How is fish behaving? ( breathing, itch/twitch, swimming up to powerhead? )
If any of above, may be a common disease with clowns known as Brooklynella which is caused by an infestation of the
protozoan Brooklynella hostilis. It is most closely and commonly associated with Clowns, Damsels and other smaller species and labeled as Clownfish Disease. This type of parasite is similar to other parasites, and requires a fish host on to survive.
If no symptoms listed above, then it may be Black spot disease which is generally on tangs but if you see tube worms then there is a chance the spots evolved from them. Black spot disease or labeled black ich is caused by an infestation of tiny Paravortex turbellarian flatworms. After feeding for about 6 days and sucking blood near gills to achieve growth, the turbellaria falls off the fish and finds home in the substrate.
Once these worms start feeding on a host fish they acquire pigmentation, which causes the appearance of
black spots about the size of a grain of salt on the body and fin membranes. The worms have the ability to freely move about on fish as the spots do not always remain stationary. On light colored fish they are easy to see, whereas on dark colored ones they may go unnoticed at first.
As with other parasites on the surface of the infected fish, the fish itself will scratch up against objects or the substrate in an attempt to dislodge the parasites, and if the infestation is allowed to progress the fish become lethargic, lose their appetite and colors, rapid respiration develops, and secondary bacterial infections can invade damaged tissue sites. If surface infections develop, treat as with any other bacterial infection which includes a
freshwater dip.