More guides and experiences about Anal fissure. Explore all →

Lidocaine for fissure pain relief

Published 13 March 2026 ·Last reviewed 13 March 2026 by the editorial team ·How we create our content

At a glance

Lidocaine is a local anaesthetic that can provide temporary pain relief for anal fissure symptoms. It does not heal the fissure, but it can make bowel movements more manageable and reduce pain during acute episodes. This guide covers how it is used practically.

What lidocaine does

Lidocaine blocks nerve signals in the area where it is applied. This temporarily numbs the tissue, reducing or eliminating pain. For fissure management, this means:

  • Less pain during bowel movements if applied beforehand
  • Reduced post-bowel-movement burning
  • More comfortable application of other topical treatments
  • Pain relief at night or during flare-ups

What lidocaine does not do

  • It does not relax the sphincter muscle
  • It does not increase blood flow to the fissure
  • It does not promote healing
  • It does not address the underlying cause

Lidocaine is a symptomatic treatment — it manages pain but not the condition itself.

Available forms

Gel

The most commonly used form for fissure pain. Applied to the anal margin with a clean finger. Provides a thin, even coating that absorbs into the tissue.

Cream or ointment

Similar application to gel. Some people find the ointment base more soothing as it also provides a mild barrier effect.

Suppositories

Inserted into the anal canal. These can provide numbness further inside, which may be helpful for pain that is felt internally. Available by prescription in most cases.

Sprays

Some lidocaine products come in spray form. Less commonly used for fissures but can be helpful for people who find direct application painful.

How to use it

Before a bowel movement

Apply lidocaine to the anal margin 10 to 15 minutes before you expect to have a bowel movement. This allows the numbness to develop before the stool passes over the fissure.

After a bowel movement

Apply after cleaning and drying the area. This helps manage the post-bowel-movement pain that can last for minutes to hours.

Before other topical treatments

If applying GTN or diltiazem is painful, a thin layer of lidocaine applied five to ten minutes beforehand can numb the area enough to make the application more comfortable.

At night

Applied before bed to reduce night-time discomfort.

Practical considerations

  • Do not exceed the recommended dose — lidocaine can be absorbed through the skin, and excessive use can cause systemic effects
  • Keep the area clean before application
  • Use as part of a broader approach — lidocaine alongside stool management, sitz baths, and healing-focused treatments
  • Short-term use — lidocaine is best used for pain management during acute periods rather than as a permanent daily treatment

Common questions

Does lidocaine help heal a fissure?

No. Lidocaine is a local anaesthetic — it numbs the area and provides temporary pain relief but does not address the sphincter spasm or promote healing. It is useful for managing pain, particularly before bowel movements or at night, but it should be used alongside treatments that actually support healing (stool management, sphincter-relaxing treatments).

How do I use lidocaine for a fissure?

Lidocaine is available in various forms — gel, cream, ointment, and suppositories. For fissure pain, it is typically applied externally to the anal margin before or after a bowel movement. Some people apply it 10 to 15 minutes before a bowel movement to numb the area in advance. Follow the specific instructions for the product prescribed or recommended by your clinician.

How long does lidocaine numbness last?

Topical lidocaine typically provides numbness for 20 to 45 minutes, depending on the concentration and formulation. This is usually enough to cover the most painful period during and after a bowel movement. It can be reapplied as needed, following the product's dosage guidance.

Can I buy lidocaine over the counter?

Low-concentration lidocaine products are available over the counter in many countries. Higher-concentration formulations typically require a prescription. Some products marketed for hemorrhoids contain lidocaine and can be used for fissure pain — check the ingredients and follow the instructions.

When to seek care Heavy bleeding or feeling faint? Get emergency help now. Emergency: 911

Not sure how urgent it is? Get help today.

  1. Emergency

    Heavy bleeding, black tarry stools, feeling faint, severe pain or trouble breathing.

    Call 911 or go to the ER.

  2. Today

    Fever, pain getting worse, a hot swollen lump, or trouble passing urine.

    Call your doctor or go to urgent care.

  3. Soon

    Bleeding or bowel changes nobody has checked, or anything lasting 3 weeks.

