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What is Heximita?[edit]

Oscar which has died from HITH

Hexamita is a flagellate protozoa and is the underlining cause of the disease in fish called 'Hole in the Head' (HITH).

This disease is said to affect mainly cichlids, though gourami are also affected.

This protozoa is usually constantly living in the average aquarium fish at low levels and causes no harm until the fish's health is compromised.


First, the fish will develop small, grey, pin-hole abrasions around the eyes and head. These lesions will grow in size and if not treated, will eventually kill the fish as it eats into its flesh. The fish may also behave in a different manner, hiding in a corner and sulking.


The protozoa hexamita was once believed to be the main cause of 'Hole in the Head', but has since been debunked as a major factor.

Usually the main cause stems from either bad water quality or malnutrition, both of which compromise the animal's immune system and allow this protozoa and bacteria to infect the fish.


  • Better water quality.
  • Better and more varied food for the animal.
  • Adding a chemical to kill the hexamita and secondary bacterial infection.
    • Flubendazole
    • eSHa - Hexamita
    • Aquarium Solutions Metro+
    • Waterlife - OCTOZIN
    • Seachem - Metronidazole CLOUT
    • Fluke-Tabs
    • Aquatronics - Hex-a-mit
    • Jungle - Parasite Clear Tank Buddies, which is easy to find in U.S.