Antibacterials
In states where sale of antibiotic treatments is restricted, aquarists often turn to antibacterial medications. Whilst these can be effective, the claims made by the manufacturers as to their efficacy have to be taken in context. Often they depend upon early diagnosis and immediate treatment. Do not expect an antibacterial medication to have much impact on an advanced case of dropsy or severe hole in the head. Since many of the problems that antibacterials and antibiotics are used to treat are typically caused by lack of quarantining, careless use of live food, or poor water quality management, this underlines the fact that prevention is definitely better than cure. In other words, the best way to deal with dropsy or hole in the head is simply not allow it to become a problem in the first place.
Tea-Tree Oil and Bay Tree Oil
Medications based on tea-tree oil (Melaleuca alternifolia) such as Melafix and West Indian bay tree oil (Pimenta racemosa) are widely sold as "natural" and therefore "safer" alternatives to standard antibiotics, antibacterials and antifungals. While such products are sometimes effective, many aquarists -- including most of us here at WWM -- tend to recommend against them.
The problem is that they are unreliable, and inexperienced aquarists often expect them to cure serious infections. By the time the aquarist realises the tea-tree oil or bay tree oil isn't working, it's already too late for standard medications to save the life of the fish. On balance then it is much better to think of these products as mild antiseptics that prevent secondary infections. So if a fish has been damaged by fighting or handling, Melafix might be used to prevent a fungal or bacterial infection. Of course, a healthy fish would fend off such infections anyway, so it's hard to know if the tea-tree oil did anything useful.
On the other hand, once a fish starts exhibiting symptoms of fungal or bacterial infection, tea-tree oil and bay tree oil are best passed over in favour of traditional antifungal, antibacterial and antibiotic medications. Such medications will work much more effectively and reliably.
One last warning: Just because these medications are marketed as "natural" doesn't mean they're not toxic. Cyanide is 100% natural, but it's still pretty deadly stuff! Some fish and invertebrates have reacted badly to tea-tree oil and bay tree oil, and just as with standard medications, the aquarist should observe the tank during treatment to ensure all livestock behaves normally, in particular looking out for signs of laboured breathing, excessive nervousness, or unusual colouration.