What are the first signs of hole in the head?

Taken these comparison photos, thereā€™s a visible irregularity with the fish in question compared to the larger one :(
 

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I personally dont think it is hole in the head. It looks like a bit a missing scales just on the lateral line likely from scratching on decor or most likely from aggression. You are keeping them in the right kind of water with your ph and gh and 5ppm nitrates is nothing. The biggest cause of hole in the head is over polluted water that causes the break down of tissue which you dont have.

Wills
 
Do you think I should get my hospital tank up and running ready for the future in case? What treatment would you recommend?
Though other fish may not show signs they probably have the Hexamita flagelates in their intestials. I am not an expert on fish but it might be an idea to still treat the whole tank. But let cichlidexperts jump in now. To me this isn't a disease that should be treated seperated.
 
I personally dont think it is hole in the head. It looks like a bit a missing scales just on the lateral line likely from scratching on decor or most likely from aggression. You are keeping them in the right kind of water with your ph and gh and 5ppm nitrates is nothing. The biggest cause of hole in the head is over polluted water that causes the break down of tissue which you dont have.

Wills
That is quite possible as the threadfins seem to be the most peaceful cichlids in there, the firemouths are probably the culprits if it was due to aggression but I would say it is quite strange that the fish in question has not grown since introduced whereas the other one grew twice the size and seems more confident than this one. I think you are right as my water conditions do seem to be on the better side of things unless the parasite associated with the disease was introduced plant wise?
 
Though other fish may not show signs they probably have the Hexamita flagelates in their intestials. I am not an expert on fish but it might be an idea to still treat the whole tank. But let cichlidexperts jump in now. To me this isn't a disease that should be treated seperated.
That seems to be the best bet.. I will have to wait and see for more symptoms before I medicate, trust my luck I prepared for all different kinds of rarer fish diseases and Iā€™ve ended up possibly having the one that I didnā€™t prepare for haha.
 
That is quite possible as the threadfins seem to be the most peaceful cichlids in there, the firemouths are probably the culprits if it was due to aggression but I would say it is quite strange that the fish in question has not grown since introduced whereas the other one grew twice the size and seems more confident than this one. I think you are right as my water conditions do seem to be on the better side of things unless the parasite associated with the disease was introduced plant wise?
The size thing could be based on dominance, I had a group of Laetacara Theyeri ended up with 3m 1f, one male grew massive really quick and the other 2 males grew the same at a slower pace. Its not that uncommon in cichlids for a dominant one to grow bigger than a sub, it could also be a male vs female thing too.

Wills
 
The size thing could be based on dominance, I had a group of Laetacara Theyeri ended up with 3m 1f, one male grew massive really quick and the other 2 males grew the same at a slower pace. Its not that uncommon in cichlids for a dominant one to grow bigger than a sub, it could also be a male vs female thing too.

Wills
Iā€™d say your definitely right with that as the large male has way more colouring than the smaller one aswell.. Iā€™ve added a natural looking log tube into the tank to provide more hiding places and a lot of hornwort but the hornwort has added cyanobacteria (blue - green algae) to the tank which is an absolute pain as itā€™s probably the hardest algae to get rid of, luckily its just on the hornwort though and nothing else otherwise Iā€™d have to deeply clean the tank for the second time this week ?
 
Iā€™d say your definitely right with that as the large male has way more colouring than the smaller one aswell.. Iā€™ve added a natural looking log tube into the tank to provide more hiding places and a lot of hornwort but the hornwort has added cyanobacteria (blue - green algae) to the tank which is an absolute pain as itā€™s probably the hardest algae to get rid of, luckily its just on the hornwort though and nothing else otherwise Iā€™d have to deeply clean the tank for the second time this week ?
Honestly I'd dump the plant asap cyano is one of those thing you do not want in your tank. Its so hard to get out once its in and so few fish eat it. Maybe your sevs but not 100%...

Wills
 
Honestly I'd dump the plant asap cyano is one of those thing you do not want in your tank. Its so hard to get out once its in and so few fish eat it. Maybe your sevs but not 100%...

Wills
Donā€™t worry Iā€™m in the process of doing so now haha, Itā€™s a tough thing to remove aswell as just after taking one of the plants out itā€™s already released a ton of the algae slime into the top column of water so iā€™m trying to keep the sevs preoccupied with bloodworms while i get this tragedy out ?
 

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