Based on your picture, you have fissures and also some hemorrhoids. It is better if you can get thoroughly evaluated by a proctologist, so that the most appropriate treatment can be advised. You don’t need to undergo surgery directly, unless you have a lot of pain or if you have been suffering with this for a long time. Continue Cremagel ointment for 3 weeks, and then reassess with a surgeon. You can look up further information and treatment options such as laser procedures for anal fissure and piles, on www.surgeons101.com