Anal Fissure Treatments You Can Buy OTC (2026): Doctor Butler's, Curist, PROKTIS-M and the Cleansers

The tube that names the problem. Doctor Butler's Hemorrhoid & Fissure Ointment states lidocaine and phenylephrine HCl in the listing title and names fissures beside hemorrhoids. Lidocaine's Drug Facts use is temporary relief of pain, itching and burning, which is the fissure's whole complaint; phenylephrine's is temporary shrinking of swollen hemorrhoidal tissue, which covers the sentinel swelling that often sits beside a tear. The ointment base matters here more than on the hemorrhoid page: it stays on the skin as a film, so the numbing lasts into the next bowel movement instead of absorbing away. Directions are the hemorrhoidal standard: adults, up to 4 times daily; under 12, ask a doctor.

The lidocaine caution matters more on a fissure than anywhere: do not use in large quantities, particularly over raw surfaces or blistered areas, and a fissure is a raw surface. Apply sparingly. Phenylephrine's ask-a-doctor conditions apply too: heart disease, high blood pressure, thyroid disease, diabetes, enlarged prostate, prescription drugs for blood pressure or depression. Stop and ask a doctor for bleeding, worsening, or no improvement in 7 days; a fissure bleeds by definition, so read that as: a fissure that keeps bleeding past the first days, or that is not better in a week, gets a visit. The brand's full line is in the Doctor Butler's review.

The value tube, with the numbers printed. Curist Fissure Hemorrhoid Cream states 5% lidocaine and phenylephrine in its title along with 6 oz (170 g), and names fissures first. Five percent is the top of the OTC range for lidocaine, and the pairing with phenylephrine gives the tube both the pain line and the swollen-tissue line. At $24.00 (verified via the Amazon Creators API on September 5, 2026) that is $4.00 an ounce ($24.00 divided by 6), against $26.58 an ounce for Preparation H's lidocaine cream and an unpublished size for Doctor Butler's.

Phenylephrine's ask-a-doctor conditions apply: heart disease, high blood pressure, thyroid disease, diabetes, enlarged prostate, prescription drugs for blood pressure or depression. Stop and ask a doctor for bleeding that continues, worsening, or no improvement in 7 days; pregnant or breastfeeding, ask a health professional first.

Same brand, absorbing base. Doctor Butler's Hemorrhoid & Fissure Cream states lidocaine in the title and describes itself as instant pain relief, fast acting; the Drug Facts panel carries the full active set, which the title does not. The difference from the ointment is the vehicle: a cream absorbs and leaves no film, which owners with a fissure often prefer because a cream can be applied to a tear with almost no pressure and does not need to be wiped away later. At $19.99 (verified via the Amazon Creators API on September 5, 2026) it matches the ointment's price, and like the ointment the listing does not state a size.

Lidocaine's lines: not in large quantities, not over raw or blistered skin, stop and ask a doctor if worse or beyond 7 days. If the panel lists phenylephrine, its ask-a-doctor conditions apply. Bleeding that continues means stop and ask a doctor; pregnant or breastfeeding means ask a health professional first.

The suppository, described as what it is. PROKTIS-M Rectal Suppositories state hyaluronic acid on the title, along with natural, non-steroidal, and the claim for healing of anus and rectum. Hyaluronic acid is the moisturizing ingredient in the vaginal inserts on our women's desk, and PROKTIS-M applies the same idea rectally. There is no monograph active, so none of the lidocaine or phenylephrine lines apply, and equally nothing on the pack is labeled with an OTC use. The healing language is the listing's positioning, and it is exactly the kind of claim no OTC label is permitted to make.

Inserting anything into a fissure hurts, and owners say so; a lubricated, sparing insertion is the practical advice, and how to use a rectal suppository covers the mechanics. The stop rules do not change for a non-drug: bleeding that continues, worsening pain, or a fissure not better in a week are a doctor's business. The standalone write-up is the PROKTIS-M review.

The homeopathic, labeled plainly. Forces of Nature Fissure Control is titled as an organic homeopathic treatment with witch hazel for anal fissures and hemorrhoids. Two things are true at once. Witch hazel is a genuine OTC astringent whose monograph use is external itching, burning and irritation. And this product is sold as a homeopathic, which means its claims are based on traditional homeopathic practice, not accepted medical evidence, and are not FDA evaluated; the fissure control in its name is a homeopathic claim, not a Drug Facts use. It contains no lidocaine and no phenylephrine, so it carries none of their warnings, and none of their labeled uses either.

The stop rules are the same for a homeopathic as for a drug: bleeding that continues, worsening pain, or a fissure not better in a week means see a doctor. Nothing about a gentler product changes that timeline.

For the skin, not the tear. Calmoseptine Ointment, 2.5 oz jar carries zinc oxide and menthol per its Drug Facts panel, and its label is a skin protectant label: irritated skin, chafing, protection from moisture, with the listing naming diaper rash, heat rash and insect bites. It has no anesthetic, no vasoconstrictor and no labeled use for fissures or hemorrhoids. What it does is coat and protect skin, which around a fissure means the perianal skin that has been wiped raw and kept damp by soaks, and which nurses treat with exactly this jar.

Its label's own stop line is the skin protectant one: stop and ask a doctor if worse or lasting more than 7 days. The fissure's stop lines are the fissure's. The standalone write-up is the Calmoseptine review.

The half of fissure care nobody sells as treatment. Balneol Cleansing Lotion, 3 oz goes on paper or a cotton pad, and the paper then cleans without friction. The title gives the use, relieves anal and vaginal irritation, and the size, 3 oz; ingredients are on the pack. It is not an OTC monograph drug and carries no witch hazel, lidocaine or phenylephrine. What it changes is mechanical: a fissure that is not dragged open several times a day has a chance to close, and dry paper, and even a wet wipe pressed hard, drags. At $15.98 (verified via the Amazon Creators API on September 5, 2026) that is about $5.33 an ounce ($15.98 divided by 3), and a few drops per use means a bottle outlasts the episode.

Ask a health professional before use if pregnant or breastfeeding, as with everything here. Balneol is also the cleanser on the pregnancy and postpartum page, where the same logic applies to a healing perineum.