Those white spots on your fish could be caused by 1 of 3 different parasites!
And all 3 have different treatments…add that to the short time it can take for fish to be fatally affected… this means you really need to know what you are doing.
If you follow all my saltwater aquarium advice so far you will have the best possible chance of a disease free tank. Keeping your water quality optimal with regular testing, minimizing stress to your marine life and quarantining all new arrivals/sick fish are all key to a perpetually disease-free aquarium.
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How do we get rid of Ich (a.k.a. white spot disease, velvet, marine ich, coral fish disease etc)?
One of the most common illnesses to befall captive marine fish is Saltwater Ich. But Ich, Clownfish disease and Velvet are all commonly confused and these terms are often used interchangeably, they are all whitespot diseases, but they are caused by different parasites.

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These parasites will show up as white spots or dust especially at eyes, mouth and where the fins join the body. The fish will also be breathing rapidly too which is another major sign of the disease.
Defense is the best offense: quarantine
The best way is to prevent disease occurring in the first place by placing your fish in quarantine for 4 weeks or so when you bring them home from the LFS as they may have the parasite and the symptoms have yet to show up.
When you first bring a fish home is the most common time you will see Ich breakout ;as the stress of capture and acclimation will often lower the immune system making the fish more susceptible to diseases.
Also when you see the tell tale symptoms of Ich in your display tank, quarantining will stop disease from spreading to other fish too.
This is the single best way to proactively prevent Ich breakouts. The quarantine tank will also best the perfect stress free environment to treat your ailing fish and give it the best chance of recovery. Another difficulty with Ich is that many commercially available treatments simply do not work effectively.

If its already too late and you have put your new fish straight into the display aquarium or you have a breakout, the first step after spotting the symptoms (white spots on skin, scratching, hyperactivity, fast breathing, reduced appetite etc) is to figure out which one of the 3 disease causing organisms is responsible for the infection.
It is important to note that the 3 different parasitic organisms responsible for Ich inflict various symptoms. However the main symptom is white spots on the fish which all 3 external parasites have in common and is the reason why white spot disease can be easily mis-diagnosed.
The 3 Ich causing parasites:
1. Clownfish disease a.k.a Brookylnella hostilis
If your afflicted fish is a Clownfish (but not limited to Clownfish, Damselfish often get it), the parasite could well be Brooklynella hostilis which appears as concentrated patches of white spots on the fishes body coupled with a large amount of slime exuding from the fish – this is a tell tale sign of a Brooklynella infection.

This disease can be treated by copper with limited success, but best is a 37% Formalin solution as a dip. It’s important to note that you should NEVER put a copper treatment into a tank containing live corals or invertebrates as it is toxic to them and can kill them, the best strategy is to transfer the diseased fish to a quarantine tank and medicate there, or if you have to medicate in a display tank get a copper test kit to ensure there is none left in the water before adding invertebrates.
2. Marine velvet a.k.a Amyloodinium ocellatum
The next potential culprit could be Amyloodinium ocellatum (which is responsible for the disease most commonly known as marine velvet), this dinoflaggelate reproduces so rapidly that if it is not identified and treated fast it could potentially kill all your fish. “Oodinium” primarily attacks the gills before the rest of the body, which is why it’s so dangerous and looks like the fish is covered in a velvet film as the white spots are tiny.

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Amyloodinium ocellatum is most effectively treated with copper, the fish should be removed into a quarantine tank after a series of 2 minute freshwater dips, then you should medicate fish that have reached secondary infection (excessive mucus production) with copper solution- always read product instructions properly. Also the fish should be treated with a course of antibiotics if it is not already too late for them.
Oodinium caused Ich can be effectively treated with products containing copper sulphate (will harm corals) which can simply be put into the water as per the instructions. For example Cupramine® copper treatment: maintain a concentration of .30 ppm for at least three weeks. Basically, you should continue treatment for a week or so after the symptoms have disappeared and try to keep the fish as free of stress as possible. Marine aquarium material with pores such as live rock and filters actually absorbs copper, so your treatment should take place in a relatively bare quarantine tank.
3. Saltwater Ich a.k.a Cryptocaryon irritans
The final organism responsible for Ich, that im going to talk about is Cryptocaryon irritans, this organism is a ciliated protozoan and is the slowest advancing in terms of disease progression so is relatively easy to catch and treat early.
Unlike Brooklynella hostilis and Amyloodinium ocellatum which begin around the gills Cryptocaryon infections begin on the body and fins, before moving in towards the gills. Like Oodinium this external parasite is often present in the marine environment in low numbers and will not cause an infection until such things as poor water quality and temperature changes will stress the fish out enough to compromise their immune systems thus becoming susceptible to these parasites.

The best way to treat for a Crypto infection is by using a copper treatment, some parasites may bury themselves deep into the fishes skin, these can be treated by freshwater and formalin dips. Once again a prolonged treatment period in a stress free quarantine tank is my recommendation.
Getting Ich out of your system
If most of your infected fish have been treated and the symptoms have disappeared for over a week, you are not yet out of the woods…
Your display tank will have to be left fish free for 60 days or so, this is so the parasites can carry out their life-cycles free of their fish hosts (which they require for reproduction) and die off for good. Hyposalinity and a higher temperature (fish only tanks) can also reduce this time frame. But the most important thing you can do to reduce and prevent an Ich outbreak is to choose healthy specimens, reduce stress and quarantine new marine life.
To learn more about how to diagnose and treat each of the 3 Ich causing parasites as well as get all my best saltwater aquarium tips, tricks and hacks I encourage you to check out how my Saltwater Success System can reduce tank problems for you .
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Thanks for reading 🙂