I had tearing with my first birth, what might happen with a second?

I had a 4th degree tear with my first child. Since then things have never really been "normal". I have occasional bleeding with and the skin have just never seemed to be really healed. My Dr suggested a steroid cream, but I am not really into putting a steroid on my taint. Has anyone else had this experience, and mostly, was it a factor in a second birth? Should I go for the steroid before even considering?