For most people dealing with a fissure alongside hemorrhoid symptoms, this is the safest first pick. It is the only over-the-counter cream here built on maximum-strength pramoxine, a numbing agent that dulls pain, burning, and itching at the same time. Two 1.8-ounce tubes come in the box, so one lives in the bathroom and the spare goes in a travel bag or desk drawer.
The formula blends in soothing extras — aloe, vitamin E, and panthenol — rather than leaning on a single numbing ingredient, which is why it feels cooling on contact instead of harsh. Its 4.7-star rating from more than 4,500 buyers is the strongest and most-reviewed showing in this lineup. As buyers put it, the itching quiets down and the relief is real. Others note a slight scent and an almost immediate cooling effect that makes sitting comfortable again.
The honest catch is skin sensitivity — reactions vary, and a few users find it irritating on very raw tissue, so patch-test if your skin runs reactive. This large 9.44 x 6.31 x 2.19-inch twin pack dwarfs the compact single tubes in this guide, which is welcome at home but bulky for a pocket. It is HSA and FSA eligible, which softens the mid-range cost.
The case for the twin pack
- Maximum-strength pramoxine numbs pain, burning, and itching together
- Aloe, vitamin E, and panthenol add a soothing, cooling feel on contact
- Two 1.8-ounce tubes mean a home supply plus a backup
Where it can fall short
- Skin sensitivity varies and a few buyers find it irritating
- The oversized twin pack is bulky to carry
Reach for this if: you want the most proven, multi-symptom cream to keep on hand for everyday flare-ups.
Look elsewhere if: your skin is easily irritated or you need a tube that fits in a purse.
2. Hemorrhoid & Fissure Ointment Extra Strength
An entry-level ointment that leans on a cooling menthol tingle to take the edge off fast.
If cost matters and you want a cooling rather than numbing effect, this is the budget-friendly option. It relies on menthol, the same cooling agent you feel in muscle rubs, plus a botanical blend that includes petrolatum, sophora flavescens root, stellera chamaejasme whole, and cnidium monnieri fruit. Petrolatum seals over the irritated tissue to form a protective layer, which is the part that helps a fissure stop stinging when it comes into contact with the world.
The box includes multiple applicators, so you can apply it with a tool, dab it onto a wipe, or use a finger for external use. At 1.41 ounces it is a compact, single-strength tube that slips into a gym bag or dopp kit. Buyers who switched from a big pharmacy brand report a clear difference after one application, describing a refreshing feel on contact and relief that beats the familiar brand.
The trade-off sits in the smell and the strength. The formula carries a noticeable medicinal odor that not everyone enjoys, and a small number of users simply find it too weak for their worst days. It also makes no claim to shrink tissue the way the lidocaine-and-phenylephrine pick does, so treat it as a comfort cream rather than a heavy hitter.
Fast and affordable: a cooling menthol ointment with petrolatum protection and a gentle botanical blend, all in a pocket-sized tube.
Set expectations honestly: the odor is strong and the formula is mild, so it suits early or moderate discomfort best.
Good match for: budget-conscious buyers who want a cooling, easy-to-apply everyday ointment.
Better to pass if: your symptoms are severe or you cannot tolerate a medicinal scent.
3. Fissure and Hemorrhoid Treatment with Lidocaine
A lidocaine-loaded ointment that numbs a stubborn tear and quiets the itch in one pass.
If the sharp sting of a fissure is your main problem, rather than swelling, start here. This formula pairs lidocaine (a numbing agent) with magnesium sulfate, witch hazel, and aloe for calming, so it hits pain and itch at the same time. It is made in Miami by a veteran-owned, USA-based company, and it is the smallest and lightest tube in this guide at just 0.99 ounces — a hair over half the weight of the big Preparation H twin pack — so it tucks into any drawer.
What wins people over is how quickly it works. Buyers repeatedly report relief by day one and zero pain by day three, including one reviewer whose external hemorrhoid and internal fissure swelling eased within a day. A thick, vaseline-like texture keeps it in place instead of running, and it stays essentially odorless. The consistency is deliberately richer than a standard prep cream, which buyers like for how long it clings to the skin.
Two honest limits. The price sits above the budget tube, and a portion of buyers feel it is steep for the size. The second is scent — a few notice the strong odor and find it distracting. Neither is a dealbreaker, but if you want a bargain tube or a completely fragrance-free formula, weigh those against the numbing power.
Why it leads on numbing
- Lidocaine numbs while witch hazel and aloe calm itch and irritation
- Thick, vaseline-like texture clings to the affected area
- Lightweight 0.99-ounce tube travels easily
Worth weighing first
- The cost runs higher for a small tube
- A few buyers find the scent strong
Top choice for: fissure pain and itching that needs real numbing in a small, portable tube.
Think twice if: you want the cheapest option or a completely unscented formula.
4. Anal Fissure Suppository 16ct
The one pick that melts inside the canal where a cream simply cannot reach.
If your doctor confirmed an internal fissure, or if you are dealing with bleeding, this is the pick that works from the inside rather than the surface. Each suppository is formulated to soothe rectal discomfort and bleeding tied to fissures caused by hemorrhoids, constipation, or diarrhea. It is made with 100% natural diarylheptanoids, curcumin, and turmeric extract, and it is free of harsh chemicals and artificial additives, so it suits skin that reacts to stronger formulas.
