Goldfish Hole In The Head Disease (Causes, Symptoms & Treatment)
Have you recently noticed something like a hole in your Goldfish’s head? If you have then you must read this article thoroughly, as I will tell you what has caused it and what you can do to get rid of this problem. It is okay to be worried about your Goldfish having a hole in its head, but maybe something in this article can still help you out in this regard.
Hole in the Head disease or simply HITH disease is being researched as to what causes it and how to cure and prevent it even. If not taken care of, this disease may even lead to the death of your Goldfish. Scientists have discovered many reasons as to what may be causing this disease in Goldfish. One of the leading causes has been identified as the parasite Hexamita. Thus, this disease is often also referred to as Hexamita. However, researchers have now been led to believe that there may be more reasons behind this deadly disease.

Causes behind hole in the head Disease
It has been observed that this disease is only limited to freshwater species of fish. This is a major transition in the research of this disease. However, the exact cause of the hole-in-the-head disease is still unknown. But here are a few reasons that may be behind such a heinous disease:
- Hexamita Parasite: The most commonly accepted cause is the presence of the Hexamita parasite in your Goldfish’s body. This parasite is single-celled and impossible to observe with the naked eye. It lives in the gastrointestinal tract of a Goldfish and feeds on the host fish. This parasite reproduces when the Goldfish is in ideal health, but if your Goldfish has recently become sick or is feeling unwell, Hexamita will now reproduce more rapidly. The parasitic infection slowly reaches all the organs of your Goldfish, such as the gall bladder, liver, and heart, destroying them one by one. Soon, the infection reaches the head of your Goldfish, and a cyst-like structure forms on the head of the Goldfish.
- Poor Water Conditions: Like with many other diseases, it is quite possible that poor water conditions are a leading cause of the hole in the head disease. As you must know, water hardness, temperature, and pH are extremely vital when you are keeping a Goldfish as a pet. If you are not changing the water in your Goldfish tank regularly, you may be inviting parasites to enter your Goldfish tank. The accumulation of nitrates from the Goldfish waste, and decaying food and plant matter, creates a perfect environment for parasites and bacteria to thrive in. These microorganisms then cause such deadly diseases in your Goldfish.
- Stress: Your Goldfish can feel stressed out if it is not living in the optimal conditions that are best for them. The stress can cause your Goldfish to become sick, which compromises your Goldfish’s immune system. This makes your Goldfish more prone to diseases such as the hole in the head disease.
- pH: If there is a drastic drop or increase in the pH of the water in your Goldfish tank, your Goldfish will certainly feel this change and feel stressed out. Hence, it is necessary that you keep a check on the pH of the water in your Goldfish tank on a regular basis. The ideal pH for your Goldfish to live in is in the range of 7.2 to 8.4.
- Temperature: Your Goldfish thrives best in temperatures ranging from 68 to 74 °F, or 20 to 23 °C. if the temperature falls out of this range, and if it does so suddenly, your Goldfish can stress out about this.
- Improper Diet: Just like you and me, your Goldfish also needs a balanced diet to live on. Regular flakes and pellets may not be doing enough for you Goldfish. it is also possible that you are feeding your Goldfish expired food or food that has gone bad. Underfeeding your Goldfish may also have suppressed their dietary needs. If you are not feeding your Goldfish good enough food, your Goldfish will be deprived of the essential minerals and nutrients that will keep them healthy. An inadequate food supply can certainly lead to infections and diseases such as the hole in the head disease, as the Goldfish’s body will not have enough energy to fight off the disease before it begins.
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Symptoms of Hole in the head Disease
Generally, observing a hole in the head of your Goldfish is the last symptom that will decide if your Goldfish has the disease. However, there are certain indications and symptoms before the final one, that may be pointing toward the hole in the head disease. If you observe the following symptoms timely, there is still a high chance that you can save your Goldfish from the said disease.

