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Breakthrough treatment proves 90 success rate on painful anal fissures. Botulinum toxin is a relatively new treatment for anal fissures. Botulinum toxin is a powerful poison thats safe to use in small doses. If you have an anal fissure, an injection of the toxin can be used to paralyse your sphincter muscle. Sitz baths, or hip baths, can promote healing of an anal fissure. By soaking the rectal area in a tub of warm water -- two or three times a day for 10 to 15 minutes -- you can clean the anus,. A fissure may fail to heal because of scarring or muscle spasms of the internal anal sphincter muscle. Surgery usually consists of making a cut to a small portion of the internal anal sphincter muscle to reduce pain and spasms and allow the fissure to heal. Cutting the muscle rarely results in the loss of ability to control bowel movements. These type of fissures cannot be effectively cured with just non-surgical medical treatments (tabletscreams). Hence chronic anal fissure treatment will require surgical intervention. anal fissures are initially treated conservatively with home remedies and otc products that include adding bulk to the stool, softening the stool, consuming a high fiber diet, and utilizing sitz baths. another possible treatment is botox injections into the anal sphincter. The injections will prevent spasms in your anus by temporarily paralyzing the muscle. i have an anal fissure and had two skin tags and a hem as well. Exactly a week ago i had them removed and the fissure cleaned up with a botox injection. Breakthrough treatment proves 90 success rate on painful anal fissures.