I am new to this forum & new to this medical issue. Had a colonoscopy last year, all good, thank goodness but my doctor mentioned I had an internal hemorrhoid & could take care of it for me. But it NEVER bothered me so I was like no thanks. Over 2 weeks ago, I was straining on the toilet (and I never have constipation or a hard stool problem) but this was hard and when I finally had the BM, it was so painful and there was bright red blood in the toilet. Hmm. But the rest of the day my anus really throbbed & hurt. I felt around and there was a large "bean" - I assumed it was my internal hemorrhoid, but now protruding. I had nothing in the house for relief so went got Prep. H Cooling Gel & Tucks pads. It brought relief at first so I thought I was fine and then by that weekend after another BM (not so hard this time) but still painful, esp. afterwards. I call my doctor, of course he's on vacation - it's mid-June, but his associate can see me because I;m in such pain & discomfort. He looks at it & says I have an anal fissure and that "bean" I feel is a skin tag. I get a compounded Rx cream Diltiazem/Lidocaine, some stool softeners and told to take sitz baths. (and to do this for a month then come back to see them). It's now six days later - at first I had two days of no pain but then 3 days in a row - where the BM was semi-hard but painful with the pain afterwards quite deep and throbbing. I'm worried that even with a Q-tip, I'm maybe not getting the cream on the fissure itself since it seems to be UNDER the skin tag - which is rather big. I also know this can take time but I am astounded about how painful it is. I had been dealing with a bad lower back (3 bulging discs) the last 2years but with Physical Therapy & losing over 25 pounds, that was so much better and now this - literally a pain in my ass. Has anyone else had to deal with a skin tag somewhat preventing the proper application of the cream on the fissure itself? Has anyone had the cream help over time? Any info is appreciated. Thanks.

Hi Skoonix. Welcome to the forum. Sorry to hear you have a fissure. The good news is you are getting early treatment though. It should have a good prognosis if you can keep your BMs soft and apply the ointment regularly (2-3 times/day). By the way, the ointment only needs to be applied to the skin around the outer anus as it absorbs into the bloodstream very well in this area. I just apply it gently to my tags. You should be careful not to pull, pry or insert anything until you are healed. The ointment can take several weeks to work though. 8 weeks is the standard, I believe. Are you taking a stool softener?

Thanks for a reply! Very helpful. I am taking a stool softener - Colace 100mg. The doc said 1 or 2 a day but that didn't seem to do much, so I take 2 in the a.m. and 2 at night & that has helped soften the stools. Yesterday, even with a soft stool it still was painful afterwards, even after a Sitz bath - question - I read conflicting reports on the baths - some say warm and some say HOT. Any personal experience with this re: temperature of the water?

you are very welcome :)

as for the stool softener, not that colace wouldn't work for you, many on here find Miralax to be the best (if you are in the U.S).

As for the baths, I wouldn't think that HOT would be good for anything as you don't want to further damage your skin. I go with warm to very warm, depending on how much the pain seems to be from spasming. Heat will also increase inflammation so that is not good. This would be why prolonged heat would likely add to pain and swelling. Any heat I would limit to 20 minutes at a time but do several times a day.

Thanks for the advice. Yes I'm here in the States. Are you a proponent of the coconut oil added to the bath water? Curious if it works - I've read on here people who swear by it & others who says it didn't help.

I don't put it in my bath but I do apply it externally after. It is nonirritating and moisturizing which is a very good thing. I certainly have not found it to be a cure as some have though. I don't put anything in my bath. I have full baths and think oil in there is just messy, and dangerous as it would be quite slippery (I would think).