Each ich spot on a fish, hatches out into numbers of new cysts that rest in the substrate for a short time, then infect other fish.
Pops suggestion (beyond simply improving water quality), of doing a water change, with a thorough gravel vacuuming, helps to remove many of those infectious cysts.
I would vacuum discarding old water just before adding medication, even if its every other day.
And just because the cysts are not visible on the fish, does not mean ich is gone, it usually takes a few weeks to rid a tank of ich.
The cysts are protected by an impermeable cell wall, and immune to medication while dormant (in the substrate and on the fish), and only become vulnerable to Tom's excellent Malachite/Formalin suggestion, when they hatch out.
Pops suggestion (beyond simply improving water quality), of doing a water change, with a thorough gravel vacuuming, helps to remove many of those infectious cysts.
I would vacuum discarding old water just before adding medication, even if its every other day.
And just because the cysts are not visible on the fish, does not mean ich is gone, it usually takes a few weeks to rid a tank of ich.
The cysts are protected by an impermeable cell wall, and immune to medication while dormant (in the substrate and on the fish), and only become vulnerable to Tom's excellent Malachite/Formalin suggestion, when they hatch out.

