Understanding Tears & Healing

Anal fissures might not be a hot topic at brunch, but if you’ve ever experienced one, you know they demand attention. These small but mighty tears in the lining of the anal canal can cause sharp pain, bleeding, and discomfort—especially during or after a bowel movement. The good news? Most fissures heal on their own with the right care.

Let’s break down what causes anal fissures, how to treat them, and what you can do to prevent them from coming back.

What Is an Anal Fissure?

An anal fissure is a tiny tear in the thin tissue (mucosa) lining the anus. While small, it can feel anything but—causing sharp pain, bleeding, and spasms in the anal muscles. Fissures are often mistaken for hemorrhoids, but they’re a separate issue with different treatment needs.

Common Causes & Risk Factors

Anal fissures happen when the anal canal stretches too much, too fast—leading to a painful tear. Some of the biggest culprits include:

Straining During Bowel Movements – The #1 cause. Hard, dry stool can stretch the anal canal too much.
Chronic Constipation or Diarrhea – Either extreme can irritate and weaken the tissue.
Pregnancy & Childbirth – Increased pressure and pushing during delivery can lead to fissures.
Anal Trauma – This can include anything from inserting objects to frequent wiping with rough toilet paper.
Tight Anal Muscles – Some people have naturally high sphincter pressure, making tears more likely.

Fissures are common and affect people of all ages, but they’re more likely to occur if you have a history of digestive issues, inflammatory bowel disease (IBD), or conditions that cause poor blood flow to the area.

Symptoms of an Anal Fissure

How do you know if you have an anal fissure? Look for:

Sharp, stinging, or burning pain during or after a bowel movement
Bright red blood on toilet paper or in the toilet
Spasms in the anal muscles that make the pain linger
A visible tear near the anus (if you check with a mirror)

If the pain sticks around for more than six weeks, the fissure is considered chronic—which means healing might require more than just home care.

How to Heal an Anal Fissure at Home

Most fissures heal within a few weeks with the right care. Try these at-home remedies:

Sitz Baths – Soak in warm water (no soap!) for 15–20 minutes to relax the muscles and promote healing.
Eat More Fiber – Load up on fruits, veggies, and whole grains to keep stools soft and easy to pass.
Stay Hydrated – Water helps keep bowel movements smooth and prevents further irritation.
Avoid Straining – Let things happen naturally—forcing it will only make matters worse.
Use a Gentle Ointment – Petroleum jelly, aloe vera, or over-the-counter creams can soothe irritation.
Skip the Rough Toilet Paper – Use soft, fragrance-free wipes instead of harsh paper.

Most minor fissures heal within a few weeks if you keep up with these habits.

How to Prevent Fissures from Coming Back

Once you’ve had an anal fissure, you’ll want to do everything you can to avoid a repeat experience. Here’s how:

Keep Your Stools Soft – Eat a fiber-rich diet and drink plenty of water.
Don’t Ignore the Urge – Holding in bowel movements can lead to straining later.
Go Easy on Wiping – Be gentle and consider using water-based wipes or a bidet.
Stay Active – Regular movement helps keep digestion smooth and prevents constipation.

When to See a Doctor

If your fissure isn’t healing after six weeks, keeps coming back, or is causing severe pain, it’s time to check in with a doctor. They may recommend:

Prescription creams – Medicated ointments like nitroglycerin or calcium channel blockers can help relax the anal muscles.
Botox injections – Yes, Botox isn’t just for wrinkles—it can also relax tight anal muscles to promote healing.
Surgery (Lateral Internal Sphincterotomy) – In severe cases, a minor procedure can reduce muscle tension and help chronic fissures heal.

Anal Sex & Anal Fissures

Increased Risk of Tearing – Receptive anal sex can stretch the anal canal, which may cause or worsen fissures, especially if there’s not enough lubrication or if penetration is too rough.
Use Lube, Always – A high-quality, water-based or silicone-based lubricant can reduce friction and tearing. Avoid oil-based lubes with latex condoms, as they can degrade the material.
Go Slow & Listen to Your Body – Rushing penetration can increase the risk of a fissure. If you experience pain, pause and check in with your body.
Take a Break If You Have a Fissure – If you have an active fissure, giving it time to heal before resuming receptive anal sex is important to prevent further irritation or worsening the tear.

HIV & Anal Fissures

For those who are HIV-positive, anal fissures can be slower to heal due to immune system challenges. Additionally, there are a few key concerns:

Increased Infection Risk – Open fissures create an entry point for infections, including HIV transmission (if the partner is HIV-negative) and other STIs. Practicing safer sex and using condoms or PrEP (for HIV-negative partners) can reduce risk.
Medication Side Effects – Some HIV medications cause diarrhea, which can irritate the anal area and delay healing. If this is a recurring issue, talk to your doctor about managing side effects.
Low White Blood Cell Counts – If your CD4 count is low, your body may struggle to heal wounds, including fissures. If a fissure isn’t healing within a few weeks, it’s worth getting medical advice.

Anal fissures are painful, but they’re treatable and preventable. The key? Be kind to your behind! Eat fiber, stay hydrated, and avoid straining to keep things smooth and pain-free. If a fissure sticks around too long, don’t suffer in silence—talk to a doctor and get the relief you deserve.

Your booty will thank you. ♥︎

Anal Fissures