- Loss in Appetite: If you have recently observed a lack of appetite in your Goldfish, you should be alarmed. Goldfish enjoy eating food, so if they are not eating food as much as before, it is possible that are being disturbed by the parasite Hexamita, internally.
- Slime Coat: If your Goldfish has something trailing off of it, it could be its slime coat. A slime coat is what protects your Goldfish from harmful bacteria and parasites. The hole-in-the-head disease can cause the slime coat to detach from your Goldfish. The slime coat will then hang off your Goldfish, in strands, and you can clearly observe this symptom.
- Faded Color: Goldfish are a bright orange shade in color, which is what makes them s beautiful. If you observe that your Goldfish appears cloudy and less bright in color than its original one, your Goldfish may be suffering from the hole in the head disease. This disease can also cause a loss of color in your Goldfish.
- Hollow Abdomen: You may notice that your Goldfish appears a little empty in the belly region. This may be a result of the parasite Hexamita feeding away on your Goldfish’s internal organs.
- String White Poop: This symptom can be identified long before the disease progresses to a hole in the head. If you observe that your Goldfish’s poop is white rather a translucent in color, and is in the form of strings, it is possible that your Goldfish is suffering from Hexamita.
- Sores: If your Goldfish is suffering from a hole-in-the-head disease, it is very much likely that there are sores all over your Goldfish’s body, especially, on the head and on the fins. These sores look like pimples and may become open ones after some time. The open sores are what you call the hole in the head. If you have good eyesight, you may even be able to see water-borne parasites in the wound.
- Erupting Sores: After the sores have further matured, they may erupt, and a yellow mucus will trail down your Goldfish’s head. This is an extreme case of the hole in the head or Hexamita disease.
Cures for hole in the head Disease
Even in the final stages, you may still be able to save your Goldfish. Fortunately, many medications are available on the market that will help treat this disease in your Goldfish. here are a few things that you can try out to help your Goldfish:
- Quarantine: The first and foremost thing you must do, once you know that your Goldfish has the hole in the head disease, is to quarantine your Goldfish. you must separate your Goldfish from its other tank mates as the parasitic infection may spread to the rest. The quarantine tank should have all the optimum conditions for your Goldfish, just like a hospital. You must keep checking the water in this tank more regularly so that the ideal conditions do not vary at all.
- Metronidazole: This medication is the most effective in treating hole in the head disease. If your Goldfish has only recently been infected with the said disease, and your Goldfish has not lost its appetite entirely, you may try this out. It is best to give this medicine in the form of food to your Goldfish, as this way it will target the gastrointestinal tract, where the parasite actually lives. To do so, you must add metronidazole powder to make a solution, and add the dry fish food to this solution. Keep the food soaked in the medication for a while, and then remove it and dry it out. After the food has been dried, you may add it to your Goldfish tank for your Goldfish to eat. This will cure your Goldfish in no time.
- Medicated Water: If your Goldfish has lost its appetite and will not eat the food that you have medicated for it, you must add the medication directly to the tank water. In a 20-gallon tank, it is best that you add 400 to 500 mg of metronidazole powder.
- Aquarium Salt: As effective as the medication is, adding aquarium salt may also be helpful in curing the hole in the head disease. You may add 2 to 3 tablespoons of aquarium salt to your 10-gallon Goldfish tank. This will nourish the water and kill off any bacteria or parasites present in the water of your Goldfish tank and will nourish the water for better healing of your Goldfish.
- Balanced Diet: Even if this disease has developed in your Goldfish, you must enrich your Goldfish’s feed by adding vitamins and minerals that your Goldfish needs. Adding live food, such as bloodworms, and brine shrimp will boost the immune system of your Goldfish and will help it fight off the hole-in-the-head disease quickly.
- Filter Changes: If your Goldfish has been diagnosed with Hexamita or hole-in-the-head disease, you must change the carbon filters in the water filter of your Goldfish tank more often. This is because the filters get polluted with the germs and parasites which have caused the disease, and if you do not clean the filter more often, they will continue to grow in number.
Prevention techniques for hole in the head Disease
Even if your Goldfish has been fortunate enough to not suffer from such a disease, you must follow a few tips that will keep your Goldfish safe from the hole-in-the-head disease, in the future as well. This is what you can do:

- Water Changes: This can not be stressed enough. The dirty water conditions are what cause the rise in the parasitic population in your Goldfish tank, which lead to the Hexamita disease. To prevent this, you must always keep the water in your Goldfish tank clean. Perform water changes once every two weeks and keep the tank walls clean as well.
- Remove extra Food: Be sure to remove the extra food that your Goldfish may not have eaten. This food, if not removed, decays, and creates the perfect environment for parasites and bacteria to foster in.
- Water Conditions: Make sure that the water conditions, such as pH, temperature, nitrite, and oxygen levels in your Goldfish tank are within their respective optimum ranges. For this, you can use a kit that you can buy from a local pet store which will help you in detecting the changes in water conditions.
- Do Not Overstock: Your Goldfish does certainly not enjoy too many fish that is invading their personal space. Goldfish require a lot of space to live a stress-free life, and for that, you must provide them with the space that they need. If you put too many fish with your Goldfish, the oxygen levels in the tank will drop and your Goldfish’s immune system will be at stake. So, keep your Goldfish tank big enough to hold all your Goldfish, having their own personal space. Ideally, a single Goldfish needs 30 gallons of water, and for every next added Goldfish, you must add another 10 gallons of water.
- Good Food: Your Goldfish need a perfectly balanced diet that will keep them healthy and their immune system strong. For this, you cannot solely rely on flakes and pellets. You must add live food and plantation to your Goldfish tank for them to eat. This will create a balanced diet for them. Also, make sure that the food that you are feeding your Goldfish, is of good quality and has not expired.
The Bottom Line on Goldfish Hole In The Head Disease
Hole in the head disease, or Hexamita can be a deadly disease among Goldfish. for this very reason, you must immediately consult a veterinarian if you are a new fish keeper and observe the above-mentioned symptoms in your Goldfish. If you simply follow the preventative measures that I have outlined above, your Goldfish will be safe from the occurrence of such harmful diseases. But in case your Goldfish does get infected, make sure to medicate properly and your Goldfish will be back to being healthy in no time!