Buttocks Post Inflammatory Hyperpigmentation.

Hey everyone.  I have post inflammatory hyperpigmentation, anal fissure and pilonidal cyst.

I had anal fissure for probably 4 years already. I'm almost 24 male. I went to a doctor and he told me to eat healthy and take sit baths but it doesn't seem to help. I read that if you have minor or moderator anal fissure then it can go away with that and sometimes cream. However, is it possible for someone who has anal fissure for 3-4 years for it to heal or is it impossible? Doctor told me most people have the 6 or 12 o clock and i had the 3 o clock one.

I have the blood when i wipe after bowel movements and sometimes that area feels like it is on fire. I also had a pilonidal cyst that i had a minor excision surgery for. Also, does anyone who have anal fissure have their butt cheeks discolored? My butt cheeks were blackish/purpish like bruised if you look at it. I am Asian. I have used some hydroquinone and now my buttcheeks look BRIGHT RED and also blackish/purpish the hyperpigmentation.

He said he did not want to do surgery on me because i am still young.  This was from a surgeon.

Does anyone know what i should do? Is it possible or have you heard of anyone healing from anal fissure after having it for 4 years like for me? I know if you have it for few weeks, it can heal easily but i had it for 4 years at least. The reason i bought this up is because i saw another dermatologist today and he said i have post inflammatory pigmentation in my butt area but tells me to see a doctor for anal fissure first to solve that problem because that is the root of the problem and that hydroquinone won't help if i still have the anal fissure.  He said my other option is to have ND YAG Laser surgery.  

What should i do??

[Bhupinder Kaur, MD]

Hello,

It is true that non surgical method like sitz bath, topical anesthetics, high-fiber diet and stool softeners are the first line of treatment for acute and chronic anal fissures. If not successful then we can opt for medicines like topical nitroglycerine ointment, topical nifedipine with lidocaine ointment and botox injections. If still the problem persists then unfortunately surgical approach has to be followed.

I hope it helps. Take care and regards.