Which cream are you using? Have you tried anusol with hydrocortisone in it? It comes with a nozzle. You need to try out different ones until you find one that works. You need to shrink it as well as numb it.
In the meantime, eat lots of insoluble fibre, that will help you go and keep poo soft - if you eat too much insoluble fibre, it’s a bit harder on digestive system. Kiwis, ripe melons and peaches - they will help.
Drink loads of water - you need more than you think you need. Seriously, it helps keep poo soft and your digestive system moving.
Go loo only when you get urge, and try squatting - I have loads of digestive issues, and I squat eastern style on loo when I need to go. May look weird but who cares, It makes you go quicker. As soon as you finish, sit down. Don’t strain - ever!
Try not to sit on bottom too much, lie on side...
Do pelvic floor exercises - it helps with that whole area.
I have tried to remember everything, hope it helps! It can be horrendous, I know.