Had this stupid fissure since September, healed and then re-tore in December. I've been on compounded nitro/Vaseline since Jan. 18th twice daily, using Vaseline before any bms, taking 2 sitz baths a day, fiber and loads of water. I also have IBS. The last time I had pain was on Feb. 1st. The nitro has been wonderful for my healing. I saw my CRS on Feb. 26th and he said the fissure was 90% healed and to use the nitro for one more month. The last few days I've had some irritation in my anal area. Not itching just irritation and only when sitting. Everything looks normal there and I am not having any other fissure pain. No spasms, comfortable bms etc. Could the nitro be causing the irritation? I hope not because it's the only thing that has helped and I dread not using it. Sometimes I wonder if constantly putting all this stuff on my butt is just causing more problems!
What do you think? Should I start to wean off the nitro? CRS said my next option if it returns is Botox. Honestly, any of these surgeries scares me to death!

I started to get some irritation (burning) from nitro about 14 days in. But only after BM. So now I use nitro before BM, diltiazem after, and nitro in the evening. Seems to work better.

Nitro has also been my savior at this point. In the beginning I got off it to quick and had a re tear and 2 weeks later I am just healing up. Needless to say I will stay on continue diet and Miralax for some time. I have plenty of irritation in this area due to the fissures and the baggage they bring that are not tears. I am currently working to resolve them but have not come across an easy answers just tube after tube of hopeful remedies. In summary I don't have an answer for you but I have been contemplating the step down myself and think I will just cut one application a day out then continue down from 3 to 2 for a couple weeks then one for a period. I have no intention of jumping off any time soon though. Good Luck and I will be watching this one for suggestions.

Vin nitro works, but it can cause irritation and rashes.
I stayed with it as long as I could, but after the irritation the rash turns into terrible itching and after the itching I developed blisters, it took 4 months for all this to happen, because I wanted to stay in the nitro as long as I could.
So be carefulful.