I am on my 14th month with two fissures and three weeks post Botox that did not help (and the exam under anestheia actually made my fissures much worse). : ( In any event, after the Botox I started my third type of cream, nifedipine. I have previously used nitro then diltiazem. None of these creams have helped at all. Over the course of my treatment I have seen three CRS doctors. Each one has said to only apply the cream externally - do not insert anything inside the anus. From reading posts on here, it definitely looks like at least some people are applying these creams internally (as in putting it inside- up into your anus) Is this what most people do? Was it prescribed by your doctor to apply it that way? Do you think it works better than if just applied outside? Or can applying it inside perhaps make your fissuers worse because you may stretch the area??? I know my one fissure is VERY bad. So maybe that’s why the doctors recommend external only treatment. But I am wondering if maybe I try applying a cream internally, it might actually work!!! Desperate to try anything for relief at this point. Thank you!

I was told to apply internally my fissure was bad down to the muscle but it went up inside past the dentate line so I’m not sure if that was why I was to,d to apply internally. In the beginning when we didn’t realise how bad it was I was told applying outside would be fine but inside is okk too.

I apply mine inside just put the cream on a gloved finger an insert it slowing relax an breath just insert it a bit no more then to the first nuckle that legnth is still just appling it to the muscle an not to far up from what I've learnt but recently I've been using a q tip to apply my cream it that's time an I use to q tips to keep pushing the cream to the tip of the q tip it take a few inserts to get it all in there an off the q too but it works for me

Some surgeons recommend that you apply it internally, and some externally. My CRS said to do the latter, and told me that it will be absorbed through the skin and the result would be the same.

Thank you. I saw my CRS today and he again said apply externally and added that it will be absorbed. I think this also prevents you making the fissure worse when trying to apply internally. Thanks!