well i was really looking closely at my pbass head it looks like he has sensory pure on his head but idk if its hole in the head i have a pic but its junk.
i cant see any HITH from the pic provided. but if he does, the best treatmant is- remove any carbon if you have any, increase you water quality & improve diet if its poor
i wouldnt say its 100% concrete but some people have connected carbon usage to HITH. it can leach out nutrients and what not, its best just to use carbon temporarily to remove discoloration or medications