treating hole in the head fish diseaseBetta hole in head is a serious affliction that can affect your betta fish at any time. Although this is more common in cichlids, that doesn’t mean your betta fish can never get this disease.

Don’t panic if you feel that your betta fish is already suffering from this serious condition. In this article, you’ll find all the information you need on how to treat this disease to keep your betta fish alive.

Hole in the Head Betta Disease: Why Does It Happen?

Hole in the head is a disease condition that affects many fish species, including betta fish, and it can be caused by Hexamita, vitamin deficiency or poor water quality, among others. It’s also known as freshwater head, lateral line erosion or hexamitiasis.

Expert aquarists believe that it’s a parasitic infection. When the parasite eats the flesh around the head of your betta fish, deep, pitting wounds start to appear.

According to expert aquarists, a hole in the head is a parasitic infection, but there is no solid evidence available to support this statement. Here are some possible reasons why your fish is suffering from the hole in the head disease:

  • Hexamita

The primary factor associated with a hole in the head disease is Hexamita bacteria. It’s a type of parasite found in the intestines of bettas and all other fish. The odd thing is that even expert aquarists are not completely sure if this parasite causes this disease or if it just takes advantage of an open wound caused by some other parasite.

It’s possible that this bacteria might be attacking an infection that was initially caused by another parasite. In this case, Hexamita can’t be labeled as a direct cause of head in the hole disease in betta fish.

  • Absence of Required Vitamins

If your betta fish isn’t getting the required vitamins, then a hole in the head disease can develop. A significant reason for vitamin deficiency in betta fish is that it is a carnivore. Therefore, your fish can’t get every vitamin from just the tank’s diet.

You must make sure that your betta fish is getting all the essential vitamins it needs, especially vitamin A and C. Both these vitamins are known to make the betta’s immune system strong.

Hole in the head disease can’t attack or do much harm to your fish if its immune system is strong and healthy. A weak immune system won’t help your betta fish fight against this disease. As a result, the disease will spread more rapidly and can even be deadly.

  • Fluctuating Tank Conditions

Like other fish species, Betta fish require specific tank conditions for survival and to be safe from a hole in the head disease. Poor tank conditions and fluctuating tank conditions are harmful to your betta fish.

In both situations, your betta fish’s immune system is affected. As the immune system weakens, this disease-causing parasite can easily attack your betta fish. For example, if the pH or temperature of the tank doesn’t remain constant, your betta fish may suffer with stress.

With a weak immune system and under constant stress, your betta fish won’t be able to resist the parasitic attack for a long time.

  • Poor Water Conditions

One major reason that affects your betta fish’s immune system and makes it sick is poor water conditions. If you don’t change your tank water routinely, there are high chances that your betta fish will get a hole in the head disease.

Moreover, poor water conditions also cause many other illnesses. A sick betta fish is more easily prone to parasitic attacks.

The simplest things that you can do to keep the tank water clean are the following:

  • Change your tank water frequently.
  • Don’t overcrowd the tank.
  • Always remove the dead debris from the tank as soon as possible.
  • Stress in Fish

There are a lot of things that can cause stress in your fish. A stressed fish is more susceptible to hole in the head disease due to the activation of its chronic stress pathway. As a result of this pathway, your betta fish’s immune system, reproductive system and even growth rate are affected.

The primary factors that can cause stress in betta fish include:

  • Water quality
  • Diet
  • Aggression
  • Limited space

What Are the Common Signs of Hole in the Head Disease?

Holes on the fish’s head and body, losing color and fish weakness are some of the common signs of hole in the head disease. Hole in the head betta disease isn’t a condition that can stay ignored for long. If you’re careful and observe your betta fish well, many other obvious symptoms can help you identify this disease.

If you identify a hole in the head disease early on, then the survival chances of your betta fish increase. Don’t wait until the lesions appear on your betta fish’s head, because by then it would be too late to treat this disease.

Some common signs or symptoms of betta hole in the head disease are below:

  • Holes on the Body and Head

The disease is so named because, when it contracts this condition, your betta will have holes in its body and head. As the disease progresses, the holes become deeper.

At this stage, this hole in the head betta disease is already very hard to treat. If you start the treatment after deep holes are already present, then the chances of curing it and your betta surviving are less.

Therefore, don’t allow the disease to progress to this stage. Instead, look for other signs and start the treatment as early as possible.

  • Betta Fish Will Lose Color

Another symptom of this disease is your betta losing its color. Betta fish is very colorful when it is healthy, so this symptom will be very easy to observe for you.

However, it’s not a sign that you can immediately associate with the hole in the head disease. There are many other conditions that could be the cause of your betta losing color, including stress and depression.

Therefore, before labeling it as the hole in the head disease, book an appointment with a vet and let them diagnose and confirm the cause of color loss in your betta fish.

  • Weakness Due to Loss of Appetite

This disease begins by targeting the intestines, so losing appetite is one of the first symptoms you’ll see from the hole in the head disease. Your betta will stop eating, and with time you’ll see it getting weaker.

As soon as you observe this, you should immediately try to find the reason. Loss of appetite and weakness can occur due to many other conditions as well. These include constipation, dropsy and swim bladder disease.

