German Blue Ram - White Pimple/Bump on Head

James_R · Feb 15, 2025

Hey guys,

While doing tank maintenance today, I noticed my German Blue Ram has about 4-5 white/beige/pink protruding spots on its head that literally look like pimples. The most concerning one is a big bump on its forehead with a pimple on top—it kind of looks like really bad acne.

Looking closer, I also noticed a tiny red vein on one side of its head. Not sure if that means anything, but I figured I’d mention it since I’m inspecting everything super closely now.

On top of that, one of my dwarf rainbowfish has a white, flat, fungus-like patch on its body—almost like a bacterial infection. There’s also a white streak along its body, and overall, it looks kind of rough. I couldn't get a nice pic since it was swimming at the back. Like I said, it still swims actively but stays near the back of the tank instead of with the rest of the fish. It’s been like this way for about a month. I think that its bacterial, so I’ve just been doing larger water changes to see if anything improves.
I used to have a school of 12 about a year ago, but they all gradually ended up swimming to the surface and dying in the same way. Now I have 2, including the 1 I'm talking about that is affected. I asked my LFS about it, and they mentioned that dwarf rainbows aren’t as hardy as they used to be.

I’ve uploaded photos of both fish. Based on what I’m seeing online, I think my German Blue Ram might have early-stage Hexamita/Hole-in-the-Head disease, while the dwarf rainbow seems to have a fungal infection. I do have Metronidazole medication on hand, but I want to be sure before treating the GBR and entire tank with meds.

I wanted to mention that I added more fish to the tank recently but I quarantined them with meds as a precaution for a little over month before I did. Ive heard that hexamita takes a very long time to show symptoms, just to let you guys know I forgot when I got the GBR, but it's been at least 5 months.

Let me know what you guys think! I appreciate any help in figuring this stuff out.

Fishfunn · Feb 15, 2025

I never seen that before, and I am wondering if it is the start of Hole in the head. I would suspect parasitic. Hopefully somebody here can jump in and know what this is.

If it is the start of hole in the head, any medication containing metronidazole like API General Cure or Seachem Metroplex would treat that.

CassCats · Feb 15, 2025

Yeah that's the start of hexamita, the sensory pores swell up and get a white center at first before they rupture.

Definitely treat with metronidazole for this

You can see here how it progressed on my elderly Bolivian ram:

James_R · Feb 15, 2025

Thanks for the info, ill promptly do a wc and start treatment with Paracleanse.

James_R · Feb 22, 2025

Hey guys,

Quick update! So, my German Blue Ram’s spot ruptured. I'm not sure when since she has usually been hiding now. It’s now Day 7 of treatment, two days after the 25% water change. I’m following the package instructions and letting her rest for two weeks before retreating. She still has some visible veins around the hole, and her head looks swollen and rounded. She’s not really coming up and eating at feeding time and mostly hides behind the driftwood, but she’s still swimming, just keeping to herself. I had to move her out with my hand to get pics.

As for the dwarf neon rainbow, it hasn’t improved. It has multiple white protruding spots, some of which are fuzzy. It’s breathing fast, and its mouth looks damaged. Meanwhile, my other dwarf neon rainbow looks perfectly healthy, so I can really see the difference. I uploaded pics of the sick one like before. Maybe bacteria, epistylis? I'm not sure, let me know what you guys think. All the other fish are healthy. I uploaded pics from my iphone, but it looks better quality on videos for some reason.

GBR

Rainbowfish