Does using a steroid cream worsen the anal fissure?

Question

Hello doctor,

I was diagnosed with anal fissure one and a half years ago. The doctor prescribed me some topical steroid cream (Anovate) and I have used it for about eight months. My fissure has healed, but I have constant pain, itching and pricking sensations around the anus while walking.

I am not able to walk normally and even when I walk for five minutes, I start developing pricking pain, itching and burning sensations around the anus. Now, I do not have any fissures, but my bowel movements are painful. I have developed stretch marks around the anus.

Since it is a steroid cream, my doctor told me that it would take some time to recover, but I am scared and do not know what to do. My concern is whether the skin will recover to normal, and if so,

What is the recovery duration?

I am not able to walk even for five minutes. Kindly suggest what to do. I have stopped using the steroid cream for a year and am using only coconut oil, but the itching and stinging persist.

Since it is a steroid cream, is there any possibility of skin thinning, and if so, how long will it take to recover?

Please suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

The treatment given was correct for anal fissure. Even after stopping the ointment, you still have some new symptoms related to the anal region. The ointment usually never causes problems in the anus. But if the fissure (wound) is bigger, then it may lead to scar formation during the healing process.

The scar may stretch the nearby skin or muscles, thus causing inconvenience, burning, and itching sensations. The recovery of the skin is solely based on the size of the fissure. Steroids have some local skin side effects, which will be reversed within three months of stopping the ointment.

After four to six months, there will be no reversibility. According to the recent diagnosis, it was diagnosed as an anal fissure. There is a high chance of having new or old non-healing fissures.

Along with the Anovate ointment, you can add the following medical advice.

Curd or buttermilk should be consumed every day in food. Tender coconut water, fresh fruit, and lemon juice are also good.
Stop or reduce spicy foods and chicken. Fish, eggs, and mutton can be taken.
Ensure that there is no constipation. You should pass stools every day without stress. If this can be done, then your fissure will heal.
Maintain strict hygiene by cleaning the anus with water followed by cleaning with a towel. After drying, you need to apply the ointment.
Internally, the Naga Parpam tablet can be taken in the morning and evening after food.
You should apply sesame oil (Gingley oil) to the head and the whole body. Leave it for one hour. Then, take a bath in warm water. This should be done once. This will maintain the normal body temperature. The excess heat will be sensed in the mucous membranes.
If you are continuously sitting and working, then please relax every half an hour. If you sit for a long period, the temperature in the anus will increase, affecting the fissure.

I hope this answers your query.

Let me know if I need to assist you further.

Thank you.

Answer 2

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

Usually, steroids delay wound healing in fissures. The second thing is that steroids make the skin thin. If you continuously apply steroids to the wound, it will heal, but it will take some extra days or weeks. Wounds healed in this way (with steroids) will have less fibrous tissue (or scar tissue). This is one effect. It is not related to your case.

The meaning of my answer is that once you stop the steroid ointment, the reversal of changes happens within four months. After that, there will be no reversal of the steroid effect. You cannot expect (no need to wait) any further reversal of steroid side effects after four months.

Whatever skin thinness happened due to the steroid, you see now (after four months of stoppage of steroid ointment), will be permanent. This will not reverse. That is the meaning of my sentence. During your recent visit, your doctor diagnosed it as an anal fissure. It means you still have the fissure.

So, your pain during walking is due to fissures and any old residual effect of the steroid. But, I am sure the steroid effect in your case (anal region - the wound is small) is very less. You can take treatment for a fissure.

I hope this answers your query.

Let me know if I need to assist you further.

Thank you.