Application of a 0. You rub a pea-sized dot of cream on the fissure twice a day. It is a good idea to either wear gloves when applying the nitroglycerin cream or wash your hands right after. The skin on your fingers can absorb the medicine and increase your chance of side effects. An increase in muscle tension, also called resting pressure, in the internal anal sphincter can lead to fissures.
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Internal sphincterotomy versus topical nitroglycerin ointment for chronic anal fissure. Anal fissure is a common benign condition. An anorectal problem is defined as a split in the anal canal mucosa that extends from the dentate line to the anal verge.