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Fissure with 1 cm long hard skin
Fissure occured 4 weeks before
bleeding stopped after 3 weeks and a hard skin of around 1cm long with a small lump at end of this hard skin is formed, lump is at outer side.
and now after 4weeks pain is lesser but still there.
During stool pass that hard skin fails to strech.
Will this hard skin plus lump will soften and stretchable with time.
This hard skin is around 10 days old.
Taking sitz bath after morning and evening stool pass
Applying cremagel after sitz bath both times.
Answers (7)
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From your history, it is encouraging that the bleeding has stopped and the pain has reduced, which suggests that the fissure is healing.
The hard skin with a small lump at the outer end is most likely a sentinel skin tag, which commonly develops in chronic or healing anal fissures.
At this stage (around 4 weeks), it is still early in the healing process. The skin tag may become softer and less tender over the next few weeks to months as inflammation settles.
However, it may not disappear completely, as it is a form of scar tissue. This does not usually interfere with normal bowel movements once the fissure has healed completely.
Continue with sitz baths, apply the prescribed ointment regularly, maintain a high-fiber diet, drink adequate fluids, and avoid constipation or straining during stool passage.
If pain or bleeding persists beyond 6–8 weeks, or if the lump increases in size or becomes very painful, you should consult a general surgeon or colorectal surgeon for examination.
Next Steps
--Continue sitz baths and the prescribed ointment.
--Maintain soft stools with a high-fiber diet and adequate hydration.
--Follow up with a surgeon if symptoms persist beyond 6–8 weeks or worsen.
Health Tips
--Healing of a chronic fissure may take several weeks.
--Do not worry if the skin tag remains after the fissure heals, as it is usually harmless.
--Avoid straining and prolonged sitting on the toilet to promote complete healing
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Based on your history it is suggestive of Chronic fissure with a sentinel pile; But there is no need to worry as of now, and continue the same conservative management which you are doing as of now.
Next Steps
If bleeding or severe pain(Severe, sharp, cutting, or tearing pain during defecation); reoccurs consult general surgeon and get examined.
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Conservative treatment
Diet modification
High fiber
Plenty of liquids
Soft softener
Sits bath
Lox anesthetic medications for pain
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Based on your history, this is most likely a healing anal fissure with a sentinel skin tag (sentinel pile). As the fissure heals, pain usually continues to improve over the next few weeks. The hard skin/skin tag may soften slightly, but it often does not disappear completely and can persist even after the fissure has healed.
Continue warm sitz baths, maintain soft stools with a high-fiber diet, adequate fluids, and stool softeners if needed, and continue the prescribed medication. Avoid straining during bowel movements.
If pain persists beyond 6–8 weeks, bleeding recurs, or the lump increases in size, consult a general surgeon/proctologist for examination, as persistent fissures may require additional treatment.
Next Steps
* Continue sitz baths and prescribed ointment.
* Keep stools soft with fiber and hydration.
* Follow up with a surgeon if symptoms persist or worsen after 6–8 weeks.
Health Tips
* Drink 2–3 liters of water daily and follow a high-fiber diet to keep stools soft.
* Avoid straining or prolonged sitting on the toilet.
* Continue warm sitz baths for 10–15 minutes after bowel movements.
* Use the prescribed ointment regularly as advised.
* Avoid spicy food if it aggravates your symptoms.
* Seek an in-person surgical evaluation if pain or bleeding persists beyond 6–8 weeks, or if the lump enlarges, becomes very painful, or develops discharge.
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You have an acute anal fissure.Please avoid constipation. Take high fibre foods including vegetables and fruits. Please continue sitting bath, apply cremagel. It should gradually resolve and you should be fine. In case of chronic pain and discharge please consult general surgeon.
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Dr. Kunal Majoka
General Surgeon
7 yrs exp
Jaipur
Do sitz bath and take good fibre diet with 4-5 litres of water
For fibres you can take chia seeds
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Dr. Raiba Deshmukh
General Surgeon
10 yrs exp
Pune
Sitz bath
Maintain hydration
High fibre diet
Avoid oily and spicy food
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.