Here is my situation:  Healing from a chronic fissure of 8 weeks, with the use of 1% hydrocortisone, and mainly witch hazel jel from Walgreens.  This is my go to OTC gel which I use twice only during the day.  I no longer experience intense pain.  I walked about 100 miles over the 8 weeks, took about 200 baths.  Today I only experience very mild irritation upon a BM, which receeds rather quickly to very low background irritation for several hours.  So, for most of the day, I am active and experience no real pain.
One caveat: I found that the 2.5% hydrocortisone prescribed by the doctor caused burning pain after one week, as well as some dizziness, as well as skin problems on my back.  Right now I stay away from Hydrocortisone. And my doctor does not like nitroglycerin, because of side effects.
Getting back to the subject:  Healing from a fissure leaves a small tab that can and may cause trouble in the future.  This tab of skin was more painful than the fissure.  Two:  I have a sentinel hemorroid left over from the fissure.  Without surgery, do I have a chance of the tab receeding to almost nothing and the hemhorroid going away?  I am going to see an superspecialist DR in two weeks to ask him this question because I want to get back to my normal life, of playing tennis and being totally active.  I won't accept a life having to use creams and taking baths all the time.  
Finally, the cause of my fissure, in my mind:  laziness.  During the winter I failed to keep playing tennis, and getting the proper exercise from the waist down.  And, in late May, I picked up something that was too heavy and experienced two fissures.  One healed within two weeks.  The other, way more serious, but is now healed.  If the Doc says I need surgery to completely repair the damage done by the fissure, than so be it.

Hi Putty,
It's good to read you are dealing with your issue in a really positive and determined mindset and I truly wish you all the best. Regarding the Sentinel pile & scar tissue issues, it's a difficult question to answer right now because only time will tell how the area completely heals.
I am healed from a long chronic fissure and am left with both, but neither of which are anywhere near as troubling or as painful as the original fissure.  I do however still continue to experience soreness at times, the odd twinge, at times and a reminder that although healed, I have memories. These aren't in themselves a bad thing as they act as a reminder for me to continue to be careful forever.
I don't know if they will ever go away, I suspect not, but one thing is for sure, based on research and personal views from people on this very site, I will not undergo further surgery and get anything removed unless it reaches a point where life becomes so uncomfortable, I can not cope any longer. Further surgery on excising skin flaps/ tags/ hems can undoubtedly lead to the development of further fissures and I would no way risk an acute fissure again. There are numerous stories on this site (which has proven to be the richest & most reliable source of information and help so far) about this and I would just leave well alone, even if I do continue to experience a little discomfort now & again and do have to take preventative measures now & again too.
My fissure was however, chronic for a lot longer than yours (nearly a year and a half) so you very possibly may make both a quicker recovery and be left with less scarring etc. than me anyway..... On saying this, I no longer have to use all the creams I did. I do continue to use Vaseline religiously before every BM just to lubricate the area and sometimes, a little Coconut Oil after BM's to keep the area nicely moisturised. From a personal cleanliness choice, I do not take a hot bath after every BM anymore, but I do use a shower head to clean up and never paper (unless I really have to) so I guess, I have just made a few toileting changes here & there to make life easier for me.
You do pretty much get back to a normal lifestyle, but I also had to accept that I did have to make the changes needed and will continue to do so, to maintain that lifestyle too.
I really would urge you to consider any further surgery very carefully before doing it because fundamentally, it could actually create more issues for you.

Hi Putty
I had my first fissure eight years ago. It healed with diltiazem in about eight weeks and the accompanying skin tag/sentinel pile also vanished. I was completey fissure free for sevn years. I lived normally, ate and drank what I liked,walked lots and cycled over 100 miles a week. The only adjustment I made was to eat more fruit and fibre and drink more to keep regular BMs.
Last September I had a recurrence. No idea why. I had completely forgotten the first fissure up till then and went into denial. I tried to ignore it and went on a long cycle ride. Big mistake!
To cut a long story short I healed again but because I had to have major stomach surgery for another potentially more serious problem I retore twice because of constipation caused by barium meals, painkillers and so on. I healed again two months ago with nothing but Movicol and I feel perfectly normal though I am still taking 1/4 sachet of Movicol. The point of all this is to let you know that some of us are fortunate enough to be able to heal without any intervention and that each time I have healed -now four if you count retears - the sentinel pile/skin tag has disappeared.
I hope this helps.

"Hear hear" for complete healing.
Hi putty, we are sorry to hear of your recent fissure but from what we have heard so far there may be good news.
Perhaps more than anything size, plays a role in figuring if tag or piles will leave anything behind in the long run. It's good to hear that you said your skin tags are small.
Mine were comparatively small too and you may be talking to the king of recurring AF's here (20 year cycle). But my last fissure was 2+ years ago and now I could not ask for a smoother stronger anal canal than I have now.
Luckily for me I was never too tight so I could put my finger in there and feel the tags and scar tissue. But today I feel nothing whatsoever and I can even depress and stretch the anal wall with zero discomfort. So this is what full healing means for me.
Good luck on your upcoming appointments, we wish you all the best.
HTH

I am going to try to play a little tennis today. Walking is just not enough. I'll be careful. I never had a fissure before. When I first got it, I thought it was an infection. I came close to going to the emergency room the pain was so intense.

Take it easy out there putty
Tennis can be very demanding. We hope you are not overdoing it now. Listen to your butt.

I did try to play tennis and exprienced irritation. Confused, I stopped and waited 'till I see a doctor.  Yesterday I saw a very exprienced physician for fissures. He operates once a week on fissures.  He examined me very thoroughly and told me I do not have a fissure, or my fissure is healed. However, because I still have irritation and soreness, he prescribed nitroglycerin.  Because of all the side effects of this drug, I will use it in very small dosages.  The doc also said I can play tennis.  He also said that surgery is not indicated for me at all.  So, I guess my path to complete healing is thru exercise and time, and conservative use of nitro.  His exam was not comfortabe at all, but it was thorough.  It did irritate my butt.

Hi guys I am new to this forum..I find it extremely useful for tips and information. I am suffering almost 8 yrs with an itchy bottom. I have scratched so much that the skin around my anus is red raw and cut. It is extremely painful and uncomfortable but nothing I have tried has taken away the itch
. I have used prescription creams and over the counter creams to no avail. I have no blood or pressure just continuous itch..This is making my life miserable. Any help would be appreciated

What you have sounds like pruritus ani. You need to see a specialist to determine a treatment.

Thank you. Do u think a dermatologist could be of any help?