    Book a doctor’s appointment.

Feeling overwhelmed? Call or text 988, any time.

See all the signs

For this topic, get medical advice if you notice:

  • Heavy or persistent bleeding that does not settle
  • Severe pain that is getting worse rather than better
  • Fever or signs of infection
  • Symptoms that have not improved after 4 to 6 weeks of self-care

Recording how you feel is not the same as being checked. These are the signs that need a doctor’s attention.

Call 911 or go to the emergency room now if you have:

  • bleeding that will not stop, a lot of blood (the toilet water turns red, or you pass large clots), or any bleeding with feeling faint or dizzy
  • fainting, a racing heart or trouble breathing
  • confusion or slurred speech, extreme shivering, no urine in a day, or blotchy skin
  • sudden severe belly pain, or a swollen, hard belly with vomiting or not passing stool or gas
  • you cannot pass urine at all, or your bladder feels full and painful and you can’t empty it
  • redness, swelling or severe pain spreading quickly around your anus, genitals or groin, especially with a fever or feeling very ill
  • a fever with a painful swelling near your anus if you have diabetes or a weakened immune system (for example, from chemotherapy or transplant medicines)
  • black, tarry stools

Call your doctor or go to urgent care today (or the ER if you can’t be seen today) if you have:

  • a temperature of 100.4°F (38°C) or higher, chills, vomiting, or feeling generally unwell
  • pain that is getting worse over days, or severe pain that stops you sitting or sleeping
  • a hot, swollen or very tender lump near your anus or at the top of the crease between your buttocks, or foul-smelling discharge
  • trouble urinating
  • bleeding that is getting heavier or more frequent, or blood mixed into your stool
  • feeling much more tired than usual, looking pale, or getting out of breath more easily than you used to
  • not passing stool for several days, or new belly pain

Make an appointment with your doctor if:

  • you have never had these symptoms checked by a doctor or nurse — whatever your age
  • you have had rectal bleeding for more than 3 weeks
  • your bowel movements have been looser, thinner or more frequent than usual for 3 weeks or more, or you have lost weight without trying
  • symptoms have not settled after a week or so, or keep coming back
  • you notice a new lump near your anus, between your buttocks or in your belly, or an itch or discharge that does not clear
  • you have new leakage or trouble controlling your bowels
  • you are 45 or over, or have a family history of bowel cancer or inflammatory bowel disease, and any of these symptoms are new for you

If you are unsure, it is always reasonable to ask. If things feel overwhelming, call or text 988 (Suicide & Crisis Lifeline) or chat at 988lifeline.org, any time. If you don’t feel safe, call 911.

Showing US care routes. Change region at the foot of the page.

Related symptoms

BleedingPain during bowel movementsPain after bowel movementsSpasm or crampingConstipation

Discreet symptom tracking

Symptoms that come and go? Keep track, day by day.

For hemorrhoids, fissures, fistulas and other anal and rectal problems. A short, discreet email asks how things have been, and saves each answer, so you can look back at every flare and every good week in your own words. If you haven’t had your symptoms checked, see your doctor first.

  • About ten seconds a check-in. No app, no password.
  • Nothing in the subject or preview says what it’s about.
  • Each Sunday, a link to your week, ready for your next appointment.
Start tracking →

Your notes

Your check-in

Takes about ten seconds.

20:00
Example. Nothing on the lock screen hints at symptoms or conditions.

Explore more

Related guides

Sleeping positions for fissure pain

How sleeping position affects anal fissure comfort, what positions people find most helpful, and strategies for getting through the night.

GTN ointment for anal fissure

How GTN (glyceryl trinitrate) ointment works for anal fissures — application, common side effects like headaches, what to expect.

Anal fissures: patterns and care

Learn what an anal fissure is, what people commonly experience, what tends to help, and when to seek medical care.

Related experiences

Acute fissure: sharp pain after BMs

A composite experience of the first weeks living with acute fissure symptoms — what people commonly report, what they try, and when they seek care.

Chronic fissure treatment journey

A composite account of the path people describe from an acute fissure that does not heal into the world of chronic fissure treatment options.

All content about Anal fissure →