Freshwater Fish Diseases Part 5 ( Hole in the Head )

 Hole in the Head (HITH)

Synonyms:
Head and Lateral Line Erosion

(1)Water Quality
Get your water quality/chemistry perfect, NH3-0, NO2-0, NO3- 0/20ppm,
check your filters & clean'em if necessary (reduces alot of NO3), gravel vac & PWC, do small PWC's (25%) every other day.
Just about everyone will agree that bad water chemistry and HITH go together like apple pie -n- ice cream...

(2)Diet
Feed a well balanced and varied diet* (See below).

(3)Vitamin Supplements
Add liquid vitamin supplements to all food and vary their diet.
Soak or load everything you feed the fish with vitamins until cured and watch your water.
Vitamins that you add to your tanks water are worthless (IMO).
We use "Vita Chem", our fish get it regularly.
This particular brand is available at most on-line retailers and at better LFS's 

(4) Supplementary treatment
I would add a dose of salt to the tank, this encourages slime-coat production and gill function amongst other things.
Also a dose of Melafix and Pimafix, these have been known to help healing and prevent secondary infection.

(5)Temperature
Gradually increase your tanks temp to aprox 80'-82'f.
Increased temp increases metabolism which can influence the immune system thus possibly speed healing.

(6)Medicate
Alot of folks blame Hexamita for HITH and thus treat for it with medications, BUT, studies have been done showing that Hex (and others) is/are a secondary infection/s (Whether or not Hexamita plays a key-role with HITH infections is controversial).
You need to do what "You" feel is right and correct after researching this for yourself, google "HITH causes prevention and cure" or some such, and visit Cichlid specific forums for more info.

Some folks also think that filter carbon dust plays a role...
Carbons role is controversial.

Some folks also think that stray electrical currents are to blame...
Stray electrical currents role is controversial at best.

It seems there are no absolutes as to the cause, but just like ICH there are many ways to treat it and proponenets/opponents of each treatment.

I say again though...
Perfect water quality and a varied nutritious diet supplemented with vitamins.