Most anal fissures heal in a few weeks once stools stay soft and the sphincter stops spasming, helped along by a prescription ointment.
A fissure that reopens after the next hard stool is a muscle problem as much as a skin problem: the tear is small, but the surrounding muscle clamps down, cuts blood supply, and keeps the cycle running. Success depends less on finding a miracle product than on three things: softer stools, warm shallow baths, and an ointment that relaxes the sphincter. Most fissures heal without surgery when these are used consistently.
Can An Anal Fissure Heal On Its Own?
Yes. Most heal on their own in a few weeks, especially when constipation and hard stools are addressed; self-care is first-line treatment, not a waiting room before something stronger.
NHS guidance recommends plenty of fluids, a high-fibre diet, and warm shallow baths after bowel movements. NHS Scotland adds: aim for soft, toothpaste-like stools, do not strain, and do not delay a bowel movement. Two habits work against healing: opioid painkillers, including codeine, slow the gut and harden stool, and If constipation is tied to a medication, review it with a GP or pharmacist.
Which Creams And Ointments Actually Help?
Two prescription ointments have the strongest support: nitroglycerin and diltiazem. Both relax the anal sphincter so blood reaches the tear. Numbing gels and barrier creams ease symptoms without closing the fissure; steroid or hemorrhoid creams rarely help either.
Mayo Clinic’s anal fissure treatment guidance spells out both.
| Ointment | What It Does | Typical Course |
|---|---|---|
| Nitroglycerin (GTN) | Relaxes the sphincter and boosts blood flow to the tear | Every 12 hours, up to 3 weeks |
| Diltiazem | Relaxes the sphincter when first measures fall short | Twice daily, about 2 months |
| Lidocaine 5% gel | Numbs the area before a bowel movement | Short-term, 20–30 minutes before |
| Hydrocortisone 1% | Soothes skin; little effect on healing | Short-term symptom relief |
| Petroleum jelly or zinc oxide | Barrier comfort between bowel movements | As needed |
| Steroid and hemorrhoid creams | May calm irritation; a NIH review finds them ineffective for healing | Not a fissure treatment |
NHS leaflets stress short-term use only, since longer use can irritate or sensitize the anal canal. Petroleum jelly, zinc oxide, and 1% hydrocortisone may soothe the area, but a NIH review states steroid creams and hemorrhoidal ointments are usually not effective for healing. If you would rather start with something you can buy today, a tested comparison of creams for anal fissures covers the over-the-counter shelf.
Treating A Fissure At Home: Ointment Steps And Next Options
Fissure ointments only work when used on schedule for the full course, and the dose is tiny.
NHS patient leaflets take a gentler line generally, advising you to apply ointment to the rim of the anus rather than pushing inside, and to finish the whole course even if pain fades early. Your prescriber’s instructions win wherever the two differ.
If several weeks of consistent treatment change nothing, or fissures keep returning, options escalate to botulinum toxin injection or lateral internal sphincterotomy.
The routine that gives a fissure its best odds:
- Fiber and fluids daily, aiming for soft, toothpaste-like stools.
- A warm shallow bath after each bowel movement.
- The prescribed ointment twice a day for the full course — 3 weeks for nitroglycerin, 2 months for diltiazem.
- No opioid or codeine painkillers while it heals.
Common Questions
How Long Does An Anal Fissure Take To Heal?
Most acute fissures close within a few weeks of consistent stool softening and ointment use. Pain often fades before the tear is fully closed, which is why NHS leaflets tell patients to finish the whole prescribed course rather than stopping when it feels better.
Can I Use Hemorrhoid Cream On A Fissure?
You can, and it may calm surface irritation, but it will not close the tear. A NIH review found steroid-based creams and hemorrhoidal ointments are usually ineffective for fissure healing. The options with solid evidence behind them — nitroglycerin and diltiazem — relax the sphincter, the part that keeps the wound open.
What Happens If A Fissure Will Not Heal?
Chronic fissures get escalated. When conservative treatment fails, doctors typically move to botulinum toxin injection, which temporarily relaxes the sphincter, or lateral internal sphincterotomy, a minor operation that releases a small part of the muscle.
Sources
- Mayo Clinic.
- NHS. Anal fissure Supports self-care guidance and the short-term limit on anesthetic creams.
- National Institutes of Health (PMC). Review of anal fissure treatment Supports the finding that steroid and hemorrhoidal creams rarely heal a fissure.