Emperor Hole In The Head Woes

[ReefKeeperElite]

I've been trying for about a month to help my juvenile emperor kick his Hole In The Head problem shown below, and it has not been getting better, and actually looks worse. The pits above his eyes are fairly new, and weren't present at all at the time I started treatment. Only the ones behind his eyes were present. The other side of his head looks the same.

I have been mixing mysis/fish frenzy daily with focus/general cure, selcon, and garlic guard, and feeding the mixture twice per day.
I also feed him unmedicated nori, and PE mysis pellets once per day. He eats everything and has a good appetite.
My nitrates are at 4, and Ph is 8.15 - 8.30.

I dose:

Seachem ReefBuilder
Seachem Reef Advantage Calcium
BRS magnesium mix
Reef Energy AB+ (14ml per day)
ChaetoGro (3ml per day).

A month seems like plenty of time to see some sort of benefit, but alas, nothing.
So just wondering if anyone has another approach, or diagnosis?

 

[Topekoms]

Try some ocean nutrition pellets type 1 & 2. It's my main staple for pellet food and never had an issue. I get a package of each and mix them together so they always getting something different. Everything else seems to be correct are you using carbon in your tank?

 

[ReefKeeperElite]

Try some ocean nutrition pellets type 1 & 2. It's my main staple for pellet food and never had an issue. I get a package of each and mix them together so they always getting something different. Everything else seems to be correct are you using carbon in your tank?

Thanks, I'll check out those pellets.
No, I don't use carbon.

 

[Privateye]

I wonder if Regranex would work on angels too. It works on tang HLLE. It's a prescription ointment for diabetic foot ulcers.

Here's the article (or abstract at least): https://pubmed.ncbi.nlm.nih.gov/18634205/

 

[JumboShrimp]

I assume you also feed nori? Other than that, since you already said you don't run carbon, I think 'the best water quality you can manage' is still your best friend. Keep us posted!

 

[Saltyreef]

A lot of people like using wondermud/miraclemud for HLLE.
Worth a shot...

Miracle Mud | EcoSystem Aquarium

Miracle Mud® – Marine Miracle Mud is the original refugium mud substrate developed by Leng Sy in late 1989. Miracle Mud is comprised of up to 80% oceanic mud, harvested from deep ocean water and then dried on land. … Continue reading →

www.ecosystemaquarium.com

 

[Jay Hemdal Verified Community Expert]

In some cases, HLLE simply isn't reversible. I've even seen a case of a juvenile emperor having HLLE in the wild. Have you seen the article I posted here (in the articles section, about six down the page). It explains the carbon connection. I understand that you don't use carbon, but it discusses other issues as well, and could the fish have been exposed to carbon prior to you acquiring it? Has this tank ever had carbon in it?

Jay