The box holds 16 suppositories, and the company behind it is a not-for-profit, women-owned maker that produces in the USA. Buyers repeatedly report bleeding stopping within a day and chronic fissures calming in about six days. One buyer reports bleeding stopped within 24 hours after two suppositories — one at bedtime, one in the morning — with no irritation, itching, burning, or pain afterward.
Two real annoyances to plan for. They melt, so they need to live in the freezer or fridge and go in cold, which some find difficult to insert at first. And the turmeric leaves a yellow residue that stains fabric — wear a liner or old underwear and use gloves, because anything they touch can pick up color. None of that undercuts the relief, but it is part of the routine.
The internal-fissure specialist: 16 cooling suppositories that melt to reach inside the anal canal, built on natural curcumin and turmeric.
Plan around the mess: freeze before use and expect a turmeric stain on whatever they contact.
Best for: internal fissures and bleeding when an external cream has not been enough.
Choose another if: you want a simple rub-on cream or cannot manage a cold insert and cleanup.
5. Advanced Hemorrhoid Cream 5% Lidocaine & Phenylephrine
The heavy hitter that numbs hard and adds a shrinking agent to boot.
When neither a mild cream nor a plain numbing ointment cuts through, this premium pick is the one to try. It carries four active ingredients, headlined by 5% lidocaine for deep numbing and phenylephrine to shrink tissue — the only formula here that pairs a strong anesthetic with a shrinking agent. That combination lets it go after pain, swelling, and the bulge itself rather than just masking the ache.
Four actives is more than any other cream on this list, and around that core the maker adds natural oils — witch hazel, aloe, vitamin E, and horse chestnut — to soothe and calm. It is made in the USA and backed by an empty-tube money-back guarantee. Buyers rank it above well-known pharmacy brands, reporting swelling improved overnight and no sticky petroleum residue.
The trade-offs are price and texture. It sits at the top of the range, and a share of buyers question whether it justifies the cost — though the numbing it delivers is exactly why the devoted keep re-buying it. Thick formulas like these can also be a little stubborn coming out of the tube, so warm it briefly between your hands before applying.
what separates it
- 5% lidocaine for maximum-strength numbing
- Phenylephrine shrinks hemorrhoid tissue rather than only soothing it
- Backed by a money-back promise on the tube
The honest trade-offs
- The price is the highest of the creams in this guide
- The dense texture can resist coming out of the tube
The one to grab if: you want the strongest numbing plus a shrinking agent and don’t mind paying for it.
skip it if: you just want an affordable everyday cream or prefer a lighter texture.
Know the Specs
Numbing agents (pramoxine vs lidocaine)
Pramoxine and lidocaine are the anesthetics that make a fissure cream work. Pramoxine is what you find in maximum-strength over-the-counter creams, and it dulls pain, burning, and itching together. Lidocaine is used in higher percentages for deeper numbing and shows up as a 5% concentration in the strongest pick here. If your priority is quieting sharp pain fast, the specific numbing agent matters more than the brand on the label.
Cream vs ointment vs suppository
The format decides where the treatment actually lands. A cream or ointment is spread on with a finger or applicator and works on the outer edge of the tear and the skin around it. A suppository melts to reach inside the anal canal, which is where an internal fissure sits. Creams are easier for daily use, while suppositories reach a spot a cream cannot touch.
Cooling and soothing ingredients
Beyond the numbing agent, look for ingredients that calm and protect. Menthol delivers a cooling tingle, aloe, witch hazel, vitamin E, and panthenol soothe, and petrolatum seals the skin to shield raw tissue from contact. These are what make a formula feel comfortable rather than simply numb.
Shrinking agents and collagen protection
Some formulas go past numbing and add agents that reduce swelling. Phenylephrine is the shrinking agent used in the premium pick here, helping to reduce the tissue itself rather than only masking the ache. When swelling is the main problem rather than the sting, a shrinking agent is the spec to look for.
Common Questions
Which ointment is best for an anal fissure?
Can a fissure cream be used for both hemorrhoids and fissures?
How long does it take for fissure relief to start?
Should I freeze the suppositories before using them?
Why does the suppository stain my underwear?
Is a lidocaine ointment stronger than a pramoxine cream?
Can I use a fissure ointment while pregnant or nursing?
How do I apply an ointment to an internal fissure?
What if the cream irritates my skin instead of helping?
Do I need a prescription for a fissure treatment?
The Bottom Line
For most people, the ointment for anal fissure winner is the Preparation H Hemorrhoid Symptom Treatment Cream because its maximum-strength pramoxine numbs pain, burning, and itching together in one trusted, multi-symptom formula. If your priority is numbing a stubborn tear, grab the Fissure and Hemorrhoid Treatment with Lidocaine. For a confirmed internal fissure or bleeding, reach for the Anal Fissure Suppository, the only pick that melts to reach inside the canal. And if you want the strongest numbing with a shrinking agent, the Advanced 5% Lidocaine & Phenylephrine cream is worth the step up. Start with the format that matches where your fissure sits, and you will spend less time guessing.
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.
As an Amazon Associate, Aappliancez earns from qualifying purchases. This does not affect which products we feature.