I've been through an ordeal the past couple months. I had a bad straining BM and then a month or so of very sharp brief stinging pain when passing stools. I've always had skin tags, one on right has always been a bit larger, but never really any issue with it. Went to doc recently, he thought it might be fissure. Gave me Nifed/Lido. Used it for awhile, mixed results. Didn't do much for pain, but recently, the pain changed from a brief stinging pain when passing stool to a sore outer butt, on the right skin tag area, to the touch. So now I'm thinking it wasn't a fissure, but maybe the external hemrrhoid. Not sure.

Last couple days the pain seems to have shifted from more inside to outside, and this morning, the skin tag or hem whatever you want to call it was swollen & much more sore. Going back to the doc yet again soon for yet another opinion. Colorectal surgeon looked at me awhile back, but said the skin tags were small & would be more trouble removing than leaving on. But now the one on the right is causing me considerable discomfort. If I move a certain way, it throbs.

Here's my quesiton. Until I see my doc yet again, should I keep using the Nifed/Lido in case there is also a fissure? I got some witch hazel wipes on advice of the on call doc, using them sparingly. Will see if that helps. Should I also keep doing sitz?

Because I've heard the treatments for hems/fissures are different, and since I still don't know which I have, I'm not sure what to do. I'm so confused, why can't anyone give me a straight answer.

Sorry Alex....only just seen your post..... Hope you have seen your dr by now.

As for treating hems and fissures.... You are right, they are usually different.
You could try keeping on with the cream for the fissure, and maybe icing the hem a couple of times a day to see if that gets the swelling and discomfort down. I just usually scrape off a bit of ice from the freezer, wrap it in cling film, and hold it on for a few seconds at a time, for a few minutes.

Hope that helps!

Omb