I've had fissures on and off for many years now

GPs always prescribed nifedipin cream and that helped fairly quickly, but the problems always came back.

I finally went to a proctologist and he said it wasn't a classic fissure. It's not related to the tonus of anal sphincter, it's too far "out". It's in the "canal" when I'm normal, and it faces the outside when i consciously relax.

He said it was probably linked to some type of allergy. Like wet wipes or soap (but I don't use that) or toilet paper (apparently recycled toilet paper can be an issue). But that it would be difficult to figure out what's causing it exactly.
He prescribed Cortisone type of ointment (Advantan) for 1 week and then some very fatty hydrating cream (almond oil).
That didn't help.

After some months of back and forth, and trying cortisone again, and quite some pain, I went back to Nifedipin and that helped much faster.

That confused him. He doesn't understand why Nifedipin helps. He could see the fissures (there were 4), but there were too far out. He's convinced it's a skin issue and doesn't understand why nifedipin helps.
He was very sorry that he couldn't help. It's very frustrating. But at least he didn't suggest surgery for no reason.

So I continued with Nifedipin until it healed, switched to Advantan for two weeks and then switched to a dexpanthenol ointment (Bepanthen). The almond oil was way too oily... I would end up with embarassing stains on my trousers.
He also said I could use the cortisone twice a week. That the skin wouldn't get used to it, if it was just twice a week.

I just stopped taking the laxative powder and switched to psyllium husks. Let's see how that goes.
Otherwise he's going to send me to a dermatologist.
I don't have any other obvious skin problems. I tend to have dry skin and it has caused some inflammation and a tiny little tear on the penis in the past... And I also get hematomas that stay a while tiny little red dots. Some kind of eczema. I've had them checked out and it's nothing serious.

Anyone else has experience with dermatologist for fissures?

Hey did you ever get your issue sorted out? I feel like I am in a similar boat. Seems more like a skin issue. Did dermatologist help?