Rescue Fish: My Experience with HLLE

I just wanted to share my experience with head & lateral line erosion (HLLE). For those of you unfamiliar, HLLE is a somewhat unexplained phenomenon that results in the erosion of the face and lateral line (along the top fin) of a fish. Some explanations are use/overuse/stopping use of carbon, poor/too clean water conditions, lack of nutrients in the diet, stress, and about a billion other reasons. Basically, if you pick something out of thin air…someone has tried to associate it with HLLE. There are a few cases of claimed success of healing the fish, but most reefkeepers seem pretty negative about it all. HLLE isn’t usually fatal, at least to my knowledge…just more of a cosmetic problem.

A local reefer had a purple tang who didn’t get along with his other fish, so the purple tang was moved to a smaller tank (not impossibly small for a purple tang…just not ideal). The tang developed HLLE, and I decided to adopt the purple tang…scars and all. I had very little hope in his healing, but as you’ve probably figured out, I have a soft spot for hurt animals.

Upon receiving the tang, I decided to put the tang through a hyposalinity quarantine (which I’ll discuss in a future article)…just to calm him down. He was extremely skittish when I got him – to the point where he would hyperventilate, hide, and act dead if I even stuck my head into the room. It was even so bad I was contemplating with a LFS and a fish vet to get a fish anxiety drug…not joking.

A couple days into the hypo treatment the tang broke out with white spots everywhere. This utterly confused me – ich starting during hypo? It got so bad so quickly that my husband suggested it was best to put him in the freezer to put him out of his misery. The tang was unable to swim upright, was covered in spots, and had labored breathing. I wasn’t about to let my adopted fish pass, so I decided it was all in or nothing. The tang was placed into a freshwater with methylene blue dip (I don’t recommend freshwater dips with tangs, but I needed a drastic measure) for about 10 minutes. Suprisingly, the tang acted as if everything was normal again…this gave me hope.

Here he was when he got Ich/Amyloodinium/whatever…you can see the damage from the HLLE:

Once I put him back into the QT, he went back to the hard breathing and lying on his side. All in…copper with formalin and erythromycin treatment. Copper was in case it was ich…and formalin in case it was amyloodinium. Secondary infections can worsen with harsh drugs like copper and formalin, so an antibiotic was necessary (hence the erythromycin). In desperation, I asked for help on Reef Central – the responses I received were angering. Here’s one of the responses I received in asking for help with the Ich/Amyloodinium treatment, “If you are looking to have a fish that will survive and function as a fish then you likely can achieve that goal. If you want a beautiful Purple Tang that will be a decorative fish for your display… I would move on.”

It amazed me that the cosmetic appearance of a fish was so important to reefers that the health of the fish was shrugged off.

After about a week, the white dots came off, and the fish starting breathing/swimming normally. He was still crazy skittish, but healthy.

I continued the hyposalinity/formalin/copper/erythromycin treatment and ended each treatment at various points. Formalin was ended first, followed by copper, then the antibiotic, then finally the hypo. After hypo I treated with PraziPro for any chance of internal parasites.

During the QT process I fed my homemade combination of raw blended shrimp, oysters, clams, scallops, mussels, red/green/brown seaweed, garlic, sugar, vitachem, and selcon. I also made sure he had enough algae sheets to eat. It took quite a while to get him eating anything but the algae sheets…and even longer to get him back to eating pellets again. Healing of the HLLE started while he was in QT (running carbon while not treating with meds).  I can’t think of a more stressful environment than a QT – small tank with few hiding places & a not-so-great biological filter. Once the tang was placed into my 150g, the healing process was exponential. The cleaner shrimp picked constantly at the tang’s face – trying to help him with the healing process. I couldn’t believe the difference. The HLLE was nearly entirely healed within about 2 months, and even the scarring mostly went away.

This is a little over a month’s time (left & right sides):

So if I had to guess at what was causing the HLLE…I’m not sure I could. The previous owner had great systems & knew what he was doing with fish. I ensured the tang had a ready supply of dried seaweed…but that’s about it. Maybe just something in the water? Regardless – never give up…and if you do…find someone who won’t!

Unfortunately the fish passed away in July 2011 in the move from Ohio to Utah. 

This article was originally published in forum thread:    Rescue Purple Tang – Help save him too on ReefCentral.com


  1. Lori

    This was a very informative story. A story of compassion for fish. I have a yellow tang with HLLE. It is very discouraging to see your fish day after day with no improvement. Along with HLLE, red streaks began to appear. As you said my fish is breathing hard and very skittish when we get near the QT. I treated with Maracyn Plus and the streaks were gone for a couple of days, reappeared then disappeared again. I was confused. I feed algae sheets soaked in Selcon and Kents Zoe, Mysis, garlic pellets, ect. She only eats the algae sheets. I have come to realize, from the endless post that I have read, that this will take TIME!!. I agree with your last words written. Never give up or find someone that won’t. This gave me encouragement. Thank you for sharing your experience.

    1. admin

      Hi Lori! Thanks for sharing your experience as well. It’s heartbreaking, isn’t it? I hope your fish is showing more signs of improvement! Best of luck!!

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