  • Feces Will Have White and Stringy Appearance

Aside from holes in the head, this symptom is also directly linked with this disease. The feces of your betta fish will become white and stringy.

This happens due to an over-production of mucus trying to remove the infection caused by the disease. Due to the high amount of mucus, it is released in the feces and gives it a white, stringy appearance.


Treating hole in the head fish disease requires a lot of patience and some medication. The most recommended hole in the head medication is dimetridazole, which is the first choice of most veterinarians.

However, if this medicine isn’t available, you can use metronidazole as a replacement. To know about the correct dose, you should always consult your veterinarian before giving any medicine to your betta fish.

You might also need a vet consultation to get these medications in some parts of the world because these medications won’t be given to you without a prescription.

How To Administer Medication

The easiest way to medicate your betta for this disease is by adding this medicine to food and water. If you add the medicine to a tank containing other plants or fish, it can harm them. Therefore, it’s better to set up a separate quarantine tank for your betta fish.

You can give medicine to your betta fish with food or by treating the tank water with it. When your betta fish is severely ill with hole in the head disease, it will stop eating.

If your betta is still eating, it indicates that this disease is still in the early stages, so before you feed your betta fish, give it the recommended medicine dosage. 

If your betta fish isn’t eating anything, then the only option is to treat the tank water with the medicine. For this method, you need to keep your betta fish in a separate tank before you start adding the medicine. Ask an expert to know the best dose for adding medication to the tank.

Frequently Asked Questions

Here are the answers to some of your questions regarding this disease.

Can Hole in the Head Kill Your Betta Fish?

Yes, a hole in the head can kill your betta fish. You can avoid your betta fish’s death by diagnosing the disease at an early stage.

When you are sure that your fish has developed the disease, you have many treatment options that can stop this disease from spreading by treating the damaged tissue.

Is Betta Hole in the Head a Contagious Disease?

Betta Hole in Head disease and treatmentNo, betta hole in the head disease is not a contagious disease. Even though it’s a parasitic infection, it cannot be transmitted to other fish from the affected fish like other parasitic diseases.

So if one of your betta fish has a hole in the head disease, then there is no need to separate it from the others if treatment is possible in the same tank.

What Are Some Tips for Preventing Hole in the Head Disease?

Adding vitamins to the tank, fixing the water quality and feeding the right diet are key tips to prevent hole in the head disease. Prevention of betta hole in the head disease is easy once you know about the risk factors. Here are some things can you can do to protect your betta fish from this deadly disease:

  • Add Enough Vitamins to Your Betta Fish’s Tank

Betta is a carnivore fish and thus won’t eat greens, but vegetables and other plants have a lot of vitamins present in them. Without these, your betta fish can develop vitamin deficiency, which can cause a hole in the head disease.

A good way to provide the required amount of vitamins to your betta fish is by giving them live food. When your betta fish eat live food such as brine shrimp, mosquito larvae and bloodworms, your fish is also eating what is inside these little critters’ stomachs.

So if these animals have recently ingested plants, they will also be ingested by your betta. In this way, you can fulfill your betta’s vitamin requirements.

  • Fix the Tank Water Quality

Balancing the tank parameters is essential to avoid this disease. Your betta is very sensitive to the water quality in its tank. For example, there are special betta sensory pits that can detect even minor changes in the water pressure of the tank.

If the water becomes dirty due to the presence of dead organic material, uncleaned gravel or high levels of ammonia, it would be harmful to your fish.

An unclean environment weakens the immune system of your betta fish, which can make you betta sick with the hole in the head disease.

  • Feed Your Betta Fish an Appropriate and Sufficient Diet

Give your betta a balanced and healthy diet. Whatever you’re feeding you betta fish, make sure it was opened not more than six months ago. After this period, the number of water-soluble vitamins decreases in the food significantly.

Therefore, always ensure that the food is fresh and contains all the important nutrients.

  • Don’t Overpopulate Your Tank

If you add more fish in the tank than it can properly contain, the ammonia levels in the tank will increase. As a result, many harmful bacteria and parasites will be produced in the tank to make your betta fish sick.

Another reason to avoid overpopulating your tank is that betta fish love to be alone. The presence of more fish in the tank will give stress to your betta fish.

Due to stress, its immune system will be affected, and the risk for the hole in the head disease will increase.


If you think that your betta is suffering from hole in head disease, you don’t have to worry as you are now more knowledgeable about this condition.

  • Betta hole in the head is deadly only if it’s diagnosed late. There are many ways to treat this disease at an early stage, including administering medicines.
  • Weak immune systems and the parasite Hexamita are the primary causes of hole in the head disease.
  • Betta hole in head disease has many visible symptoms for early detection.
  • It’s not a contagious disease, so your other fish in the tank are safe.
  • You can prevent betta hole in head disease with a good diet containing required vitamins, good water quality, and adding less fish in the tank.

Fishkeeping isn’t all fun and games; you also have to be very careful regarding your fish’s health. You can help your betta fish stay healthy, without developing hole in the head disease, by ensuring you perform all the required preventative measures.

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